Chief minister M K Stalin on Wednesday wrote to Prime Minister Narendra Modi urging him to direct the Union health ministry to keep in abeyance the recent guidelines rolled out by the National Medical Commission (NMC) which caps the annual MBBS student intake in medical colleges.

This encroaches on the rights of the states and penalises those like Tamil Nadu, who have invested for decades to build its public health infrastructure, said Stalin.

“In both public and private sectors, our skilled medical professionals have been able to successfully serve not only the people of Tamil Nadu but also of other states as well as other nations,” he said. “This has generated huge demand for quality health services and new institutions are absolutely necessary for us to cater to it in the future.”

HT had reported in September that after the 2023-24 academic year, permission for establishing new medical colleges, according to the NMC, will be issued only for an annual intake capacity in the specific numbers of 50, 100 and 150 seats. “Provided that [the] medical college shall follow the ratio of 100 MBBS seats for 10-lakh population in that state/ UT,” the NMC notification said.

The guidelines were published in the Gazette of India on August 16 by NMC’s Under Graduate Medical Education Board titled, ‘Guidelines for Under Graduate Courses under Establishment of New Medical Institutions, Starting of New Medical Courses’.

Stalin contended that this is a regressive scenario. “This is a direct encroachment on the rights of all state governments and penalisation of states who have invested more in their public health infrastructure over the years,” the Tamil Nadu chief minister said. “Progressive states like Tamil Nadu have been strengthening their tertiary healthcare network for many decades. This has led to ample availability of doctors and nurses, which has manifested in their better performance in terms of various health indicators. Chennai has emerged as the healthcare capital of India.”

He added that the criterion proposed for such restriction, higher doctor-population ratio at the state level as compared to the norms, is also not appropriate. “Even when there is adequate availability of doctors at the state level, there are districts where their availability continues to be a persistent issue,” he said. “This problem can be effectively addressed only by opening new medical colleges in such backward areas.”

Stalin also pointed out that Tamil Nadu’s higher doctor-population ratio and high availability of doctors has been achieved predominantly due to investments made by State Governments and private sector and not by the Union government. “We have been continuously urging that the Union Government needs to contribute more but projects like AIIMS, Madurai are yet to take-off. Given this situation, a restriction on new institutions will completely eliminate any chance of Tamil Nadu getting new investments in the health sector by the Union Government in future,” he said.

Stalin also cited a Supreme Court judgement from a 2002 case which held that executive instructions could not impose restrictions on the fundamental right to establish educational institutions under Article 19(1)(g) of the Constitution and hence arguing that the NMC notification may be legally untenable.

“Considering all the above issues,” Stalin requested Modi to “instruct the Union Ministry of Health and Family Welfare to keep this notification in abeyance and initiate a consultative process with the state governments on the steps to address this issue.”