Introduction
Recently, the National Nursing and Midwifery Commission (NNMC) Act, 2023 was implemented by the government to initiate comprehensive reforms in the nursing sector. It was passed in the Lok Sabha on July 28, 2023 and in the Rajya Sabha on August 08, 2023. Finally, it received the presidential assent on August 12, 2023 to become an Act. It is aimed at improving the standards of nursing education and services, guaranteeing more transparency and accountability, and facilitating professional conduct. It is a remarkable step of the government that focuses on bringing about fundamental changes in the field of nursing education and service.
This Act will introduce an advanced regulatory structure and replace the current Indian Nursing Council Act, 1947. This will be a crucial legislative reform in the nursing sector that aims at regulating and maintaining the standards of education and services for the workforce of nursing and midwifery.
Main Provisions of the Act
Some important provisions of this Act are mentioned below:
Establishment of National Nursing and Midwifery Commission As per the NNMC Act, the concerned authorities will set up an NNMC.
NNMC will act as a regulatory body to supervise nursing and midwifery professionals. It will comprise 29 members—a Chairperson, 16 ex officio members, and 12 members. The chairperson of this commission is required to be a postgraduate in nursing and midwifery and should have a minimum of 20 years of field experience. Apart from different ex officio members, nursing and midwifery professionals, and one person as a representative from charitable institutions are also the members of this commission. Different ex officio members would represent the National Medical Commission, the Department of Health and Family Welfare, the Department of Military Nursing Services, and the Directorate General of Health Services.
Functions of the Commission The commission has to perform the following functions:
- To formulate policies and modify standards for nursing and midwifery education
- To specify a uniform method for getting admission into nursing and midwifery institutions
- To supervise such institutions
- To specify the standard for teachers in such institutions
Autonomous boards Three autonomous boards are to be set up, subject to the supervision of the national commission. These boards include
- the Nursing and Midwifery Assessment and Rating Board to provide the criteria for examining and rating nursing and midwifery institutions;
- the Nursing and Midwifery Undergraduate and Postgraduate Education Board for the regulation of education and examination at both undergraduate and postgraduate levels; and
- the Nursing and Midwifery Ethics and Registration Board for controlling professional conduct and encouraging ethics in the profession.
State nursing and midwifery commissions A State Nursing and Midwifery Commission will be established by state governments in their respective states if there is no such commission under state law. It will comprise ten members, which may be representatives from any nursing or midwifery college of the state, from the health department, and nursing and midwifery workforce. The state commission will perform various functions, such as issuing certificates of specialisation, conducting skill-based examinations, updating online and offline state registers for registered professionals regularly, and implementing professional conduct, code of ethics and etiquette.
The Ethics and Registration Board will be set up so that appeals against decisions made by state commissions may be filed here. The state commission has to comply with the judgment given by the board. However, such a judgment may not be binding on the state commission in case a second appeal is filed with the national commission.
Uniformity in admission process and competence Under the NNMC Act, a standardised admission process will be executed so that there is consistency throughout nursing education. Further, superior quality healthcare services will be ensured by hiring nursing and midwifery professionals of equal competence.
Tenure and accountability The NNMC Act introduces a critical reform, which includes providing fixed tenures for the chairperson as well as the members of the commission. This will remove the need for reappointment, and thus, avert vested interests. In the nursing education field, transparency and accountability can be ensured among the regulators owing to this provision. Apart from this, the government will be authorised under the NNMC Act to direct the commission for the welfare of the citizens of the country as a whole.
Acceptance of innovation and collaboration In the Nursing Education field, opting for and utilising revolutionary technology and innovation will be promoted. In order to support research, synergy, and excellence in the nursing sector, there will be a collaboration between the commission, the industry, and other institutions.
Development of specialised courses and soft skills Certain specialised courses and certification programme in the field of nursing and midwifery are recognised. The Act also lays emphasis on the fact that registered professionals should develop soft skills. With this significant provision, the expertise of nursing professionals in varied domains will be augmented.
Mobility and expertise at a global level The mobility and employability of Indian nurses at a global level will be facilitated by organising the meetings of the national commission, which will be attended by domain specialists and foreign experts. This will result in the international collaboration, and thus, enhance the skills and expertise of the nursing professionals.
Setting up of nursing and midwifery institutions A new nursing and midwifery institution can be established only with the prior permission of the Assessment and Rating Board. This permission is also needed to increase the number of seats and initiate any new postgraduate programme. The board is obliged to make the decisions regarding the aforementioned cases within a period of six months. If the board disapproves, the authorities can first appeal against such a decision to the national commission, and later, a second appeal can be made to the central government.
Enrolment in the national or state register All the candidates must get themselves enrolled in the national or state register if they desire to work as qualified professionals in the nursing or midwifery sector. If they do not abide by this rule, they may be imprisoned for up to one year, or may be fined Rs 5 lakhs, or both, as punishment. It is the responsibility of the Ethics and Registration Board to maintain an Indian Nurses and Midwives’ Register online. This register may include the qualifications of professionals and associates along with their other details.
Nursing and Midwifery Advisory Council A Nursing and Midwifery Advisory Council will be formed by the central government so that a balanced representation from all states and union territories can be ensured. Further, this council will recommend the national commission on various matters, such as nursing education, services, research, and training.
Apart from these, the healthcare services will be delivered with a team-based approach owing to the joint sittings with appropriate statutory bodies, such as the Pharmacy Council of India, the National Commission of Indian System of Medicine, the National Medical Commission, the National Commission for Allied and Healthcare Professions, and the National Commission of Homeopathy.
The members of the council include
- chairperson, i.e., the same person who is the chairperson of the national commission;
- representatives from each state and union territory;
- representative from the Ministry of Ayush, the National Assessment and Accreditation Council, the University Grants Commission, the Indian Council of Medical Research; and
- nursing and midwifery professionals.
Conclusion
The implementation of the NNMC Act, 2023 is a landmark move taken by the Government of India, as it not only encourages innovation but also facilitates collaboration among various domains of the healthcare sector. This significant milestone highlights the commitment of the government, which includes the development of highly skilled and capable nursing professionals. This would ensure the availability of superior healthcare services to all the citizens of the country.
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