Now, we know a few things about The National Eligibility cum Entrance Test or NEET, the all-India examination to select candidates for undergraduate and postgraduate students in the field of medicine. The Justice A.K. Rajan Committee, constituted by the Tamil Nadu government, concluded that NEET is non-egalitarian, discriminatory, and exclusionary. The Committee concluded that after the introduction of NEET, fewer students from Tamil Nadu state boards were granted admission in the private and government medical colleges, and most of the selected candidates (99 per cent) had received prior coaching/training provided by private institutes. It also observed that candidates from rural backgrounds had lesser chances of selection. Before NEET was introduced in 2013, about 65 per cent of the selected medical candidates were from rural background — a number that went down to about 50 per cent. It was the same for candidates from Tamil-medium schools. Their proportion in selected candidates went down to 1.9 per cent from around 15 per cent before NEET.
The nine-member committee, headed by Justice Rajan, conducted extensive surveys and received more than 86,000 responses. The committee submitted its report to the state government in July 2021. The committee has recommended that the NEET should be scrapped in Tamil Nadu, and the old system of selection, based on class XII results, should be restored. Based on the recommendation of the committee, the government passed legislation to scrap NEET in Tamil Nadu.
Is this the end of the road for NEET or, for that matter, any other all-India examination to select candidates for medical colleges? We don’t know for sure, but we certainly know that this committee has been able to create some reasonable doubts.
In the pre-NEET era, all states used to have their own methods for selection. Even private medical colleges and minority institutions used to have their own entrance exams. Only 15 per cent of seats were kept aside for All-India Quota, except in Jammu and Kashmir, Andhra Pradesh and Telangana, and those seats were filled based on the All-India Pre-Medical Test. On the surface, this system of multiple exams may appear to be chaotic. So the government of the day, the United Progressive Alliance (UPA) II, decided to intervene and issued a notification on 20 December 2010 and made provisions for pan-India NEET.
Was NEET needed?
NEET was introduced with great promises. It was done at a time when debates related to high capitation fees and costly medical education were raging, and there were allegations that private medical colleges had commercialised medical education. When the gazette notification of 20 December 2010 was challenged in the Supreme Court, in Christian Medical College vs Union Of India case on 18 July 2013, both the lawyers of Medical Council of India (MCI) and Additional Solicitor General (ASG) of India defended NEET saying this was an effort to streamline the admission process.
The MCI advocates argued: “This Court had repeatedly emphasised how profiteering and capitation fees and other malpractices have entered the field of medical admissions, which adversely affect the standards of education in the country. Such malpractices strike at the core of the admission process and if allowed to continue, the admission process will be reduced to a farce. It was to put an end to such malpractices that the MCI introduced NEET and was within its powers to do so.”
Whereas ASG Siddharth Luthra said: “The logic behind enacting the said Regulations was to introduce uniformity of standards, merit and transparency and to lessen the hardship of aspiring students.” He alleged that “the earlier system of multiple examinations was neither in the national interest nor in the interest of maintaining the standards of medical education, nor did it serve the interest of poor/middle class students who had to buy forms of several examinations and travel across the country to appear in multiple examinations.”
The stated purpose for the introduction of NEET was to end profiteering and capitation fee, stop malpractice, and create uniformity and end multiplicity of entrance exams making things simple for students.
National interest was also cited as one of the reasons to bring NEET, but as it was not elaborated upon.
We can say with certainty that NEET has not served any of these purposes. The idea of an all-India entrance examination has only created a mirage of ending malpractice and ushering equality of opportunity. In actuality, it delivered the exact opposite. Cost of medical education in private colleges remained quite high. NEET was not able to stop profiteering. In fact, there is no mechanism in the process of NEET that can lead to the end of profit-making. It was a hollow promise. Rather, NEET has created new business opportunities for coaching centres.
Earlier, there was not much scope for the coaching centres in those states where the medical admissions were based on class XII results. Now, coaching centres are almost a prerequisite to secure admission to medical colleges. This is, again, putting a financial burden on families of students, especially those from poor households. Scams and paper leaks happen regularly, and now have all-India scope and implications.
NEET also challenges the basic idea of federalism, as it has made the state government a non-entity in the admission process in colleges founded, financed and run by them. It has also curtailed the autonomy of private and minority institutions. Based on these grounds, and also seeing the merits of the equality principle, the Supreme Court bench of Altamas Kabir, Anil R. Dave and Vikramajit Sen, in their majority judgment on 18 July 2013, rejected the idea of NEET.
Justice Kabir and Justice Sen opined: “There can be no controversy that the standard of education all over the country is not the same. Each state has its own system and pattern of education, including the medium of instruction. It cannot also be disputed that children in the metropolitan areas enjoy greater privileges than their counterparts in most of the rural areas as far as education is concerned, and the decision of the Central Government to support a single entrance examination would perpetuate such divide in the name of giving credit to merit.”
The change in the judiciary
The previous judgment was later set aside by a Constitution bench headed by Justice Dave, who opposed the majority judgment in 2013. Interestingly, the Constitution bench decided not to “state the reasons in detail.” The bench goes on to say: “The majority view has not taken into consideration some binding precedents and more particularly, we find that there was no discussion among the members of the Bench before pronouncement of the judgment.”
In their further pronouncements also, the reason for setting aside the 2013 judgement was not cited.
Later on, in 2019, the Narendra Modi government passed the National Medical Commission Bill that replaced the Medical Council of India. According to the provisions of the new Act, the commission was empowered to conduct uniform NEET for all undergraduate and postgraduate super-speciality courses in all medical colleges.
We can see continuity in policy regarding centralisation of the medical admission process during UPA and NDA governments.
The question is, why are successive Union governments bent upon keeping the medical admission process in their own control and, that too, in those medical colleges where it has not put any money in terms of infrastructure or operational expenditure?
This has more to do with the interests of the ‘power elites’ who remain almost the same in both governments. Pre-NEET processes provided many poor and rural background students with an opportunity to become doctors. As the medical profession has become quite lucrative and doctors wield a whole lot of power and prestige, so a system was introduced to weed out the subalterns from this field. NEET has actually served its purpose, in that sense.
The author is the former managing editor of India Today Hindi Magazine, and has written books on media and sociology. He tweets @Profdilipmandal. Views are personal.
(Edited by Srinjoy Dey)