The Nepal Health Professional Council, an autonomous body of health professionals, should stop issuing licence until the board gets its full shape, stakeholders say.

Associations of health professionals, who are directly associated with the council (NHPC), have said the Act does not allow it to issue licence without absolute majority among its board members.

“There are only four members on the board while there should be 13. The Act clearly says that licence should be issued on the basis of majority, but only four members are involved in issuing them,” Michael Devkota, president of the Nepal Dental Science and Hygiene Association, told the Post.

As per the Nepal Health Professional Council Act-2053, the council has 13 board members including the council chair, and the council can take any decision only through majority votes.

The council chairperson and three other representatives are from the Paramedicals’ Association of Nepal, Nepal Pharmaceuticals Association and Nepal Radiological Society.

“According to the Act, the Paramedicals’ Association of Nepal refers three individuals from pathology, physiotherapy and public health [sectors] to the Health Ministry from where they should be appointed as members of the council. But none of the three has been recommended from the Association,” NPHC Chairman Ram Prasad Bhandari told the Post.

Four members are elected from among the health professionals from various sectors registered with the council.

“There has been no election for more than a decade, due to which the council has been without members. The associations are not ready to conduct their election but are complaining about the lack of board members at the council,” said Bhandari. They cannot halt licence issuance and affect students even as the board is incomplete, he added.

According to the associations, the election will be conducted only if the health worker of every rank is allowed to file nominations.

“The council’s law only allows health staff of the certificate level to vote. It does not allow them to compete. Only health personnel above the certificate level are allowed to be representatives at the election. If the council amends the provision and allows everyone to file candidacy, election can take place next month,” said Devkota.

However, the council has said that it is difficult to amend the provision because an elected individual will be a board member of the council and should inspect colleges which teach bachelor and master level courses.

“How can health personnel of the certificate level inspect colleges of bachelor and master level? It is not only about inspection; members also must review the curriculum,” said Basanta Adhikari, registrar at the council. Adhikari is an under-secretary at the Ministry of Health and Population.

There are a total of 32 medical faculties including medical microbiology, haematology, physiotherapy, biochemistry, nuclear medicine and anaesthesia under the NHPC. The council also issues licences to students returning from abroad after studying a course which is not offered by the universities in Nepal.

“The subject studied by the student, which is not available in Nepal, is verified by our experts. The students’ certificate is also verified by the University Grants Commission. The licensee is however awarded only after proper study of the respective subject,” said Adhikari.

There are eleven faculties of certificate level, nine faculties of bachelor level and three faculties of master levels available at 218 institutes across the country.

Every faculty has a ‘subject committee’ to inspect colleges and suggest the board on issuing licence to any health worker by going through their certificates “without any licensing exam”. A total of 110,210 health personnel have got the licence from the council till date.

Meanwhile, the council neither has a proper subject committee nor enough members in the board to coordinate the committee.

“A member of the board works as the coordinator for a couple of committees. The council however does not have enough members in its board and experts in the committee,” Rajendra Khadka, president of Medical Laboratory Association of Nepal, told the Post.

The Council inspected 11 institutions in recent years while their committee is inspecting six other institutions in Sunsari and Morang districts. The council, however, said “we have no record of inspection in previous years”.

“The council is recently giving feedback to the institutions which are not meeting the required standards. It is very difficult for us to conduct inspection but we are trying our best,” said Bhandari.

According to Bhandari, whose chairmanship began on October 22, 2017, institutions were mostly found to not be meeting the standards of labs and teachers were teaching in more than one institutions.

However, the council has taken no action and none of the colleges is named for action by the ministry.

Devkota, who was an expert on the dental subject committee, said that eight out of ten institutions inspected by the committee failed to meet the minimum standards.

“We had recommended action against the institutions but they are still operating freely with the same minimum standards. We could not pressurise the council further as our committee was dissolved due to some internal conflict and resignation of our coordinator,” said Devkota.

As the problems concerning the council are yet to be resolved, both the association and the council agree that the 23-year-old law should be amended.

“We need to amend the existing Act. The amended Act will have proper provision for members of the board and will provide for a licensing examination system,” said Bhandari.

The amendment proposal seeks to remove board representatives from the Institute of Medicine, Nepal Medical Council, and the Pharmaceuticals Association as the three are autonomous organisations.

According to the council, a report recommending necessary amendments to the Act was sent to the Ministry of Health and Population more than three months ago but the ministry is yet to respond.

“The council is in a bad shape and amendments to the Act are a must to improve it. However, I am unaware of the developments in amending the Act,” Mahendra Prasad Shrestha, spokesperson for the Health Ministry, told the Post.

The council and the association have also suggested that the government use Clause 4.2 of the Act and increase, decrease or change the number of members on the board by publishing their respective decisions in the Nepal Gazette.

“The council looks after not only the certificate level or a single subject like any other medical related council does. If the situation persists, the country will never receive quality health personnel,” said Devkota.