National Medical Commission Has Power To Stop Admissions In Medical Colleges: Supreme Court

"Prima facie, it appears the finding of the High Court regarding lack of authority to issue an order for stoppage of admissions does not appear to be correct in view of Section 26(f) of the National Medical Commission Act. We accordingly order and direct that the operative direction in para 37 in the impugned order, permitting the institution to admit 100 MBBS students for 2021-2022, shall remain stayed pending further orders."

Considering the glaring deficiencies captured in a report pursuant to a surprise inspection conducted on 14-15.01.2022 a Bench comprising Justices D.Y. Chandrachud and Aniruddha Bose directed the National Medical Commission ("NMC") and the Medical Assessment and Rating Board ("MARB") to carry out a fresh inspection within a period of two months to ascertain if the deficiencies continue to exist. It noted -

"The NMC and MARB would be at liberty to carry out a fresh inspection within a period of 2 months for the purpose of determining whether any deficiencies in complying with the required norms continue to exist."

Senior Advocate, Mr. Nidesh Gupta appearing on behalf of the Medical College apprised the Bench that it has already admitted students for the academic year 2021-2022, and therefore stoppage of admission would be detrimental to them. The Bench noted, that on the contrary if the students are allowed to pursue the course and down the line in about six months if recognition is withdrawn, then the students will be left in the dark. It noted -

"If we allow this to continue then it would prejudice the students. 6 months down the line when permission is withdrawn they will be completely in the dark…We have to ensure that we maintain a balance not in favour of the institution but in the interest of the students. You might have to refund their money."

On the last date of hearing, the Court was appalled by the discrepancies, in the nature of fake patients and forged data. It noted that the High Court had merely ordered a fresh inspection and remanded the matter for consideration. On 04.03.2022, the Bombay High Court, Aurangabad Bench had passed the impugned order holding that the MARB does not have the power to issue order directing stoppage of admission. Thereafter, a notice was issued by the authorities to the concerned college to show cause as to why their recognition granted by letter dated 15.07.2021 should not be withdrawn in view of the deficiencies noted during the surprise inspection. In the show cause notice, the college had been directed to stop admission for the year 2021-2022.

At the outset, Justice Chandrachud expressed concern with respect to the order of the High Court which, he opined, had failed to consider Section 26(f) of the National Medical Commission Act, 2019 ("Act") conferring power on the authority to issue order of stoppage of admission.

"Section 26(f) of the Act gives you power to stop admission. What is the High Court doing?"

Mr. Gupta informed the Bench that there are two categories of seats. For the first five years there is a provision for permitted seats, after which the seats get recognised. He submitted that MARB has absolute power to stop admission to the permitted seats, but for recognised seats MARB only has power to recommend withdrawal of recognition to NMC, which can pass an order under Section 38 of the Act. It was pointed out that the show cause notice was issued to the concerned college by MARB and not NMC, which is the appropriate authority to do so.

Baffled by the findings of the report, Justice Chandrachud remarked -

"On the day when the inspection team came in, the data for a future date was recorded there. Patients are examined in the morning, but in the evening they all leave; children do not match up with records, they were all healthy."

Mr. Gupta relied upon judgments of the Apex Court to submit that there are guidelines for the manner in which assessment is to be conducted. One of the requirements is to have independent assessors, which has been flouted in the present case.

"This assessment is to be done by independent assessors who are chosen from a random pool of professors with 6 years experience. Here they are employees of the Union. This is prohibited. Assessors are handpicked."

He argued that, in fact, all the safeguards set out in the guidelines have been violated while conducting the inspection.

"The assessment guidelines were not followed. We can demonstrate that all parameters were violated. Your lordships, if the inspection reports are correct, then can I have the highest marks in the whole state with 90%+ pass marks."

Justice Chandrachud noted that the contour of scrutiny by the High Court was limited to the ground of the authority lacking power to stop admission.

Mr. Gupta argued that the report being the sheet anchor of the matter, if the same is vitiated, the other issues would not hold ground.

"I am saying the whole basis is the report which is mala fide and carried out by incompetent assessors. We are not alleging mala fide against any individual."

To demonstrate the shortcomings of the inspection report, he submitted -

"For disapproving a professor, a reason has to be given. The name of the professor is only not mentioned in the report. Deficiency of infrastructure in college and hospital is left blank, deficiency of clinical material also left blank, this is because they can fill up later. Whether one can have a report of this nature is the question."

Mr. Gaurav Sharma appearing on behalf of NMC submitted that NMC is run by members who are ex-officio members of reputed medical institutions.

"The MCI was dissolved in 2019. A new body was created. Most of the members are ex-officio members of different medical institutions in the country. These people are controlling the agency."

In order to show that a third party agent can be hired to carry out inspection, he referred to Section 26(1)(c) of the Act.

"(c) carry out inspections of medical institutions for assessing and rating such institutions in accordance with the regulations made under this Act:

Provided that the Medical Assessment and Rating Board may, if it deems necessary, hire and authorise any other third party agency or persons for carrying out inspections of medical institutions for assessing and rating such institutions…"

He pointed out that there were independent assessors in the team that went for inspection -

"Here three doctors went, three director level offices, one teaching facility of Safdarjung also went. The inspection was photographed and videographed. Report runs into more than 250 pages. Signatures were taken. They cannot now say the inspection was wrong. We are ready for inspection by any agency if the report was right or not."

Justice Chandrachud asked him, "Are you ready to carry out fresh inspection?"

He responded, "There has to be a surprise factor in inspection. If they know when we are going, everything will be in order."

Justice Chandrachud further enquired, "Why did you only send your people?"

Mr. Sharma submitted that everything was done as per the provisions of the Act. Moreover, he argued that the allegations pertaining to the report were merely an afterthought.

Justice Chandrachud enquired about the fate of the existing students -

"As a consequence of your order of stoppage they cannot admit any fresh 100 students for this year. What happens to the existing students?"

Mr. Sharma responded that time has been provided for compliance, after which they would re-inspect. If everything is in place then the recognition would continue.

"We have given them time to comply and we would again inspect them. We also want to give opportunities. If you rectify then it is fine. We will give you continuation of recognition. We generally give two opportunities."

Mr. Gupta urged the Bench to provide for three independent assessors of its choice.

The Bench stated -

"We will say that you will cause the inspection to be made by three professor level officers. Let there be someone from AIIMS and Maulana Azad College."

He asked the Bench to consider not passing the interim order as it would be in the nature of allowing the petition.

Justice Chandrachud remarked -

"Where will medical education go to? Doctored data is produced by college. The children were found to be completely healthy."

He further stated that it is imperative to set aside the order of the High Court, which had clearly overstepped -

"We have to correct this kind of an order of the High court or else it would cause serious prejudice.The High Court had completely overstepped here."

[Case Title: National Medical Commission And Anr. v. Annasaheb Chudaman Patil Memorial Medical College And Ors.]

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