Establishment of medical colleges: MCI and Central Government must show due diligence right from the day when the applications are received: SC

Considering a batch of petitions arising out of communications issued by the Central Government recommending disapproval of applications preferred in respect of Medical Colleges for the academic year 2014-2015 for the reason that the Medical Council of India (MCI for short), after inspection, had found infirmities or inadequacies in the infrastructure, facilities and faculty in the said colleges, though the respective applicants  claimed to have rectified the shortcomings and asked for compliance verification which was refused by the Central Government and/or the MCI refused for want of adequate time,  the Apex Court has held that the MCI and the Central Government must show due diligence right from the day when the applications are received.

Writing the judgment [Royal Medical Trust (Regd) and Another vs Union of India and Another] for a bench of 3 judges, Justice U.U. Lalit observed that inaction on the part or non-observance of the time Schedule by the MCI and the Central Government is bound to have an adverse effect on all concerned. “The MCI and the Central Government have been vested with monitoring powers under Section 10A and the Regulations. It is expected of these authorities to discharge their functions well within the statutory confines as well as in conformity with the Schedule to the Regulations. If there is inaction on their part or non-observance of the time Schedule, it is bound to have adverse effect on all concerned,” the Court said.

The Court also reminded the MCI and the Central Government that the Schedule giving various stages and time limits must accommodate every possible eventuality and at the same time must comply with the requirements of observance of natural justice at various levels.

The Court was considering broadly the following categories of cases:

(I) Cases where new Medical Colleges were sought to be established for the first time and where such colleges were seeking appropriate permission to admit students to the first year of MBBS course

(II) Cases where the existing approved Medical Colleges were seeking increase in intake of seats for admissions of students to the first year of MBBS Course

(IV) Medical Colleges seeking renewal of permission, who had already received permission in the previous year(s) either for establishing new Medical College or for increasing intake capacity of the existing Medical College. In this category of cases, the renewal for subsequent batches and for permission to admit students to the first year course was sought.

In these cases, during inspections conducted by the MCI in respect of Medical Colleges falling in Categories I, II and III certain deficiencies were found which were then communicated to the concerned applicants. According to the concerned applicants, either the deficiencies were wrongly noted or they had since then been rectified and compliance was reported. Though compliance was so reported and the Central Government / the MCI were asked to have inspection to verify such compliance, the Central Government communicated its disapproval without taking any steps to assess or verify the compliance report.

In most of the matters the applicants approached Supreme Court under Article 32 of the Constitution of India while in some cases they went to the High Court. In certain cases the High Court directed the Central Government and the MCI to undertake fresh inspection.

These orders, at the instance of the MCI were challenged before the SC and the Court had earlier suspended the operation of directions so issued by the High Court.

In some cases the High Court did not grant any interim relief and the applicants had preferred special leave petitions challenging the correctness of such refusal.

All these petitions were considered together by the Supreme Court.

The Apex Court initially referred to the statutory provisions governing the field.

The Court tracing the statutory provisions said, “In exercise of powers conferred by Section 10A read with Section 33 of the Act, the MCI with the previous sanction of the Central Government has made “Establishment of the Medical College Regulations, 1999” Paragraph 8 of the Regulations states that permission to establish new Medical College may be granted initially for a period of one year and would be renewed on yearly basis subject to verification of the achievements of annual targets. The process of renewal of permission continues till such time that the establishment of the Medical College and expansion of hospital facilities are completed and formal recognition is granted to the Medical College. A Medical College which gets initial permission to establish and admit first batch of students will thus be required to seek renewal till such time that it gets formal recognition and the students admitted in the first batch are ready to pass out and secure recognized medical qualification. This process thus continues for five years and Category No. III were cases of such Medical Colleges.

The Schedule to the Regulations sets out various stages dealing with processing of applications preferred by the Medical Colleges and how the matter is to be dealt with at various stages. This schedule had undergone changes over a period of time.”

The Regulations were further amended by Amendment Notification dated 21.09.2012 which was published in the Gazette of India on 1.10.2012 [Establishment of Medical College Regulations, (Amendment), 2012]

The Bench observed that the schedule to the Regulations, the stages mentioned therein regarding processing of applications and the requirement to adhere to the dates specified therein, had been considered by the Apex Court in some cases and proceeded to consider the dictum laid down therein.

In Priyadarshini Dental College and Hospital v. Union of India and others the Supreme Court was called upon to consider the implications of similar such Schedule annexed to the Regulations of Dental Council of India. (The statutory provisions and the Regulations under the Dentists Act, 1948 are pari materia with those in the present case.) In Priyadarshini SC had said

“The entire process of verification and inspection relating to renewal of permission, should be done well in time so that such existing colleges have adequate and reasonable time to set right the deficiencies or offer explanations to the deficiencies. The object of providing for annual renewal of permissions for four years, is to ensure that the infrastructural and faculty requirements are fulfilled in a gradual manner, and not to cause disruption.”

In a subsequent decision in Priya Gupta v. State of Chhattisgarh and others, the SC had issued the following directions:

“46.1. The commencement of new courses or increases in seats of existing courses of MBBS/BDS are to be approved/recognised by the Government of India by 15th July of each calendar year for the relevant academic sessions of that year.

46.3. After 15th July of each year, neither the Union of India nor the Medical or Dental Council of India shall issue any recognition or approval for the current academic year. If any such approval is granted after 15th July of any year, it shall only be operative for the next academic year and not in the current academic year. Once the sanction/approval is granted on or before 15th July of the relevant year, the name of that college and all seats shall be included in both the first and the second counselling, in accordance with the Rules.

46.4. Any medical or dental college, or seats thereof, to which the recognition/approval is issued subsequent to 15th July of the respective year shall not be included in the counselling to be conducted by the authority concerned and that college would have no right to make admissions in the current academic year against such seats.

47. All these directions shall be complied with by all concerned, including the Union of India, Medical Council of India, Dental Council of India, State Governments, universities and medical and dental colleges and the management of the respective universities or dental and medical colleges. Any default in compliance with these conditions or attempt to overreach these directions shall, without fail, invite the following consequences and penal actions:

 47.1. Every body, officer or authority who disobeys or avoids or fails to strictly comply with these directions stricto sensu shall be liable for action under the provisions of the Contempt of Courts Act. Liberty is granted to any interested party to take out the contempt 25 proceedings before the High Court having jurisdiction over such institution/State, etc.

 47.5. The college which grants admission for the current academic year, where its recognition/approval is granted subsequent to 15th July of the current academic year, shall be liable for withdrawal of recognition/approval on this ground, in addition to being liable to indemnify such students who are denied admission or who are wrongfully given admission in the college.”

The SC however observed that the Schedule as it stood then, when it rendered its Judgment in Priya Gupta did not enable the Central Government to modify the schedule, as was permissible under the concerned Dental Council of India Regulations considered by the Supreme Court in Priyadarshini. On and with effect from 01.10.2012 i.e. after the Judgment in Priya Gupta, the substituted Schedule now empowers the Central Government to that effect.

Since the deadline for effecting admission as per Medical Council of India Regulations on Graduate Medical Education, 1997 namely 30.09.2014 was approaching and large number of seats were involved because of recommendations for disapproval without having assessed or verified compliance as reported by the applicants, the matters were considered for grant of suitable relief.

The Medical Colleges in Category III were considered fit to be granted such relief as they were all renewal cases. All these Medical Colleges had received permission to set up and/or to increase the intake in previous year(s). The cases in Category III being renewal cases were considered differently as against other cases in the light of the law laid down in Priyadarshini.

The Apex Court therefore by orders dated 18.09.2014 and 25.09.2014 had permitted all the medical colleges falling in category No.III to give fresh admissions in the first year of the M.B.B.S. Course subject to certain conditions mentioned in those orders. The Medical Colleges in that category were required to file an undertaking on same terms as Government Medical Colleges that there was no deficiency and that if the undertaking so submitted was found to be incorrect in the next inspection, their deposit with the MCI, which was around Rs.10 crores, would be forfeited by way of penalty. It was further directed that admissions could be given to only those students from the merit list prepared by the respective States and that the students would be charged fees prescribed by the Government Medical Colleges of the respective States. These orders were passed as the concerned medical colleges had already received permission to establish new medical college or to increase the intake capacity and the matters in issue were only concerning renewal permissions and as the concerned colleges had statedly removed deficiencies and submitted their compliance reports.

On behalf of the colleges, it was contended as follows:

1. Section 10A of the Act read with the Regulations and the Scheme framed thereunder contemplates certain initial prerequisites such as Essentiality Certificate, Consent of Affiliation, a suitable plot of land as prescribed and a three hundred bed hospital with necessary infrastructure and facilities. If these qualifying pre-requisites are not met, the permission to establish a medical college will certainly not be granted. However, in none of the present cases, the denial or disapproval was on account of inability to meet these qualifying pre-requisites
2. According to sub-section (7) of Section 10A, the Scheme and the Regulations, certain requirements like necessary facilities in respect of staff, equipment, accommodation, training as well as hospital facilities could be provided within the time limit specified in the Scheme. Unlike the qualifying pre-requisites as stated earlier, these facilities could be put in place and made effective at a later point of time. (c) Reading of sub-sections (3) , (4) and (8) of Section 10A read with Clauses 7 and 8 of the Regulations as well as the underlying idea behind sub-section (7) of Section 10A would show that the concerned applicant ought to be afforded time and sufficient opportunity to rectify the deficiencies.
3. The compliance having been reported, the MCI and the Central Government were obliged to assess whether such deficiencies stood removed or not. Inability of the MCI to perform its statutory obligation and initiate appropriate action within the time frame has penalized the respective colleges for no fault of theirs. (e)The MCI and the Central Government must arrange their affairs in such a way that the respective stages in the Schedule are adhered to, affording reasonable opportunity to the concerned medical colleges to rectify the deficiencies. Having pushed the concerned colleges close to the dead line, the MCI and the Central Government cannot then take refuge under the Schedule and project their inability to carry out any compliance verification.
4. The Note under the Schedule to the regulations, as brought in by Amendment Notification dated 21.9.2012 sufficiently enabled the Central Government to modify the time schedule, as laid down by this Court in Priyadarshini. The Central Government did make an exception and modified the time limits in the Schedule in favour of Government medical colleges. Similar such benefit ought to have been extended in favour of the private Medical Colleges as well.

Appearing for the MCI senior counsel Vikas Singh submitted that the Scheme contemplated that the concerned applicants must have the necessary facilities, faculty and infrastructure in existence and operational as on the day the application was made. He submitted that most of the applicants themselves would request the MCI to conduct inspections as late as possible, which would give additional time to the concerned applicants to put the facilities in order. In these circumstances, the inspections were carried out in the months of April and May. In his submission, because of mandatory directions in Priya Gupta, the MCI refused to undertake any inspection for compliance verification.

After considering the rival contentions the Court held that the Scheme under Section 10A, with due regard to the factors referred to in sub-section (7), may contemplate putting in place necessary facilities at a later point of time. “Paragraphs 7(b) and 8(3) of the Regulations also speak of defining and achieving annual targets respectively. Naturally, it needs to be assessed and verified whether such annual targets are achieved or not. The timely assessment is integral to the Scheme itself and the MCI and the Central Government are therefore obliged and required to conduct renewal inspections every year so as to ensure that the establishment of the Medical College and expansion of hospital facilities are completed in time and in accordance with the Scheme. In Swamy Devi Dayal it was observed that the provision requiring such opportunity being given to the applicant applies not only at the initial stage when permission for establishment of new College is under consideration but must apply even in cases of subsequent renewal of such permission In our view, the ratio in Swamy Devi Dayal must apply as regards cases of renewal under the Act.”

“As regards cases of renewal, it was laid down in Priyadarshini that the process of decision making for grant of fresh or initial permission for establishment of a new college is exhaustive and elaborate when compared to such decision making in regard to grant of renewal of permission for the four subsequent years. It was further stated that before grant of initial permission the aspects whether the institution would be in a position to offer the minimum standards of education in conformity with the Act and Regulations and whether the institution has adequate resources and whether the institution has provided or will be able to provide within the time limit specified in the Scheme all the required facilities and faculty are required to be considered and scrutinized very closely. On the other hand for the purposes of grant of renewal what is required to be considered is whether the prescribed faculty and infrastructure is available. Considering renewal cases on a parameter distinct and different from that relating to establishment of a new college for the first time, it was observed that the entire process of verification and inspection relating to renewal ought to be done well in time so that the existing colleges have adequate and reasonable time to set right the deficiencies or offer explanation to the deficiencies.”

The Court accordingly said that the requirements of reasonable opportunity must be afforded not only at the initial stage but also in cases of subsequent renewal and further that the opportunity must be afforded at both the stages namely by the MCI as well as by the Central Government, the Schedule under the Regulations must accommodate and provide for adequate time limits to take care of such eventualities.

The Court however noted that the Schedule which was brought in force by way of an amendment dated 21.09.2012 does not provide for such stage wise consideration. “ It simply gives four stages without indicating any time limits to ensure grant of such reasonable opportunity in case the decisions of disapproval are taken against the applicants. It also does not speak of any compliance verification,” the Court said.

The Court then proceeded to hold that the MCI and the Central Government have been vested with monitoring powers under Section 10A and the Regulations. “It is expected of these authorities to discharge their functions well within the statutory confines as well as in conformity with the Schedule to the Regulations. If there is inaction on their part or non-observance of the time Schedule, it is bound to have adverse effect on all concerned.

“The MCI and the Central Government must therefore show due diligence right from the day when the applications are received. The Schedule giving various stages and time limits must accommodate every possible eventuality and at the same time must comply with the requirements of observance of natural justice at various levels.”

SC then declared that the directions in Priya Gupta must now be understood in the light of such statutory empowerment and that it is open to the Central Government, in terms of the Note, to extend or modify the time limits in the Schedule to the Regulations. However the dead line namely 30th of September for making admissions to the first MBBS course as laid down by this Court in Madhu Singh and Mridul Dhar must always be observed.

Considering next the question of relief to be afforded in the petitions, the Court said:

“Since the deadline for making admissions was over and there was no formal permission to establish new Medical Colleges or to increase the intake capacity in respect of existing Colleges, applicants in Categories I and II were not considered fit for grant of any interim relief. For the same reasons no relief can be granted to them.

The relief granted in respect of those falling in Category III, vide orders dated 18.09.2014 and 25.09.2014 is made absolute in terms of those orders and the writ petitions and appeals arising from special leave petitions in Category III stand disposed of in such terms.” 

Image from here.

Read the Judgment here.