The article discusses the provision of the medical board in the MTP (Amendment) Act and issues with it.

Proposal of medical board

• The Medical Termination of Pregnancy (Amendment) Bill (‘MTP Bill’) passed in the Lok Sabha is scheduled to be tabled for consideration in Rajya Sabha.
• The Act prescribes the setting up of medical boards in every state and Union territory (UT), consisting of a gynaecologist, paediatrician, radiologist or sonologist and any other members as proposed by that state or UT.
• Each board will be responsible for diagnosing substantial foetal abnormalities that necessitate termination of pregnancy after a 24-week gestation period.
• Medical boards are a form of third-party authorisation and were not envisaged in the MTP Act, 1971.

Issues with the proposal

• In the context of the current healthcare budgetary challenges, this proposal to set up infrastructure across the country to regulate medical termination of pregnancies is both financially unsound and practically impossible.
• India’s healthcare system has neither the financial investment nor the infrastructure to sustain the operation and functioning of medical boards in every state and UT.
• Due to the weak healthcare infrastructure in the country, it would be practically impossible to constitute these boards with the requisite specialists.
• Even where they are set up, the accessibility of such boards for pregnant persons, especially those living in rural areas, remains a major challenge.
• More importantly, subjecting people to multiple invasive examinations is a grave violation of their rights to privacy and dignity.
• Requiring pregnant persons to navigate a bureaucratic web of authorisation will inevitably lead to delays and thereby impede access to safe and legal abortion services.

Poor public financing and privatisation of healthcare

• At 1.6 per cent of GDP in 2019-20 India’s current level of public financing of health is one of the lowest in the world
• This has meant that most health expenditure in the country is out of pocket (OOP) — borne by patients themselves.
• OOP expenditure on healthcare is recorded at 58.7 per cent as per the National Health Accounts in 2016-17.
• The central government has preferred to incentivise private players to set up or offer services, instead of building infrastructural and professional capacity.
• Privatisation drives up costs of care and the handing over of public facilities to the private sector can have catastrophic consequences.
• They additionally remain non-accountable to state authorities in terms of affordability or transparency for instance, through Right to Information enquiries, or to uphold fundamental rights like non-discrimination in treatment or employment, or even the fundamental right to health.
• The National Sample Survey Organisation (NSSO)’s 75th report shows that less than 20 per cent of the population is covered by health insurance in India.
• According to the National Health Profile 2017, India has only one doctor for roughly 10,200 people in the public sector.

Consider the question “Discsss the changes made by the Medical Termination of Pregnancy (Amendment) Bill and the challenges its provision could face.”

Conclusion

Poor public health infrastructure and absence of specialists across the country have meant that most abortions do not happen in the public sector, but at private centres or at home. With overwhelming shortfalls in specialist availability, especially in rural and scheduled areas, it would be impossible to constitute boards with requisite specialist representation as contemplated under the MTP Bill.

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