The reform of professional councils in healthcare — from the Medical Council of India to the Pharmacy Council of India — reflects a broader shift in India's regulatory philosophy. Analyse this transition with reference to the principles of transparency, accountability and federal balance.

India's healthcare regulators were built on the elected-council model of the Pharmacy Act, 1948 [1] and the Indian Medical Council Act. Repeated integrity failures pushed the State towards commission-style regulation — nominated experts, functionally separated boards, and central oversight — a shift visible from the National Medical Commission Act, 2019 [2] to the draft National Pharmacy Commission (NPC) Bill, 2026 [3].

The old philosophy: self-regulation by elected councils

• Councils like PCI, constituted in 1949 under Section 3 of the Pharmacy Act, 1948, combined education standard-setting, inspection, registration and discipline in one elected body [1].
• Fusion of functions invited regulatory capture by college interests; the CBI probe into PCI's leadership mirrored the earlier collapse of the Medical Council of India.

Transparency

• The new template separates functions into autonomous boards — education, assessment and rating, ethics and registration — so the rater is not the regulated [3].
• Pre-legislative consultation is now the norm: the NPC Bill's revised draft (1 July 2026) followed a first comment round, inviting fresh comments till 31 July 2026, published in multiple regional languages [3].

Accountability

• Statutory national registers — the National Medical Register, the Central Register under the NCAHP Act, 2021 [4], and the proposed National Pharmacy Register — create a single verifiable database against ghost registrations.
• A proposed National Exit Test for D.Pharm and B.Pharm shifts accountability from institutional inspection to demonstrated competence [3].

Federal balance

• Parliament legislates on standards under Entry 66, Union List, while practice and registration touch Entry 6, State List — hence State Pharmacy Councils survive under the new design.
• Yet nominated members outnumber elected representatives, and professional associations have flagged excessive centralisation — the core criticism of the NMC Act too [3].

The transition trades democratic representation for functional separation and enforceable standards — a defensible bargain given past capture, provided States retain genuine voice. Anchoring board composition in transparent selection, guaranteeing State representation, and phasing the exit test would let the commission model advance both quality and cooperative federalism, serving the Article 21 promise of safe healthcare.