In an era where consumer activism is at its forefront and where patients prefer to settle scores in courts rather than in the corridors of medical councils, the MMC has been relegated to the role of registering and reregistering practitioners -- even this is a function that it struggles to fulfill.

Thanks to its lack of autonomy and the confidentiality surrounding its proceedings -- as provided by the act -- the perception of MMC as a ``powerless'' body has come to be shared by both doctors and patients.

Says a senior doctor practising in a public hospital, ``The MMC is seen as a body that serves only to shield doctors. With its closed-door meetings fortaking any decision on medical negligence cases, both the patient and the doctor have no idea of what is going on.''

That coupled with the MMC's dependence on state government for funds, and its inability to expolit its given powers to the hilt, has affected its functioning adversely, say doctors.

For instance, medical negligence cases at the MMC, says the doctor, drag on for several years. All the 22 committee members -- who form the council -- are expected to be present for the hearing. The hearing is however allowed to be conducted if the required quorum is present. But, as Dr Ketan Parikh, a contestant in the current MMC polls points out, some members will be absent for one meeting and present for the other. In that case, the proceedings of the earlier meeting will have to be repeated for the benefit of the new entrants -- all of which take up valuable time.

Not only that, allegations about under-hand dealings at the MMC never peter out. As a private medical practitioner recalls, ``A patientcomplained at the MMC about a doctor...and the very next day, the doctor received a call saying if he could cough up a few lakhs the matter would be settled quietly.'' Doctors are said to have got away with their mistakes, and none of this has served to enhance MMC's reputation. The proceedings need to be made transparent and the hearings held in public, point out doctors, so that any malafide intentions can be easily detected.

One of the major reasons why doctors were brought under the Consumer Protection Act is the failure of the councils to effectively settle negligence cases, say several doctors. MMC officials however question the validity of this claim -- pointing out that only 12-odd of the 25 states have medical councils.

But as another doctor points out, ``Of all the complaints made against doctors, there are very few cases when action has been taken. After all, how many doctors have been stripped of their licenses....?'' MMC officials on the other hand had no time to spare to give statistics,``as we are busy with election work.''

The ``undemocratic'' way of MMCs functioning, and its dependence on the state government for funds -- thereby affecting its autonomy -- has struck a jarring note with its envisaged regulation of medical profession, point out doctors. First of all, of the 22-member committee, only nine are elected by the medical fraternity, in accordance with the 1965 MMC Act, and the other posts are filled through nominations. Though the number of medical practitioners has gone up nearly three-fold since its inception, the number of elected representatives has remained the same -- which is anything but proportional, says a doctor working at the Grant Medical College, Byculla.

Secondly, the MMC charges meagre fees for registration and reregistration -- leaving it cash-strapped, say doctors. While the registration fee is Rs 150, the reregistration fee is Rs 50. So bad is the financial situation that the MMC is never able to carry out reregistration properly; every five years, doctorshave to reregister themselves, and the MMC has to write to the doctors about it. On most occasions, the MMC has not had the money to send registered letters to the practitioners, a fact admitted by MMC officials themselves!

If funds come in the way of fulfilling some of its basic functions, MMC's handling of medical education has also come in for criticism. There have been cases where a college had MMC recognition but not that of the Medical Council of India (MMC is the MCI's state branch). This points to the fact that medical colleges without sufficient infrastructure have got MMC recognition, thanks to political and monetary factors, say doctors.

For instance, in the eighties, a college in Pune conducted a Diploma in Medicine and Surgery course, which did not have MCI recognition but had MMC recognition, says Dr Suhas Pingle, a contestant in the MMC polls. The students of course could practise only in the state.

On the other hand, the MMC's handling of the grace marks controversy -- when theUniversity of Mumbai granted eight grace marks to medical students after the declaration of results -- shows its concern for medical education, says a doctor working in a government hospital.

Another opinion doing the rounds is that the MMC should take interest in areas outside their jurisdiction like quackery. While MMC officials stress that they have no control over those not registered with the council, there is an urgent need to tackle the issue, says Dr Satish Naik, formerly with the General Practioners Association-Greater Bombay.

Dr Arshad Ghulam Moh'd, a contestant, recalls an incident that happened five years back; he came across a book supposedly giving the list of 400-best doctors in the city. ``It was obviously the work of a private party...how can anyone name 400 best doctors?' he asks. But complaints to the council served no purpose, he states.

The MMC's contention that these issues fall outside its jurisdiction is not an answer, say doctors, who suggest amendments to the MMC act to solvethe problems.

But there are doctors who share the MMC view as well. Like Dr Shashank Joshi, who works at the MGM ESI Hospital, Parel. ``The MMC is not equipped to handle quackery and problems of sub-standard drugs -- the police and the FDA (Food and Drugs Administration) are there to handle that,'' he says.

But one of the lobbies contesting the current MMC elections has been suggesting changes in the act, to make the MMC more active, so that all the problems of the medical fraternity can be taken up. But broadening the scope of the act might not be the envisioned panacea. As a doctor points out, ``We should take care of our own moral fabric instead of seeking more powers.'' Such powers might be misused for stronger protection from consumers, he says. In the worst-case scenario, the corporate hospital lobby in the current elections, pushing for these powers, might finally be helping these hospitals and not the patients. If that happens, says the doctor, ``The day will not be far off when patients willdrag doctors out of their chambers and flog them for their mistakes.''