– Moving medical education back from the concurrent List to the State List.
– Abolishing the National Medical Commission and reinstating the Medical Council of India.
– Ensuring State consultations for designing national health programmes for better resource allocation.
– Allowing States to reallocate up to 50% of Central health grants based on local priorities without requiring Union government clearance.
The submission by DMK MLA Ezhilan Naganathan underscores longstanding tensions between Center-State relations regarding public healthcare governance in India. the emphasis on decentralising authority aligns with Tamil Nadu’s well-documented record of robust public healthcare systems and could be seen as a call for tailoring interventions closer to ground realities rather than using a one-size-fits-all approach from New Delhi.
The central focus here-a stronger role for States-is consistent with constitutional provisions designating “public health” under State jurisdiction but raises questions about coordination and standardization across India if too much autonomy is granted. Additionally, repealing central institutions like the National Medical Commission could potentially reverse attempts at introducing uniformity meant to address disparities in medical education quality across regions.
Restoring greater fiscal flexibility (by reallocating up to 50% of funds) may enable States like Tamil Nadu with proven efficiency models to innovate further but risks inefficiencies if similar freedoms are extended indiscriminately nationwide without accountability frameworks.
The debate reflects broader concerns about federalism as applied specifically within India’s healthcare sector-where equity goals at national levels must balance against regional needs and successes already demonstrated by some States like Tamil Nadu.
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