caselaws
Supreme Court of India
Medical Council Of India vs Kalinga Institute Of Medical … on 6 May, 2016Author: M B Lokur
Bench: Madan B. Lokur, N.V. Ramana
REPORTABLE
IN THE SUPREME COURT OF INDIA
CIVIL APPELLATE JURISDICTION
CIVIL APPEAL NO. 4914 OF 2016
(Arising out of S.L.P.(C) No.9997 of 2016)
Medical Council of India .…Appellant
versus
Kalinga Institute of Medical Sciences .…Respondents
(KIMS) & Ors.
J U D G M E N T
Madan B. Lokur, J.
1. Leave granted.
2. This appeal is yet another chapter in the sordid saga of admissions
to medical colleges. Undoubtedly, there is something rotten in the state of
medical colleges. Unless the concerned Ministries in the Government of
India take a far more proactive role in ensuring that medical colleges have
all the necessary facilities, clinical materials, teaching faculty, staff,
accommodation etc. the health of the people of our country will take a hit
in the coming years due to inadequately educated doctors. Quality in
medical education is equally important, if not more, than quantity.
3. The respondent Kalinga Institute of Medical Sciences (for short
KIMS) is a recognized medical college. It is entitled to admit 100
students every year to the MBBS course.
4. For the academic year 2014-15, it was granted permission to admit an
additional 50 students over and above the 100 students that was already its
entitlement.
5. KIMS was desirous of granting admission to 100 plus 50 students for
the academic year 2015-16. With a view to ensure that adequate facilities
were available for the increased number of students, an inspection was
required to be carried out by the Medical Council of India (for short ‘the
MCI’) in accordance with the Medical Council of India Establishment of
Medical College Regulations, 1999.
6. Consequently, an inspection was carried out on 27th and 28th
January, 2015 by an Inspection Team of the MCI which revealed quite a sorry
state of affairs. A large number of serious deficiencies were pointed out
by the Inspection Team and communicated to the MCI. Thereafter, in a
communication sent by the MCI to the Dean Principal of KIMS on 31st
January, 2015 the deficiencies were indicated and KIMS was informed that a
show cause notice was proposed to be issued for withdrawal of recognition
of the courses run by it. Be that as it may, the MCI took a decision
recommending to the Central Government through the Ministry of Health and
Family Welfare (Department of Health and Family Welfare) to deny permission
to KIMS to add 50 additional seats for the MBBS for the academic year 2015-
16.
7. We enquired from learned counsel for the MCI the procedure for
carrying out an inspection. Our attention was drawn by learned counsel to
Page ‘J’ of the appeal paper-book wherein it is stated (and not denied)
that an inspection is conducted by a team of three neutral Professors. Of
these, one is a coordinator and the other two are taken from an approved
list of eminent medical Professors from reputed Government institutions
only. Some of the institutions mentioned are the All India Institute of
Medical Sciences, Post Graduate Institute, Chandigarh, Maulana Azad Medical
College (Delhi), Safdarjung College (Delhi), Medical College (Kolkata),
Madras Medical College (Chennai), Osmania Medical College (Hyderabad),
Grant Medical College (Mumbai), G.S. Medical College (Mumbai), Bangalore
Medical College (Bengaluru) etc. There is therefore no doubt that not only
are the medical colleges highly reputed but it is also stated that the
Professors from these colleges are eminent medical Professors randomly
selected by computer software from a list of coordinators and inspectors.
8. Our attention was also drawn to the decision of this Court in
Manohar Lal Sharma v. Medical Council of India[1] wherein it was held that
since the inspection is taken by “doctors of unquestionable integrity and
reputation, who are experts in the field, there is no reason to discard the
report of such an inspection.” In the present appeal, there is no
allegation made by KIMS of any mala fides of the Inspection Team or any
perversity in the inspection report and hence there is no question of
challenging the conclusions of a neutral, randomly selected Inspection Team
in its assessment.
9. As mentioned above, the inspection report and the decision of the
MCI were communicated to the Central Government. On a consideration of the
material made available, the Central Government sent a communication dated
15th June, 2015 to the Dean Principal of KIMS directing the institute NOT
to admit any students in the second batch of MBBS course against the
increased intake from 100 to 150 seats for the academic year 2015-16. The
text of the letter sent by the Central Government to the Dean Principal of
KIMS on 15th June, 2015 reads as follows:
“I am directed to refer to MCI letter (s) dated 01.04.2015 thereby
recommending to the Central Government not to renew the permission for
admission of 2nd batch of MBBS course against increased intake i.e. from
100-150 seats Kalinga Institute of Medical Sciences, Bhubaneswar for the
academic year 2015-16 and to say that the Central Government has decided to
accept the recommendations of MCI.
2. You are therefore directed NOT to admit any student in 2nd batch of
MBBS course against increased intake i.e. from 100-150 seats for the
academic year 2015-16. Admission in next batch of students against
increased intake for the year 2016-17 will be made only after obtaining the
Central Government Permission.
3. Any admission made in this regard will be treated as irregular and
action will be initiated as per the provisions of IMC, Act, 1956 and
Regulations made thereunder.
4. Further, the MCI has also informed to apply Clause 8(3)(1) (c) & (d) of
Establishment of Medical College Regulation (amendment), 2010.”
10. Feeling aggrieved by the adverse decision, KIMS preferred a writ
petition in the High Court of Orissa being W.P. (C) No.15685 of 2015. The
writ petition was taken up for consideration on 14th September, 2015 when
the direction dated 15th June, 2015 passed by the Central Government was
set aside on the ground that no hearing was given to KIMS before that order
was passed. The High Court then directed KIMS to appear before the
Secretary to the Government of India in the Department of Health and Family
Welfare or any other authorized officer on 18th September, 2015 with all
documentary evidence. The said officer was directed to hear KIMS, consider
the compliance reports of KIMS and the views of the MCI and then pass
necessary orders.
11. In obedience to the order passed by the High Court a hearing was given
to KIMS by a Hearing Committee. Thereafter, the Central Government passed
an order on 24th September, 2015 which observed as follows:
“The college was earlier given hearing on 12.03.2015. The compliance
submitted by the college is same as the last time. Though the college
claims to have rectified the deficiencies, it can only be verified through
physical assessment by MCI.
The deficiencies are non-condonable. The documents alone submitted by the
college do not sufficiently inspire confidence as to rectification of the
deficiencies. Therefore, this Committee has considered the assessment
report of the MCI assessors dated 27th and 28th January, 2015 and the
compliance report submitted by the representatives of the college and
decided that the Ministry may accept recommendation of MCI.”
12. On a consideration of the order passed by the High Court and the
recommendations of the MCI, the Central Government decided not to renew the
permission for admitting the second batch of MBBS students against the
increased intake that is from 100 to 150 for the academic year 2015-16 at
KIMS.
13. The writ petition was then taken up for consideration by the High
Court on 25th September, 2015. The High Court considered the facts of the
case and placed reliance on Rajiv Memorial Academic Welfare Society v.
Union of India[2] (which appeal was decided in the circumstances of the
case and was not a general direction) and a decision of the Kerala High
Court and directed, inter alia, that the Central Government shall grant
provisional permission to KIMS to conduct the course for the additional 50
students in the academic year 2015-16. While giving this direction, the
High Court noted that admission to the MBBS course was required to be
completed by 30th September, 2015. The High Court made it clear that this
interim order would be subject to further orders passed in the writ
petition and it was also made clear that neither KIMS nor any of the
students would claim any equity on the basis of the approval permission
granted by virtue of the orders of the High Court.
14. Pursuant to the mandatory direction given by the High Court, the
Ministry of Health and Family Welfare passed an order on 28th September,
2015 granting provisional permission to KIMS to conduct the MBBS course for
the second batch against the increased intake from 100 to 150 MBBS seats
for the academic year 2015-16 subject to certain conditions. One of the
conditions was to the effect that KIMS would make it clear to the students
who are admitted that their admission is subject to the result of the writ
petition. Consequent upon this decision, KIMS admitted 50 students to the
MBBS course for the academic year 2015-16. These students are represented
before us in this appeal and have been heard.
15. At this stage, it may be mentioned that against the interim order dated
25th September, 2015 passed by the High Court, the MCI preferred a petition
in this Court which came up for consideration on 13th October, 2015. In
that petition being SLP (C) No. 28312 of 2015, special leave to appeal was
granted and the order passed by the High Court on 25th September, 2015 was
stayed and status quo as on the date on which the impugned order was passed
(25th September, 2015) was directed to be maintained.
16. Be that as it may, when the appeal filed by MCI came up for
consideration on 4th November, 2015 it was directed that the High Court
should endeavour to hear the pending writ petition expeditiously. It was
also directed that the interim order earlier passed on 13th October, 2015
would continue till the High Court decided the writ petition.
17. When the writ petition was again taken up by the High Court, an
amendment application was filed by KIMS and the amendment allowed. It is
not necessary to go into the details of the amendment since that has no
bearing in this appeal.
18. In any event, when the writ petition was taken up for expedited
consideration by the High Court on 3rd December, 2015 it was noted that 50
students had already been admitted by KIMS pursuant to the directions given
by High Court on 25th September, 2015 and the provisional permission
granted by the Central Government on 28th September, 2015. The admission
was of course subject to the outcome of the writ petition. The High Court
then directed that necessary affidavits be filed and in the meanwhile MCI
was directed to constitute a fresh Inspection Team to inspect KIMS and to
check up the purported compliance claimed by KIMS of the deficiencies
pointed out in the earlier inspection. It was further directed that the
Directorate of Medical Education and Training, Government of Odisha would
also participate in the inspection and the report be submitted on or before
23rd December, 2015.
19. Feeling aggrieved by the order passed by the High Court on 3rd
December, 2015 requiring the Directorate of Medical Education and Training,
Odisha to be a part of the Inspection Team, the MCI preferred a petition in
this Court being SLP (C) No.34856 of 2015. Special leave was granted and
by an order dated 16th December, 2015 it was made clear by this Court that
the Directorate of Medical Education and Training, Odisha shall not
participate in the inspection.
20. There appears to have been some dispute in this Court (which was not
resolved) with regard to the academic year for which the fresh inspection
was required to be carried out. According to learned counsel for the MCI
the inspection was to be carried out for 2016-17 while this was opposed by
learned counsel appearing for KIMS. This Court however did not record
anything in this regard one way or the other.
21. A fresh inspection was in fact carried out by MCI on 7th and 8th
January, 2016 and the Inspection Team once again found a very large number
of deficiencies in the facilities available at KIMS. The report of the
Inspection Team and the consequent resolution of the MCI were communicated
to the Central Government to the effect that the Central Government should
not renew permission for admission of the 3rd batch of MBBS students
against the increased intake from 100 to 150 seats for the academic year
2016-17.
22. Thereafter, the pending writ petition was taken up for hearing by the
High Court on 17th February, 2016 and the impugned judgment and order
delivered on 4th March, 2016.
23. A perusal of the decision of the High Court clearly indicates that it
considered the latest report of the Inspection Team as if it was hearing an
appeal against the report. In doing so, the High Court went into great
details on issues relating to the number of teaching beds in the hospital,
the limitations in the OPD Department, the number of units available in the
subjects of General Medicine, Pediatrics etc., bed occupancy, number of
Caesarean sections, discrepancy in data of major and minor operations,
computerization in the institution, number of patients in the ICU, number
of static X-ray machines, deficiency of examination halls, lecture
theatres, library, students hostel, interns hostel, playground etc. etc.
Surely, this was not within the domain of the High Court in exercise of its
jurisdiction under Article 226 of the Constitution.
24. The High Court did not appreciate that the inspection was carried out
by eminent Professors from reputed medical institutions who were experts in
the field and the best persons to give an unbiased report on the facilities
in KIMS. The High Court under Article 226 of the Constitution was certainly
not tasked to minutely examine the contents of the inspection report and
weigh them against the objections of KIMS in respect of each of its 18
items. In our opinion, the High Court plainly exceeded its jurisdiction in
this regard in venturing into seriously disputed factual issues.
25. Learned counsels for KIMS and the students submitted that the High
Court was left with no option but to critically examine the report of the
Inspection Team since it was factually erroneous and did not deserve to be
relied on either for the increase in intake of seats for the academic year
2015-16 or the academic year 2016-17. We see no reason to accept the
submission of learned counsels.
26. Medical education must be taken very seriously and when an expert body
certifies that the facilities in a medical college are inadequate, the
Courts are not equipped to take a different view in the matter except for
very cogent jurisdictional reasons such as mala fides of the Inspection
Team, ex facie perversity in the inspection report, jurisdictional error on
the part of the MCI etc. Under no circumstance should the High Court
examine the report as an appellate body – this is simply not the function
of the High Court. In the present case there was no ground made out at law
for setting aside the report of the Inspection Team.
27. The High Court was of opinion that the Inspection Team was required to
conduct the inspection with reference to the academic year 2015-16 but the
report pertains to the academic year 2016-2017. If that was so, the High
Court could have passed an appropriate order in this regard rather than
examine and scrutinize the inspection report prepared for the academic year
2016-17 which academic year was not at all the subject matter of
consideration or discussion before it. Moreover, invalidation of the
inspection report for the academic year 2016-17 would not automatically
invalidate the inspection report for the academic year 2015-16.
Unfortunately, the High Court spent its energy on adjudicating a non-issue.
28. It appears to us that both the MCI and the Central Government each
having twice considered the inspection report submitted by neutral medical
Professors, with the Central Government having given a personal hearing to
KIMS on the second occasion (and perhaps on the first occasion as well) the
matter ought to have been given a quietus by the High Court at least for
the academic year 2015-16.
29. That apart, we are of opinion that the High Court ought to have been
more circumspect in directing the admission of students by its order dated
25th September, 2015. There was no need for the High Court to rush into an
area that the MCI feared to tread. Granting admission to students in an
educational institution when there is a serious doubt whether admission
should at all be granted is not a matter to be taken lightly. First of all
the career of a student is involved – what would a student do if his
admission is found to be illegal or is quashed? Is it not a huge waste of
time for him or her? Is it enough to say that the student will not claim
any equity in his or her favour? Is it enough for student to be told that
his or her admission is subject to the outcome of a pending litigation?
These are all questions that arise and for which there is no easy answer.
Generally speaking, it is better to err on the side of caution and deny
admission to a student rather than have the sword of Damocles hanging over
him or her. There would at least be some certainty.
30. Whichever way the matter is looked at, we find no justification for the
orders passed by the High Court particularly the order dated 25th
September, 2015 and the order dated 4th March, 2016.
31. It was submitted by the learned counsel for the KIMS that the Central
Government has decided to accept the decision of the High Court and it has
in fact issued an order dated 26th April, 2016 virtually to this effect.
We have gone through the order dated 26th April, 2016 and find that the
permission granted to continue with the studies of the students for the
academic year 2015-16 is subject to the orders passed by this Court in this
appeal. Since we are allowing the appeal and setting aside the order
passed by the High Court, the order dated 26th April, 2016 passed by the
Central Government is of no consequence and does not come to the aid of
KIMS or the students.
32. Learned counsel for KIMS and the students contended that unless this
appeal is dismissed it will result in the students suffering a loss of two
years of their studies. This may be so – but if such a situation has come
to pass, KIMS is entirely to be blamed. KIMS was specifically told not to
admit students by the Central Government in its letter dated 15th June,
2015. Despite this KIMS persisted in litigation to somehow or the other
accommodate 50 additional students. This was certainly not with a
charitable motive. As an institution that should have some responsibility
towards the welfare of the students, it would have been far more
appropriate for KIMS to have refrained from giving admission to 50
additional students rather than being instrumental in jeopardizing their
career.
33. However, for the fault of KIMS, the students should not suffer nor
should KIMS get away scot free. KIMS must pay for its inability to
introspect and venture into adventurist litigation. Accordingly, we direct
as follows:
The admission granted to the 50 students pursuant to the order of the High
Court dated 25th September, 2015 and the provisional permission granted by
the Central Government only on 28th September, 2015 shall not be disturbed.
How the students will complete their course of studies without putting
undue pressure on them is entirely for the MCI and KIMS and other concerned
authorities to decide.
Costs of Rs. 5 crores are imposed on KIMS for playing with the future of
its students and the mess that it has created for them. The amount will be
deposited by KIMS in the Registry of this Court within six weeks from
today. The amount of Rs. 5 crores so deposited towards costs shall not be
recovered in any manner from any student or adjusted against the fees or
provision of facilities for students of any present or subsequent batches.
KIMS is restrained from increasing the intake of students from 100 students
to 150 students for the MBBS course for the academic year 2016-17 and 2017-
2018. The MCI and the Central Government shall enforce strict compliance of
this direction.
The MCI or the Central Government will proceed to take action against KIMS
(if deemed advisable) under Clause 8(3) of the Medical Council of India
Establishment of Medical College Regulations, 1999 (as amended) as
mentioned in the communication of 15th June, 2015 of the Central
Government.
During the hearing of the appeal, we were informed that there is no fixed,
set or laid down procedure prepared by the MCI for conducting an inspection
or assessment as postulated by the Medical Council of India Establishment
of Medical College Regulations, 1999. Rather than every Inspection Team
following its own procedure for conducting an assessment, the MCI should in
consultation with the Central Government prepare a Standard Operating
Procedure for conducting an inspection as required by the Medical Council
of India Establishment of Medical College Regulations, 1999. The Standard
Operating Procedure should be finalized within a period of six weeks from
today and should be accessible on the website of the MCI.
To introduce transparency and accountability in the medical colleges, the
report or assessment of the Inspection Team should be put up on the website
of the concerned medical college as also on the website of the MCI so that
potential students are aware of what is likely to be in store for them.
Similarly, the decision of the Central Government on the report should be
put up on the website of the concerned medical college as also on the
website of the MCI.
34. To ensure compliance of Directions 2 and 5 and for an update on
Directions 4 and 6 list the appeal in the first week of July 2016.
35. The appeal is disposed of on the above terms.
..……………………..J
(Madan B. Lokur)
New Delhi; ………………………J
May 6, 2016 (N.V. Ramana)
———————–
[1] (2013) 10 SCC 60
[2] 2016 (3) SCALE 184
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