High level of corruption was known to be rampant in the Madhya Pradesh Vyavsayik Pariksha Mandal or Vyapam, long before the agency responsible for conducting several entrance tests came in the eye of the multi-million scam storm. However, it was only after irregularities in admissions to medical schools in MP came to light that the state government was forced to establish a committee to investigate the matter.

Over the years medical colleges across the country have come under fire for various reasons – be it charging arbitrary capitation fee or flouting established rules for infrastructure, number of students and faculty, etc. While the Vyapam issue gained national attention, the arbitrary functioning of private medical colleges went unnoticed, by media as well as public.

With the admission season already underway, private medical colleges in the country are openly flouting rules when it comes to deciding their fee structures.

Amid all this, the two agencies responsible for keeping a tab on private medical colleges only pass the buck.

Mukesh Yadav, a forensic doctor, has, under the Right to Information (RTI), asked both the medical council of India (MCI) and the health ministry whether there was any rule that barred private medical colleges from charging arbitrary fees.

Governance Now has a copy of MCI’s answer on June 25, 2013 to Yadav’s RTI, in which it says matters pertaining to fees did not come under its purview and that the state government was solely responsible for fixing the fees.

In its reply, on February 5, 2015, to a similar RTI, the health ministry said the unethical practices adopted by medical colleges came under the purview of the state government and the university grants commission (UGC) and that the ministry had no role even if a medical college charged a capitation fee. The ministry, in its reply, said, “Capitation fee and exploitation of students and parents is an unfair practice and the respective state government under their own laws and the university grants commission under the ministry of human resource development are competent to handle this appropriately. The ministry of health and family welfare does not have any role in this regard.”
So, the nodal ministry, which decides if a new medical college is to be set up, denies any role in the fees charged by the same college.
Law, however, stipulates otherwise.

The fee fixation committee that decides the fee for all medical colleges in a state should have a retired high court judge as its chairman and the director of medical education as well as the state’s principal secretary and secretaries of finance and health as its members. This committee also needs to have a member from the MCI, who is supposed to monitor the fee charged by the medical colleges in that particular state. The committee reviews the fee structure every three years.

“There seems to be no regulation in India even though a proper coded rule is there. Law enforcers as well as the government turns a blind eye to favour the mafia, that’s why medical seats are sold in the country by taking capitation fee in the form of black money and the total fee they charge is often double of that fixed by the fixation committee,” said Dr Kunal Shah, another campaigner against corruption in medical education.

Dr Yadav said, “If there is clear proof that more than double fee is being charged, why is everybody including the regulatory body sitting mum and desisting from discharging their responsibilities?”

Governance Now is also in possession of the Uttar Pradesh government letter where the fee fixation committee fixed the fees on September 14, 2011 for another three years, i.e., till the 2014 session. The committee had fixed '4.07 lakh fee for all medical colleges, except Sri Ram Murti Medical College, Bareilly, for which it fixed a fee of '4.75 lakh a year.

But it is an open truth that none of the private medical colleges follow rules and instead charge much higher fees than prescribed by the committee. But neither the state government nor the regulatory body has taken any action against any private college, most of which are charging students anything between '7 lakh and '10 lakh a year.

While private colleges went on charging arbitrary fees, the UP government failed to form the committee afresh after the tenure of the previous panel was over in 2014.

“There are 11 private medical colleges and they all violate rules openly, but neither the regulatory body nor the government at the centre or state does anything to restore the law of the land,” said Yadav, who is campaigning to cleanse medical education as well as medical practices in the country.

Ironically, when he tried to verify whose responsibility it was to regulate the fee structure, the MCI, health ministry and HRD ministry, all pointed to the others.

Private colleges have a different opinion.

“An MBBS degree in a government college costs about '1.5 crore (funded by the student’s fees plus the government grants to the college). They expect private colleges to provide the same education for '25-30 lakh. How is it possible?” a private college owner, who did not want to be named, told Governance Now.

It is not that every MCI official is shirking his responsibility.

Governance Now has a copy of a circular issued by former MCI secretary RP Meena (March-July 2013), in which he advised students aspiring to take admissions in private medical colleges not to pay fees more than that fixed by the fixation committees of the respective states. Meena even appealed students to report to the medical council any instances of medical colleges flouting the rules.

It may be noted that Meena was shown the door in less than six months. Now, the same office has taken a completely opposite stand in the matter.

The capital of the country tells no different story. Here too there is a huge difference in the fees of the two private colleges – Army College of Medical Sciences and Hamdard Institute of Medical Sciences & Research (HIMSR). This is despite the 2005 judgment of the supreme court stipulating a similar structure of fees for all private colleges in a state.

“From the MCI to the state medical council and even the district administration, everyone knows what goes on, but there is wilful inaction and that’s why such problems persist,” said former director general health services Dr RK Srivastva.

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(The article appears in the August 1-15, 2015 issue)