Governance and Policy

Betraying a constitutional promise: How NMC’s guidelines undermine Article 371J

Jehosh Paul

The constitutional promise under Article 371J must be honoured, not just in letter but in spirit, ensuring that every citizen has an equal opportunity to thrive and prosper, writes Jehosh Paul.

RECENTLY, the National Medical Commission (NMC) put a controversial regulation on hold for further reconsideration.

This regulation, titled Guidelines for Undergraduate Courses Under the Establishment of New Medical Institutions, Starting New Medical Courses, Increase of Seats For Existing Courses, and Assessment and Rating Regulation 2023, proposed capping medical seats in each state based on population.

The debate over this policy has brought to light several critical perspectives. Arguments against the NMC's proposal have ranged from its unscientific approach to students' concerns about the rising cost of medical education and the potential reduction in opportunities that could result from the new guidelines in Karnataka.

However, amidst these discussions, there is a crucial but under-discussed aspect. A key constitutional promise, embodied in Article 371J, is at risk of being overshadowed and neglected. This aspect deserves more attention in the ongoing debate.

NMC's seat capping threatens the covenant for equitable development in Karnataka

Article 371J, a symbol of hope and equitable progress, was incorporated into the Constitution to address historical imbalances and foster development in the Hyderabad–Karnataka region comprising Kalaburagi, Yadgir, Bellary, Bidar, Raichur and Koppal districts.

A key constitutional promise, embodied in Article 371J, is at risk of being overshadowed and neglected. This aspect deserves more attention in the ongoing debate.

It anchored a future where education and employment opportunities in the region remained not just political promises but a constitutional obligation. Under it, the Karnataka Educational Institutions (Regulations of Admission in the Hyderabad–Karnataka Region) Order 2013 provides for reservation of 70 percent of the available seats in the Hyderabad–Karnataka region and 8 percent of seats in state-wide institutions.

Similarly, the Karnataka Public Employment (Reservation in Appointment for Hyderabad–Karnataka Region) Order 2013 provides for the creation of a local cadre and reservation in the Hyderabad–Karnataka region as Group A Junior Scale: 75 percent; Group B: 75 percent; Group C: 80 percent; and Group D: 85 percent; besides the reservation of 8 percent of the posts in state-level offices or institutions.

However, the National Medical Commission's (NMC) decision to cap MBBS seats in Karnataka poses a direct challenge to the 70 percent seat reservation in educational institutions within the region, and the 8 percent reservation across state-wide institutions, guaranteed under Article 371J.

The cap not only threatens to diminish the number of seats available to local students but also undermines their constitutional right to equitable educational opportunities.

Furthermore, the cap jeopardises the comprehensive development of the Hyderabad–Karnataka region. With potentially fewer medical graduates emerging from the region, the healthcare sector's growth, crucial for the social and economic upliftment of the region, is at risk.

The impact extends to employment prospects as well. The capping could significantly hamper the realisation of Article 371J's vision for local employment in the healthcare sector, given the reduced number of medical graduates.

The creation of a local cadre in healthcare, vital for fulfilling the reservation percentages in public employment (ranging from 75–85 percent across various groups), may not materialise as envisioned.

The state-level impact of the NMC regulation is also a concern. The 8 percent reservation for the Hyderabad–Karnataka region in state-level offices or institutions, a key aspect of Article 371J, is at risk of being diluted, diminishing the region's representation in state-level healthcare services.

Upholding constitutional morality

What is profoundly troubling is the NMC's apparent indifference to the voices of those the regulation impacts the most— the marginalised and historically disadvantaged communities of the Hyderabad–Karnataka region.

Arguably, this not only reflects a lack of empathy but also a gross disregard for the principles of federalism and regional autonomy that are the bedrock of our democratic polity.

The NMC's apparent indifference to the voices of those the regulation impacts the most— the marginalised and historically disadvantaged communities of the Hyderabad–Karnataka region— is troubling.

As the NMC has postponed its decision to cap the number of MBBS seats in Karnataka for further reflection, it must realise that its decisions have far-reaching implications and must be made with a deeper understanding of and sensitivity to the Hyderabad–Karnataka region's aspirations.

The constitutional promise under Article 371J must be honoured, not just in letter but in spirit, ensuring that every citizen has an equal opportunity to thrive and prosper. The NMC Bill capping the medical seats in Karnataka needs to go.