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Table of Contents
EDITORIAL
Year : 2021  |  Volume : 53  |  Issue : 1  |  Page : 1-3

National commission for allied and health-care professions act 2021 and the central council of occupational therapy


1 Rehabcare, Lucknow; Deenbandhu Rehabilitation Center, Ayodhya, Uttar Pradesh; The All India Occupational Therapists' Association, Mumbai, Maharashtra; The Indian Journal of Occupational Therapy; The Academic Council of Occupational Therapy; WFOT Delegate, India
2 Department of Occupational Therapy, Composite Regional Centre, Davanagere, Karnataka, India

Date of Submission27-May-2021
Date of Acceptance27-May-2021
Date of Web Publication22-Jun-2021

Correspondence Address:
Anil Kumar Srivastava
93, Laxmanpuri, Faizabad Road, Lucknow - 226 016, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijoth.ijoth_52_21

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How to cite this article:
Srivastava AK, Mishra N. National commission for allied and health-care professions act 2021 and the central council of occupational therapy. Indian J Occup Ther 2021;53:1-3

How to cite this URL:
Srivastava AK, Mishra N. National commission for allied and health-care professions act 2021 and the central council of occupational therapy. Indian J Occup Ther [serial online] 2021 [cited 2021 Jul 28];53:1-3. Available from: http://www.ijotonweb.org/text.asp?2021/53/1/1/318987




  A Giant Leap toward Regulation and Standardization of Occupational Therapy in India Top


March 28, 2021 marked the beginning of a new era for occupational therapy (OT) professionals of India. This date would be inked forever in the archives of professional history because the long awaited dream of OT professionals of the country has now come to a reality. This day marked the first major step toward professional recognition, autonomy and independence for all those who had been dreaming to get a national regulatory body for more than six decades. On this day the “The National Commission for Allied and Health-care Professions Act, 2021” came into existence. The Act recognizes OT as an independent profession and as a recognized category of health-care profession.[1]


  Background of the Bill Top


Although the demand for a regulatory body for OT has continued in the last 60 years, but formal, sincere and dedicated efforts were made in the last three decades. The first of such efforts to establish a regulatory body in India started about three decades ago when a bill for physiotherapists and occupational therapists was drafted in 1994. In 1998, the Ministry of Social Justice and Empowerment, Government of India (GoI) notified to include physiotherapy and OT under the ambit of Rehabilitation Council of India. After intervention by Honorable High Court, New Delhi on the All India Occupational Therapists' Association (AIOTA)'s petition challenging it, the said notification was withdrawn by GoI in 1999.

The issue was kept under the neglected list of the Government. In 2007, it gathered momentum with the formulation of “The Paramedical and Physiotherapy Central Councils Bill, 2007” which was strongly resented. Subsequently, it was referred to Department Related Parliamentary Standing Committee on Health and Family Welfare (DRSCHFW) for the examination. The Standing Committee analyzed the subject in its 31st report. However, the bill lapsed with dissolution of 14th Lok Sabha in 2009.[2] However, the 31st Report of the Departmental related Parliamentary Committee on Health and Family Welfare on the Paramedical and Physiotherapy Central Councils Bill, 2007 invited concerned stakeholders and recommended that (i) The title of the Act needs to reflect the basic objective behind its enactment and should use a common term in the title of the Bill. On the basis of the structural components of the Council presented under then 2007 Bill, it was suggested that title of the Bill be changed to “The Allied Health Professions Central Councils Act, 2007.” Considering this would not only cover all the disciplines then being brought under the act (which were physiotherapy, OT, medical laboratory technology, and radiology technology) but also allow for the inclusion of other disciplines in the future. (ii) The word “technician” be replaced by “technologist” and the term “Paramedical” be deleted; (iii) The term “medically directed” in case of Physiotherapy and/or OT may be deleted.


  The National Commission for Human Resources for Health Bill, 2011 Top


Another proposal for constitution of Allied Health (Paramedical) Council was included in the NCHRH Bill, 2011 which was introduced in Rajya Sabha in December 2011. The Parliamentary Standing Committee rejected the bill in its stated form due to strong opposition by Medical Council of India, Dental Council of India, Indian Nursing Council as well as AIOTA and other concerned associations. It ultimately led the Committee recommend to revise the bill.[3]

The Journey “From Paramedics to Allied Health Services: Landscaping and Way Ahead” With recognition of the problem being faced by the allied and health-care professionals, the Ministry commissioned a report, with a mandate to understand the current status, identification and state of affairs of various unregulated professionals in the health-care system.[4] The report was the first attempt of the Ministry to understand the human resources for health system in the absence of any verifiable, coordinated or consolidated repository regarding information of the professionals in the system. Although the report did not focus on any particular profession, drew attention of the Ministry on the overall situation and problems resulting in access, quality of care and affordability out of such a situation. After more than 300 experts were consulted and inputs were received from wide variety of stakeholders, a broad common definition was arrived upon to indicate the breadth and scope of their work. ”Allied and healthcare professionals, thus, include those individuals who were involved with the delivery of health or health-care-related services, with qualification and competence in therapeutic, diagnostic, curative, preventive, and/or rehabilitative interventions. They could work in interdisciplinary health teams in varied healthcare setting that include doctors, nurses and public health professionals to promote, protect, treat and/or manage a person's physical, mental, social, emotional, environmental health, and holistic well-being.” Further the breadth and scope of the practices were also identified and highlighted as follows:

  1. Work through the age span of human development from neonate to old age
  2. Work with individuals with complex and challenging problems resulting from multisystem illnesses
  3. Work toward health promotion and injury prevention, and the assessment, management and evaluation of interventions
  4. Work in a broad range of settings including the patient's home and acute, primary and critical care settings
  5. Have an understanding of the health-care issues associated with diverse cultures within society.



  National Task Force 2014 Top


In the absence of a Council, efforts were made by the Ministry of Health and Family Welfare to standardize the norms for education for such professions, wherein in 2014 National Taskforces for eight (8) different professional categories comprising of eminent professionals and academicians from respective fields, were constituted including major professional groups such as Physiotherapy, OT, Optometry, Medical Laboratory Science, Radiology, Imaging Technology and Radiotherapy. The Taskforces were mandated to draft the common minimum curriculum, indicative career pathways, roles, and responsibilities at different levels as well as skills and competencies of qualified professionals in respective fields.

The comments received by the stakeholders were intensely deliberated and accordingly changes were made in the proposed structure. In 2016, the Bill underwent several iterations and was presented to Finance Ministry (FM) on January 2, 2017. The draft proposal, as approved by FM, was then sent for inter-ministerial consultation on February 8, 2017. Changes reflecting inclusion of financial details, preamble, etc., as highlighted by Ministry of Law and Justice were incorporated and a corrigendum to this effect was sent to all the Ministries/Departments on February 17, 2017. Several comments and suggestions were received on the Bill, which was then redrafted by Ministry of Law and Justice (Department of Legislative) in close consultation and collaboration with Ministry of Health and Family Welfare and was jointly signed by JS (ME) on May 29, 2018, after due approvals. During the clause by clause consideration of the Bill, the Special Secretary, Ministry of Health and Family Welfare apprised the Committee that the Bill had almost undergone several rounds of amendments and finally the Allied and Healthcare Professions Bill, 2018 was introduced in the Rajya Sabha on December 31, 2018 which was referred to the DRSCHFW on January 2, 2019.[5]

Department-Related Sub header Parliamentary Standing Committee on Health and Family Welfare Rajya Sabha Secretariat, Report on the Allied and Healthcare Professions Bill, 2018.

After the bill was referred to the DRSCHFW, GoI, it undertook a major exercise to connect with all the stake holders of the bill. The committee had a series of deliberations with the major national associations (the AIOTA, the Indian Association of Physiotherapists, etc.). The committee gave a very neutral and unbiased opportunity to all stakeholders to discuss their apprehensions, objections, and doubts related to the bill. Not only these ample opportunities were provided by the above committee to all stakeholders to present before it to put forth any suggestions, modifications and alterations in the existing draft of the bill.

Department-related Parliamentary Standing Committee on Health and Family Welfare Rajya Sabha Secretariat, New Delhi, tabled its One Hundred Seventeenth (117) report on the Allied and Healthcare Professions Bill, 2018 on January 31, 2020.[5] The major overhaul in the existing bill ultimately made sure that this bill now would be named as “The National Council for Allied and Health Care Professions Bill” with separate councils for all recognized categories including OT.

The Ministry of Health and Family Welfare, GoI accepted most of the recommendations made by the DRSCHFW and after various round of deliberations, discussion, and redrafting the finalized draft of “The National Commission for Allied and Healthcare Professions Bill 2020” was finally tabled in Rajya Sabha by the Health Minister on March 16, 2021 and was subsequently passed by Lok Sabha on March 24, 2021. On March 28, 2021, this bill became an act with the title “The National Commission for Allied and Healthcare Professions Bill 2021” and was published in the Gazette of India making it a law applicable all across the country.[6]


  Highlights of the Bill Top


Definition of Occupational Therapy Professional

”OT Professional is a person who delivers client-centered services concerned with promoting health and well-being through occupation to enable people to participate in the activities of everyday life, which includes professionals such as occupational therapists who achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they are expected to do, or by modifying the occupation or the environment to better support their occupational engagement. The occupational therapist can practice independently or as a part of a multi-disciplinary team and has a minimum qualification of baccalaureate degree.”

The definition itself opens up a very important and one of the most sought after demands of OT Professionals in India; the authority to practice independently. Time and again there were questions related to the autonomy in practice of OT. In one of the earlier bills related to formulation of a regulatory body OT was written as “medically directed” profession. The current definition puts an end to all such unnecessary authority of any other professional over the practice of OT and paves the pathway towards autonomy and independent practice.

Inclusion of Occupational Therapy as a Separate, Independent, and Unique Entity

Earlier drafts of the bill did not give a separate identity to OT professionals and they were clubbed together with many heterogeneous professionals like Movement Therapist (including Art, Dance and Movement Therapist or Recreational Therapist) and Podiatrist.

The current act now very clearly mentions the unique identity of Occupational Therapist and has removed all other heterogeneous professions which were unnecessarily clubbed into the OT professional domain.

Independent National Council for Occupational Therapy Professionals

The bill has made clear provision about setting up of a National Commission with Separate Councils for all recognized categories. OT being one of the recognized categories is all set to now have an independent National Council for OT Professionals. Not only this, the bill also provides the roadmap for formulation of separate Council for OT in all states of India. This is going to be a landmark step toward nationwide regulation and standardization of OT in India.


  The All India Occupational Therapists' Association and the NCAHP Act 2021 Top


The AIOTA has been the flag bearer of OT in India since the time of its inception. Fighting against all odds and with the immense support of all its members, the AIOTA has always been championing the cause of Occupational Therapists of the country and acted as a bridge between the professionals and the Government authorities. There have been many ups and downs throughout this journey but the NCAHP Act 2021 comes as a silver lining amidst all the adversities which were being faced by the professionals. The sincere and dedicated efforts of the national association (AIOTA) have ensured that the identity and independence of the profession is established forever and the regulation by a national council will provide a further impetus to the Profession of OT. The way forward is now streamlined and we have to ensure that no stones remain unturned so that this achievement can be fully utilized for the standardization and upgradation of OT in India.



 
  References Top

1.
Government of India, Ministry of Law and Justice, Legislative Department. The National Commission for Allied and Healthcare Professions Act, 2021 (Publication No. 14-2021). Available from: https://egazette.nic.in/WriteReadData/2021/226213.pdf. [Last accessed on 2021 May 26; Last updated on 2021 Mar 28].  Back to cited text no. 1
    
2.
Parliament of India Lok Sabha- Paramedical and physiotherapy Central councils bill, 2007(Bill No. 96 0f 2007). Available from: https://prsindia.org/files/bills_acts/bills_parliament/1196830081_paramedical_20To_20be.pdf. [Lastaccessed on 2021 May 28; Last updated on 2021 May 22].  Back to cited text no. 2
    
3.
Parliament of India Rajya Sabha- The National Commission for Human Resource for Health Bill, 2021 (Bill No. LIX of 2011). Available from: https://prsindia.org/billtrack/the-national-commission-for-human-resources-for-health-bill-2011. [Last accessed on 2021 May 28; Last updated on 2021 May 24].  Back to cited text no. 3
    
4.
Narayan K, Kar S, Gupta N. From Paramedics to Allied Health Professionals: Landscaping the Journey and Way Forward; 2012. Available from: https://www.researchgate.net/publication/323280487_From_Paramedics_to_Allied_Health_Professionals_Landscaping_the_journey_and_way_forward. [Last accessed on 2021 May 28; Last updated 2021 Mar 16].  Back to cited text no. 4
    
5.
Occupational Therapy in India. [Karnataka, India]. Available from: https://en.wikipedia.org/wiki/Occupational_therapy_in_India. [Last accessed on 2021 May 28; Last updated on 2021 Mar 17].  Back to cited text no. 5
    
6.
Parliament of India Rajya Sabha Department-Related Parliamentary Standing Committee on Health and Family Welfare Rajya Sabha Secretariat (2020). One Hundred Seventeenth Report on the Allied and Healthcare Professions Bill, 2018 (Publication No. 117). Available from: https://rajyasabha.nic.in/rsnew/Committee_site/report_search.aspx. [Last accessed on 2021 May 26; Last updated 2021 May 23].  Back to cited text no. 6
    




 

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A Giant Leap tow...
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