The much-awaited report of a high-level committee for reforms in medical education will soon be made public. Its recommendations will be based on the charter of demands put forward by Dr Govinda KC during his fifth fast-unto-death three months ago. Among other things, Dr KC had asked for a new policy on medical education, implementation of all past accords between him and the government, making MD/MS education free and establishment of at least one medical college in each of the five development regions of Nepal. A selfless doctor who has devoted his entire life to the sick and needy, we had unreservedly supported his one-man crusade against the medical mafia. Many recommendations of the Kedar Bhakta Mathema-led committee, we are confident, could be milestones in the development of a more accountable and service-oriented medical sector. Dr KC, for instance, is bang on when he suggests that the country's major urban hubs, and chiefly Kathmandu, are already saturated with medical establishments. There is just no point in adding more medical colleges there.Dr KC is also right when he says that the available manpower at Tribhuvan University and Kathmandu University are not enough to properly monitor even existing medical colleges under them. Many of these colleges are woefully short of trained doctors and teachers—as well as patients to fill up their beds—putting a question mark over the quality of doctors and nurses they produce. Many of them would, says Dr KC, be disqualified as medical colleges under a stricter supervisory regime. These are all feasible demands. But other demands of Dr KC are more idealistic than practical. Take the case for making MD/MS courses free. Private medical colleges charge above 10 million rupees for an MD degree. Government colleges, though relatively cheaper, still ask for around six million rupees for the two-three year course. These are big amounts, no doubt. But the government has to invest three to four million rupees in each student at a government-supported medical college. Moreover, every year, it has to cover the costs of around 50 to 60 MD/MS students who are studying under various scholarship schemes. So either these medical colleges have to raise the needed funds through fees or the government has to bear all costs of all medical students.
Why put so much pressure on government treasury when well-off parents are so eager to pay for the education of their children? Yes, by all means, continue to provide scholarships to deserving students. There might even be a case for raising the scholarship quota. But, at the end of the day, someone has to sponsor their education. If our medical colleges are capable of raising billions of rupees on their own, it would be daft for the government to accept that burden. Instead, why not use the money raised in fees to establish hospitals in rural areas and equip them with proper manpower and material? Isn't that how a welfare economy is supposed to work? By taking from the haves and giving to the haves-not. The ultimate goal should be to make our medical colleges self-sufficient and accountable and to make medical care accessible to every Nepali. Done right, both these goals can be achieved simultaneously.
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