The impact of colonial-era policies on health workforce regulation in India: lessons for contemporary reform

摘要

In 1912, the provinces of India—beginning with Bombay—began constituting their own provincial medical councils (Table ​(Table1).1). These councils excluded indigenous providers—not making them illegal, but making them unregistrable in the ‘official’ system. These Acts also gave the councils considerable power and insulation from provincial governments, including in cases of neglect or abuse of power, while Indian medical graduates continued to be registered and recognized by the GMC [23–25]. The era of centralized oversight appears to have accelerated in the 1920s, when GMC initiated a review of the standard of medical education in India based on reports concerning the teaching of midwifery. In 1928, following some years of periodic inspections through their appointed inspectors, the GMC finally recommended constituting a full-fledged All India Medical Council. The provinces—who on paper still had some level of control—resisted this idea of centralized regulatory institution on the grounds that health was a provincial issue. In 1930, the GMC informed the government that they would derecognize degrees from Indian medical universities [24].