Muscle versus moral

  • Muscles and money won the day; quality medical education suffered
- Naresh Koirala

Feb 1, 2019-

On January 25, the Nepal Communist Party (NCP) government ramrodded their National Medical Education (NME) bill through the din of chaos in Parliament. They deployed the muscle of marshals to protect the education minister who tabled the bill snubbing the opposition’s cry of foul play and the party’s parliamentary majority to push the bill. There was no discussion on the bill.   

For the government, it was critical not to let the bill play out in the public domain for too long.  Dr. Govinda KC, who was protesting the bill’s divergence from the agreement the government had signed with him in July 2018 was already on the 17th day of his 16th hunger strike and a groundswell of support had started to build for him. If this was allowed to grow, like in KC’s previous 15 strikes, the government would have been forced to give in to KC’s demands and to sign yet another agreement with KC, which it would fail to honor due to opposition from vested interest within its own party—ultimately triggering another round of KC strikes.

The bill passed by Parliament contains clauses that adversely  impact  the quality of medical education envisioned by the agreement, thus compromising the central purpose of KC’s crusade: to upgrade the quality of medical education. It also contradicts the assurances given by Prime Minister KP Sharma Oli following the signing of the agreement.

Answering cynics who wondered whether, like his predecessors, he too would renege on the agreement, Oli had said: ‘I do what I say’. Subash Nembang, who had negotiated with KC on the prime minister’s behalf, had assured a skeptical media:  ‘We will implement the agreement verbatim through Parliament’. This was on July 26, 2018.  

By lending his authority to the agreement, Oli had set himself up against the vested interests of making money from the current (virtually unregulated) laissez faire medical education industry. A number of Oli’s senior colleagues are major beneficiaries of this business.

How does the bill differ e from the agreement?

Under the agreement, the government would limit the maximum number of medical colleges each university could affiliate to five; to create an independent oversight authority that would monitor the standards of medical colleges and disband the practice of training health care workers in the Council for Technical Education and Vocational Training (CTEVT).

The limitation on the number of affiliations would deny immediate affiliation to the BNC Medical College Teaching Hospital and Research Center (BNC), operated by a close associate of the NCP leaders. The oversight provided by an independent authority would reduce political interference in regulating medical education.  The training

of the health care workers would be taken out of the CTEVT, which had proved to be ineffectual and incompetent.

The government’s bill waives the limit of affiliation to colleges outside Kathmandu who already have a letter of consent.  It proposes the creation of a medical university—though it is unclear who would serve as its authority.  It proposes the continuity of CTEVT training.

The dean of Nepal’s premier medical school, The Teaching Hospital, and the dean of Kathmandu University have publicly stated that their universities are already compromising on quality education and monitoring of currently affiliated medical colleges and have no capacity for more affiliations.

 Why did the government tamper with the agreement?

The Prime Minister’s only defense of the tampering is a bland ‘It is the will of the parliament that this must be respected’.  They have not been able to come up with any

rational explanation for why the tampering was necessary to enhance the quality of medical education.  After all, that is the central purpose of the NME.

Nations have faltered  and disappeared when unpopular public policies are pushed under the cover of supremacy-of-the-parliament. The history of the annexation of Sikkim provides a sobering example.

Sikkim ceded its autonomy to India after the Sikkim Congress party, which was working at the behest of India’s spy agency (RAW), won Sikkim’s election by an overwhelming majority and the quislings in the legislator voted overwhelmingly to support Sikkim’s annexation to India.

And there are a number of recent examples that to point to where  democracy has fallen to majoritarian logic and the use of  power to snub the opposition. Six years ago, Egypt’s hard-won democracy reverted back to military dictatorship because Mohamed Morsi, abused his parliamentary majority to push an unpopular Islamists agenda. Poland and Hungary are going through severe domestic tensions because their right wing government is leveraging its parliamentary majority and snubbing the opposition to push its agenda.

The lack of explanation for the egregiously distorted bill lends support to the popular belief that the waiver of the limitation of medical college affiliations outside Kathmandu was to facilitate the affiliation of BNC. It further supports the belief that the proposal of a new medical university is simply to upgrade the ‘Manmohan Memorial Institute of Health Sciences’, in which NCP leaders have large investments and for which they had been pushing for affiliation for a long time. Not to mention, these distortions also muddle the authority of the independent oversight body. The continued training of health care workers in CTEVT will allow the party to continue using it to the benefit of its cadres.

Oli had a moral duty to own the agreement signed under his directive and canvass for it. He failed and let vested interests reign in on him. His credibility as a ‘doer’ and ‘the man who claims to keep his words’, have  sunk to a new low.

Muscles, money and greed won the day; quality medical education suffered. But the force of moral authority has not died. KC has not given up; he has continued his hunger strike. Nepali doctors have announced walk outs from hospitals in KC’s support.

KC’s moral fortitude will, forever, shame Oli and his ilk.

 

Koirala is a geotechnical engineer in Vancouver, Canada

Published: 01-02-2019 12:11

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