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Different concepts of quality in health care have implications for nature, structure and composition of health service systems. Issues of access, cost and quality of care are intricately linked; for recipients, providers as well as for policy-makers. Quality in health care is a complex construct because it is linked not just with the quality of services provided at the institution and systemic level but has several tangible and intangible dimensions including individual patient's interests and larger societal concerns about improvement in health status. Quality is an important consideration for choosing the services for recipients, accreditation of hospitals for care providers, and for policy-makers while making decisions regarding health service system models. This article traces the way the issue has been dealt with at the policy and planning level so far, including the National Rural Health Mission (NRHM) as well as in the proposed models for Universal Health Care by the High Level Expert Group (HLEG) and 12th Plan Steering committee reports.

The National Medical Council Bill, 2017, was tabled in Parliament on 29 December 2017 with the proposal to replace the Medical Council of India (MCI) as the regulatory body for medical education and practice in the country. This was the response of the PMO-NITI Aayog Committee, which was formed after the Parliamentary Standing Committee for Health and Family Welfare in its 92nd report strongly indicted the functioning of the MCI and recommended a complete restructuring. The Bill sets out various proposals with the aim to regulate the quality of doctors produced as well as the ethics of their practice. Its content has raised much contestation from the medical fraternity. A host of issues have emerged, such as, what professionalism should mean and what forms of regulation should be put in place, and what mechanisms have to be considered in order to balance the interests of the public and the medical fraternity so that the restructuring that is sorely required can go through.