MLA Ezhilan’s 6-point charter wants medical education, on State list
State’s feats in health delivery system are getting diluted due to norms favouring Centre, says report
State Planning Commission member Ezhilan Naganathan submitting the report to the committee on Centre–State relations
CHENNAI: Medical education should be restored to the State List, state-led organ transplant models must be protected, and central ‘overreach’ in health governance must be rolled back—these are among the major recommendations made by DMK MLA and State Planning Commission’s part-time member Ezhilan Naganathan in his report on “State Autonomy in Health and Medical Education,” submitted to the High-Level Committee on Union–State Relations.
The report highlights six critical areas where State autonomy has been allegedly diluted: the shift of medical education to the Concurrent List, replacement of the Medical Council of India with the National Medical Commission, over-centralisation of the National Health Mission, tightening of drug regulation by the CDSCO, centralisation of organ transplantation through NOTTO, and ideological impositions in health education and policy.
“The unitary approach adopted by the Union government has systematically eroded the Constitutional space for states in health and medical education. This undermines efficiency, social justice, and context-specific delivery of care,” Ezhilan stated in his report.
One of the strongest recommendations is to undo the 42nd Constitutional Amendment of 1976, which moved medical education from the State List to the Concurrent List. According to Ezhilan, this created “a disconnect between public health, which is a state subject, and medical education, which is now subject to central control.”
The report also critiques the National Medical Commission (NMC), which replaced the Medical Council of India. “The NMC functions as a sub-unit of the Union Health Ministry with minimal state representation. This is antithetical to cooperative federalism, the report noted. It further observed that centralised examinations such as NEET and NEXT have disadvantaged rural and vernacular-medium students.
Tamil Nadu’s pioneering achievements in health delivery and organ transplantation were cited as examples of state-led success threatened by centralisation. On the Union’s attempt to bring state-level transplant networks under the National Organ and Tissue Transplant Organisation (NOTTO), Ezhilan cautioned: “Tamil Nadu’s cadaver transplant programme has set international benchmarks. Forcing centralised allocation risks delaying time-critical procedures and diluting equity.”
The report also expressed concern over drug regulation, noting that the Central Drugs Standard Control Organisation has reduced the role of state agencies, which has slowed down responses to local disease patterns and created barriers for smaller pharma manufacturers.
On cultural and linguistic impositions, the report stated: “Unscientific agenda such as compulsory Ayurveda integration in the MBBS curriculum and the branding of wellness centres in Hindi are examples of ideological overreach that alienates local communities.”