Medical Assessment & Rating Board Entrusted To Regulate Medical Education In India, Must Show Prima Facie Justification For Its Orders: Delhi HC

"If the MARB were to make such far-reaching observations, merely on the basis of suspicion and that too without even giving any opportunity to the institute, its action would not only be violative of the principles of natural justice but would also amount to giving unbridled power to the MARB to routinely overrule the assessors reports, which would be whole impermissible," Justice Rekha Palli observed.

The Court did not find any deficiency in the infrastructure or the clinical material of the petitioner, and directed the respondent to forthwith issue the letters of permission, as per the petitioner's applications.

"…in the present case, it evidently emerges that it is not as if the experts who had inspected the petitioner institute had found any deficiency with the petitioner institute, but it is the MARB which has chosen to ignore those reports and form its own arbitrary conclusions, without giving any opportunity to the petitioner to explain the so-called deficiency or suspicious information"

It added,

"When every institute is entitled to an opportunity to explain the deficiency found in an inspection report, there is no reason as to why a similar opportunity ought not to have been given to the petitioner to explain the so-called suspicious circumstances noted by the MARB from the inspection reports which were otherwise in order."

In March 2020, the Ministry of Health & Family Welfare (Ministry) had issued a public notice inviting medical colleges to apply for increase of seats/commencement of postgraduate (PG) disciplines. Responding to this notice, the petitioner, had sought permission to admit students in 13 PG disciplines. However, the respondent had rejected the petitioner's applications seeking permission for commencing 3 courses, and partially allowed the latter's applications seeking permission for commencing certain other courses. As regards increase of seats, after an initial disapproval, the petitioner was permitted to admit an increased number of students in 2 disciplines, with no inspection carried out with respect to the remaining courses. The reasons cited in the disapproval letters issued to the petitioner were lack of "essentiality certificate" and non-recognition of PG courses.

Interestingly, the Medical Council of India regulations provide that an institution which already has permission for starting an MBBS course does not require formal permission for commencing a post graduate course. In the instant matter, the petitioner had already received the Ministry's assent for its establishment and commencement of MBBS programme in 2017

The petitioner approached the respondent seeking a review of the disapproval letters and preferred appeals before a designated Appellate Committee since it did not receive any reply to its initial request for review. When the respondent refused to entertain its appeal as well, the aggrieved petitioner approached the Delhi High Court by way of a writ petition seeking quashing of the disapproval letters.

The court, in its order during a preliminary consideration in Jan 2022, found merit in the petitioner's plea that both the grounds on which the respondent had rejected the petitioner's applications were erroneous. The court, observing that though the petitioner has statutory remedies for filing appeals under the National Medical Council Act 2019, rejected the respondent's objection on maintainability of the writ petition on the ground that those remedies would not be efficacious at the eleventh hour when the counselling period for admission to the relevant courses is about to end.

"Since the Court, prima facie, finds substance in the submissions addressed on behalf of the petitioner, the Court is of the view that before the petitioner is forced to pursue the alternative remedy, if at all, the respondents would have to establish at least at the threshold level that there would be a substantial dispute with respect to the legal position as articulated on behalf of the petitioner."

In the instant ruling as well, the court rejected the respondent's objection to the maintainability of the writ petition on the same rationale, and also took note of the fact that the petitioner served as a designated Covid hospital by the Gujarat Government in 2020.

"…therefore, in my opinion, it would be a travesty of justice if the petitioner were relegated to the remedy of appeal at this belated stage"

Additionally, the court noted the conduct of the parties wherein the petitioner had submitted applications seeking permission to commence 13 PG disciplines in August 2020. The respondent chose to pass orders (rejecting the petitioner's applications in these orders) for the first time only in end-Nov 2021, and offered no explanation for this inordinate delay.

The petitioner argued that the purported pleas adopted by the respondent regarding the discrepancies in the number of investigations, lack of clinical material, non-verification of publications of some of the faculty members etc, are evidently grounds which appear to have been taken by the respondent only to justify their arbitrary decision of non-granting approval despite the inspection report being satisfactory. It supported its arguments by relying on the Supreme Court's position in Medical Council of India v. Vedanta Institute of Academic Excellence Pvt. Ltd. (2018) 7 SCC 225 wherein the apex court had laid down that it is not for the courts to either question the inspection report issued by an expert team of assessors, or to sit in appeal of the same.

The petitioner further cited Delhi High Court's decision in Sri Lakshmi Narayana Institute of Medical Sciences W.P.(C) 1458/2022 which laid down that when no deficiencies are revealed in the inspection report, the petitioner's prayer for grant of recognition deserves to be allowed.

The respondent submitted that as per regulations, the respondent is duty bound to assess relevant considerations even after the expert assessors have submitted their inspection report before arriving at a decision as to grant or rejection of any permission sought. The respondent categorically contended that the assessor's report cannot be considered as the final word. It put forth that its decision to allow fewer seats for admission to a few PG courses was justified on the basis that it was entitled "to take any decision after taking into account all the relevant factors", having been conferred with the power to take a decision for granting permission for commencement of PG courses. At an earlier stage in the writ proceeding, the respondent had changed its stance and conceded that that reason for issuing all the disapproval letters was the lack of essentiality certificate. The respondent prayed that the writ petition be dismissed.

The High Court justified its intervention under its writ jurisdiction in the instant matter given that the respondent, being an authority under law, has failed to follow the procedure established by law or adhere to the principles of natural justice by relying on the Supreme Court's ruling in Rajiv Memorial Academic Welfare Society and Anr v Union of India &Anr, 2016 (11) SCC 522. The court strongly criticised the manner in which the respondents dealt with the with the applications of the petitioner, by first adopting inaccurate grounds and thereafter, taking grounds which are contrary to the inspection reports.

In relation to the number of seats, the court formulated that in all relevant disciplines of study, the respondent granted permission for fewer seats than applied for only on the basis of suspicion and certain purported inconsistencies. In this context, it noted that the assessors appointed by the respondent itself had in the physical inspections found the petitioner's infrastructure and faculty to be sufficient for the number of seats applied for. Moreover, there was no explanation given by the respondent as to why if suspicious circumstances were indeed found to exist in the information provided by the petitioner, was permission granted for even three seats in the one the PG departments.

The court held that the respondent's actions were based merely on suspicions and have been arrived at without even giving any opportunity to the petitioner to explain the same. It found the respondent's reasons for the disapproval letters, not sustainable and went on to quash them. Further coming to the petitioner's rescue, given that the petitioner had already missed 2 rounds of the National Eligibility cum Entrance Test (NEET) 2021-22 counselling owing to the grave lapses by the respondent, the court granted the former permission for participating in the counselling for the remaining seats.

Case Title: Dr. M. K. Shah Medical College and Research Centre v. Union of India & Anr. W.P.(C) 3271/2022 & CM APPL. 9518/2022 (stay)

Citation: 2022 LiveLaw (Del) 306