Supreme Court of India
MEDICAL COUNCIL OF INDIAversusTHE CHAIRMAN, S. R. EDUCATIONAL AND CHARITABLE TRUST & ANR.
- Citation
- 2018 INSC 1014
- Decided
- 29 October 2018
- Disposal
- Appeal(s) allowed
- Bench
- ARUN MISHRA
Holding
The Supreme Court held that the High Court erred in quashing the Government’s order; the statutory regulations are binding and the MCI’s decision to deny admission based on gross deficiencies stands, and the Hearing Committee’s recommendation to review compliance is not binding.
Summary
The Medical Council of India (MCI) appealed against a Kerala High Court order that quashed the Government of India's decision to deny renewal of permission and admission to several medical colleges on the ground of gross deficiencies. The Supreme Court examined whether the Hearing Committee’s recommendation to review compliance was binding, and whether the MCI could refuse to reconsider after the statutory deadline. It held that the Establishment of Medical Colleges Regulations 1999, particularly Regulation 8(3)(1)(a) and (b), are mandatory and preclude granting admission when faculty shortfall exceeds 30% (or 20% for later batches) or bed‑occupancy falls below the prescribed thresholds. Consequently, the High Court’s direction to admit students and to order a fresh inspection without regard to the regulations was illegal. The Court set aside the High Court judgment, upheld the Government’s order, and allowed the MCI’s appeal.
Issues considered
- The propriety of the High Court’s quashing of the Government’s order denying renewal of permission and admission to the medical colleges.
- Whether the Hearing Committee’s recommendation to review compliance is binding on the MCI and the Government.
- Whether the MCI can decline to review the compliance report after the statutory deadline.
- The mandatory nature of Regulation 8(3)(1)(a) and (b) of the Establishment of Medical Colleges Regulations, 1999 in cases of gross deficiencies.
- Whether a court can interfere with the factual findings of the assessors’ inspection report.
Legislation cited
- Indian Medical Council Act, 1956s. 10A, s. 11(2), s. 33
Subjects
medical educationrenewal of permissionMedical Council of IndiaEstablishment of Medical Colleges Regulationsjudicial reviewadmission to medical collegesfaculty deficiencybed occupancySection 10Ahearing committee
Judgment
[2018] 10 S.C.R. 1039 1039
MEDICAL COUNCIL OF INDIA A
v.
THE CHAIRMAN, S. R. EDUCATIONAL AND CHARITABLE
TRUST & ANR.
(Civil Appeal No. 10372 of 2018) B
OCTOBER 29, 2018
[ARUN MISHRA AND VINEET SARAN, JJ.]
Education/Educational Institutions:
Medical Colleges – Denial of renewal permission/ C
recognition – Propriety of – On inspection of colleges by Medical
Council of India (MCI) deficiencies found – Government of India/
Hearing Committee directed MCI to review the recommendation and
consider the compliance reported – MCI declined to review its
recommendation – Thereafter Government of India denied renewal/
D
recognition – Writ petition challenging the denial – High Court
quashed the orders whereby permission was declined – Directed to
admit students to the Colleges for academic year 2018-19 – Also
directed MCI to carry out inspection to verify rectification of the
deficiencies found at the time of earlier inspection – On appeal,
held: For effective implementation of provision of s. 10A of Medical E
Council Act, 1999 Regulations have been made – The Regulations
are binding with respect to availability of teaching faculty,
infrastructural and other facilities – With the advancement of the
batches, this requirement becomes more rigorous – Therefore,
recommendations made by Hearing Committee to review and consider
F
the compliance is not binding – Provisions of 8(3)(1)(a) and (b) are
binding upon the Hearing Committee/Government of India and
MCI – In case there are gross deficiencies, more than prescribed in
the Regulation, for the concerned batch, then the compliance
verification would not be considered in the same year – A decision
taken by Union of India on the basis of recommendation of an expert G
body regarding the inadequacy of facilities cannot be interfered
with lightly – Interference is permissible only when there are
jurisdictional errors, ex facie perversity or mala fide – High Court
has gravely erred in law in quashing Government’s order, allowing
the admissions for academic session 2018-19 without there being
H
1039
1040 SUPREME COURT REPORTS [2018] 10 S.C.R.
A permission by Government of India and recommendation of MCI –
Such general directions without considering the provisions of the
Regulations are illegal and unwarranted and on inspection decision
has to be taken in accordance with law as per regulations – However,
it would be appropriate that MCI and Government of India take
decision at an early date i.e. by the end of February or latest by
B
March and not by the end of the Scheduled date i.e. May –
Establishment of Medical Colleges Regulations, 1999 – Regulation
8(3)(1)(a) and (b) – Judicial Review.
Allowing the appeals, the Court
C HELD: 1. The Medical Council of India (MCI) has been
established in order to streamline the standard of medical
education. It has the power to supervise qualification and eligibility
standards for admissions into medical institutions. [Para 22]
[1061-E]
D State of Kerala v. T. P. Roshna (1979) SCC 580; Medical
Council of India v. State of Karnataka (1998) 6 SCC
131 : [1998] 3 SCR 740 – relied on.
2. For effective implementation of provisions of Section 10A
of the Indian Medical Council Act, 1956 requiring prior
E permission from the Central Government for the establishment
of medical colleges, regulations have been made in exercise of
powers under Section 10A read with Section 33 of the Act.
Consequently, the Establishment of Medical Colleges
Regulations 1999 are binding with respect to availability of
teaching faculty, infrastructural and other facilities and with the
F advancement of the batches this requirement becomes more
rigorous as there is more requirement in the faculty than the
college is recognized after fulfillment of all the conditions as
apparent from the provisions contained in the Regulations. With
the aforesaid objective, the provisions contained in Regulation
G 8(3) have been carved out and amended in 2016. In case there
are gross deficiencies, more than prescribed in regulation for
the concerned batch then the compliance verification would not
be considered in the same academic year. [Paras 24-25] [1062-
D-G]
H
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1041
CHARITABLE TRUST
Dr. Preeti Srivastava v. State of Madhya Pradesh & Ors. A
(1999) 7 SCC 120 : [1999] 1 Suppl. SCR 249 – relied
on.
3. It is apparent from regulation 8(3)(1)(a) of Regulations
of 1999 that in the case of the third batch, if deficiencies of
teaching faculty and/or residents are found to be more than 30% B
and bed occupancy less than 50%, a college cannot be given an
opportunity for compliance in the same year. In the case of the
4th and 5th batch as provided in regulations 8(3)(1)(b), if the
deficiencies of teaching faculty and the residents is more than
20% and bed occupancy is less than 65%, such college cannot
be given opportunity of reporting compliance during the same C
academic year. [Paras 14 and 15] [1056-A-B]
4. Considering the deficiencies in case of S.R. Educational
Trust, Regulation 8(3)(1)(a) was attracted. In Al-Azhar Medical
College and P. K. Dass Institute of Medical Sciences for 5th Batch
deficiencies found by the assessors were gross so as to attract D
the provisions contained in amended Regulation 8(3)(1)(b). [Para
16] [1056-C]
5. Therefore, the recommendations made by the Hearing
Committee to review and to consider the compliance could not
be said to be binding. The provisions of the regulations 8(3)(1)(a) E
and (b) are binding upon the Hearing Committee/Government of
India and the MCI. It is only in a case when a report of the
Assessors on the face of it, makes out that the same is incorrect,
a reconsideration or review is called for. Otherwise, in the case
of gross deficiency, the yardstick contained in regulation 8(3)(1)(a) F
or (b) has to be applied by the Hearing Committee, Government
of India or the MCI, as the case may be. It is not open to the
Government of India/ MCI or Hearing Committee to depart in a
few cases and in some other to take a different stand. They have
to scrupulously observe the provisions of regulations which are
binding on them. [Para 26] [1036-B-D] G
Royal Medical Trust (Registered) & Anr. v. Union of
India & Anr. (2015) 10 SCC 19; Madha Medical
College and Research Institute v. Union of India & Anr.
(2017) 15 SCC 791; I.Q.City foundation and Anr. v.
Union of India & Ors. (2017) 16 SCC 249 – relied on. H
1042 SUPREME COURT REPORTS [2018] 10 S.C.R.
A 6. It is high time for the MCI to ensure its functions well
and eradicate all the loop-holes and decide the case within a
reasonable time and not to lend the colleges in a situation with
no legal remedy available once case is decided at the fag end of
the academic session on 31st May. It would be appropriate that
MCI and Government of India take a decision in all the cases at
B
an early date and not by the end of May 2018. The next academic
session has to commence from first of July of the Gregorian
calendar year as such at least 3-4 months’ time should be available
to seek judicial review of the action or re-inspection, if any, so
warranted by the MCI or Government of India. Once a petition
C is filed and even if in some cases the Court is inclined to grant a
relief of re-inspection to a college, but due to the lapse of the
time schedule and the admissions having already been made, it
is not considered appropriate to disturb the uniform schedule of
various Universities. It would be appropriate that the MCI, as
well as the Government of India, should take a final decision after
D
inspection, by the end of February or latest by the end of March.
[Para 28] [1063-G-H; 1064-A-B]
Medical Council of India v. Vedantaa Institute of
Academic Excellence Pvt. Ltd. & Ors. (2018) 7 SCC
225; Medical Council of India v. The Principal, KMCT
E Medical College, and Anr. (2018) 9 SCC 766 – relied
on.
7. In the case of P.K. Dass Institute of Medical Sciences,
as per the Assessors, the bed occupancy was 40.30% i.e. 262
patients out of 650 patients which were required. Whereas college
F claimed that 493 indoor patients were there at 10.00 am on
31.10.2017. There was 80% bed occupancy on 30-31.10.2017
and 1.11.2017. The College has drawn support from the website
portal. Whatever college says is not a gospel truth. There is no
case wherein college does not dispute the report of the Assessors
G and contend that there were no such deficiencies. It is clearly
disputed fact. Firstly, the report of the Assessors cannot be lightly
disbelieved. It is not open to examining the case set up by the
college as facts found by Assessors are at great variance;
secondly, in the judicial review, the report cannot be discarded
relying on data put up by the college on self-serving website
H
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1043
CHARITABLE TRUST
portal. The High Court was right in discarding the explanation A
offered by the colleges with respect to deficiencies. Even the
Hearing Committee with respect to the College did not doubt
the report of Assessors as to bed occupancy. It is not what the
institution asserts on website but what is actually found on
inspection, that has to be considered by the court and while
B
exercising judicial review it is settled law that court cannot sit in
appeal over the report of the assessors. It was also observed
that at the time of inspection faculty should be present barring
certain exceptions otherwise the very purpose of the inspection
would be defeated. The Report of the Assessors cannot be lightly
faulted and the court cannot sit in an appeal and go into disputed C
facts. There were other deficiencies too but due to the aforesaid
gross deficiencies, the provisions of regulations 8(3)(1)(b) were
clearly attracted. [Paras 30-31] [1065-A-D, G-H; 1066-E-F]
Medical Council of India v. N.C. Medical College &
Hospital and Ors. 2018 (9) JT 204; Medical Council D
of India vs. Kalinga Institute of Medical Sciences
(KIMS) & Ors. (2016) 11 SCC 530 : [2016] 4 SCR 403
– relied on.
8. A decision taken by the Union of India on the basis of a
recommendation of an expert body regarding the inadequacy of E
facilities in medical colleges cannot be interfered with lightly.
Interference is permissible only when the colleges demonstrate
jurisdictional errors, ex facie perversity or mala fide. It is not
open to the court in judicial review to accept tenuous objections
as to bed occupancy in the absence of mala fide. [Para 32] [1067-
B-C] F
Medical Council of India v. The Principal, KMCT
Medical College, and Anr. (2018) 9 SCC 766 – relied on.
9. The High Court has gravely erred in law while passing
the impugned judgment and order in quashing Government’s G
order, allowing the admissions for the academic session 2018-
2019 without there being Government of India’s permission and
the recommendation of the MCI. The High Court has issued
direction for fresh inspection and thereafter the MCI to consider
the report after the grant of opportunity to remove defects if any.
H
1044 SUPREME COURT REPORTS [2018] 10 S.C.R.
A Firstly, it could not have issued such a direction in view of
regulations and also the blanket direction that college should be
permitted to remove the deficiencies if any found. Deficiencies
can be removed, if found, within the permissible limits as provided
in regulation 8(3), not in a case Regulation 8(3)(1)(a) or (b) is
attracted. Thus, such kind of general direction issued without
B
considering the provisions of the Regulations are wholly illegal
and unwarranted and on inspection, the decision has to be taken
in accordance with law as per regulations. [Para 33] [1067-C-F]
10. The case of D.M. Education and Research Institute of
Medical Sciences is of recognition and admission. For the purpose
C of recognition, the Regulations of 1999 contains the provisions
in Regulation 8(3)(1) wherein the process of renewal of permission
will continue till such time the establishment of the medical college
and expansion of the hospital facilities are completed and a formal
recognition of the medical college is granted. Further admissions
D shall not be made at any stage unless the requirements of the
Council are fulfilled. The Central Government may at any stage
convey the deficiencies to the applicant and provide him an
opportunity and time to rectify the deficiencies. It is the stand of
the MCI also that the matter of recognition is under consideration
and shall be considered in terms of said regulation after giving
E the opportunity to make good deficiency. However, with respect
to admissions in 2018-19, the recommendation was made not to
admit the students. [Paras 34 and 39] [1068-C-D; 1071-H; 1072-
A-B]
11. It was clearly mentioned by the MCI in its letter dated
F 25.5.2018 that the matter could not be considered for renewal of
permission for admission for the academic year 2018-2019, but
compliance of the medical college for the purpose of recognition/
approval under Section 11(2) of the Act was under consideration
of the MCI and compliance verification/assessment and
G recommendations of the MCI would be sent to Central
Government in due course of time. The matter was under
consideration before the MCI for recognition, renewal of
permission for admission had been declined by the MCI on
28.5.2018. Thereafter, the Government of India has passed the
order on 31.5.2018 declining admission for 2018-19. [Para 40]
H [1072-D-F]
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1045
CHARITABLE TRUST
12. In view of the deficiencies of faculty and of bed A
occupancy, the decision not to grant permission for admission in
the year 2018-2019 was appropriate. However, the compliance
that had been submitted by the college on 22.5.2018 will be
considered for the purpose of recognition by the MCI as provided
under the regulation 8(3). Let the MCI consider the matter for
B
the purpose of recognition duly considering the compliance
unfettered by the order passed by the Government of India on
31.5.2018. The Government of India also to consider the matter
of recognition in accordance with the law. Let the decision be
taken by the respondents- MCI and Government of India as
expeditiously as possible. [Para 41] [1072-F-H] C
Mridul Dhar v. Union of India (2005) 2 SCC 65 : [2005]
1 SCR 380; Priya Gupta v. State of Chhattisgarh (2012)
(7) SCC 433 : [2012] 5 SCR 768 – relied on.
Swamy Devi Dayal Hospital & Dental College v. Union
of India & Ors. AIR 2014 SC 284 : [2013] 14 SCR 105; D
Priyadarshini Dental College and Hospital v. Union of India
& Ors. 2011 AIR SCW 2383 : (2011) 4 SCC 623 : [2011]
2 SCR 945; D.M. Education and Research Foundation
v. Union of India [2016 KHC 171] 5 – referred to.
Case Law Reference E
[2013] 14 SCR 105 referred to Para 5
[2011] 2 SCR 945 relied on Para 5
2016 KHC 171 relied on Para 5
(2018) 7 SCC 225 relied on Para 6
(2018) 9 SCC 766 relied on Para 6 F
(2015) 10 SCC 19 relied on Para 18
(2017) 15 SCC 791 relied on Para 18
(2017) 16 SCC 249 relied on Para 18
[1998] 3 SCR 740 relied on Para 23 G
(1979) SCC 580 relied on Para 22
2018 (9) JT 204 relied on Para 31
[2016] 4 SCR 403 relied on Para 31
[2005] 1 SCR 380 relied on Para 40
[2012] 5 SCR 768 relied on Para 40 H
1046 SUPREME COURT REPORTS [2018] 10 S.C.R.
A CIVIL APPELLATE JURISDICTION : Civil Appeal No. 10372
of 2018
From the Judgment and Order dated 30.08.2018 of the High
Court of Kerala at Ernakulum in W.P. (C) No. 19386 of 2018.
WITH
B
C.A. Nos. 10373, 10374, 10375 of 2018.
Vikash Singh, Jaideep Gupta, Neeraj Kishan Kaul, Huzefa
Ahmedi, C. S. Vaidyanathan, Ajit Kumar Sinha, Sr. Advs., Gaurav
Sharma, Prateek Bhatia, Abhishek, Dhawal Mohan, Prasanna Mohan,
C Vishal Arun, G. Prakash, Jishnu M. L., Ms. Beena Prakash, Divyanshu
Srivastava, Vivekananda Bomminneni, Varun Mathur, Hario Beeran,
Usman Ghani Khan, Pallavi Pratap, Zulfiker Ali P. S, Radha Shyam
Jena, K. V. Mohan, George Jacob, K. V. Balakrishnan, Anirudh Gupta,
Gaurav Sharma, Venkita Subramani T. R., P. Sreekumar, Amit
Sharma, Raghenth Basant, Mithun Verghis, Advs. for the appearing
D parties.
The Judgment of the Court was delivered by
ARUN MISHRA, J. 1. The Medical Council of India (for short,
“the MCI”) is aggrieved by the judgment and order dated 30.8.2018
passed by the High Court of Kerala at Ernakulam. The High Court has
E
quashed the order passed by the Government of India declining to grant
renewal permission/ recognition to respondents – medical colleges. The
High Court has directed the Commissioner for Entrance Examinations,
Government of Kerala to allot students to the colleges for the academic
year 2018-2019 immediately. The MCI has also been directed to carry
F out the inspection to verify whether the colleges had rectified the
deficiencies found at the time of earlier inspection. In case they have
not done so, the MCI shall be at liberty to take appropriate action against
them including the enforcement of the Bank Guarantees. At the same
time, it has been ordered that in case fresh deficiencies are detected, the
colleges shall be given the opportunity to rectify such deficiencies within
G
a stipulated time.
2. The High Court has decided the petitions of the four colleges
by the common order. Probably, High Court had felt that the question on
which it decided the matters was common, however, the facts of each
and every college are different, the deficiencies found obviously varies
H
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1047
CHARITABLE TRUST [ARUN MISHRA, J.]
and the order of the High Court is subject to further judicial review. It A
would have been appropriate for the High Court to decide the matter by
separate orders duly reflecting the facts of each case and the deficiencies
found. Clubbing of matters in the method and manner it had been done
may indicate non-serious approach. In three of the matters, question
was that of admissions in the academic session 2018-2019 and in one of
B
the matters, the question pertains to the grant of recognition as well as
admissions.
3. The High Court has observed that there are many serious
deficiencies and the lack of patients would result in a lack of exposure
of the students in so far as treatment of patients was concerned. The
deficiencies, such as lack of teaching faculty, residents, lack of a sufficient C
number of surgical procedures, though, are of nature which would have
a serious impact on the quality of education, the explanation offered by
the colleges on the deficiencies has not been found to be genuine to
impress the court. Notwithstanding the aforesaid observations, the High
Court has proceeded to grant the relief to the medical colleges. D
4. The colleges had contended that they had rectified the
deficiencies and the Hearing Committee had recommended the MCI to
review the case. Accordingly, the Central Government had required the
MCI to review its earlier stand. However, the Executive Committee of
MCI refused to reconsider its earlier stand in view of the provisions E
contained in the Regulations 8(3)(1)(a) of the Establishment of Medical
College Regulations, 1999 (for short, “the Regulations”). The MCI
declined to review the order on the ground that the time for the MCI to
send its recommendations to Central Government had already expired
on 30th April 2018 and the schedule was required to be strictly adhered
to. F
5. The High Court had observed that opportunity of hearing would
mean to make a representation. Timely assessment is integral to the
scheme and such an opportunity is to be given not only when permission
for the establishment of a new college is under consideration but even in
cases of subsequent renewal of such permission. The High Court had G
referred to the decisions in Swamy Devi Dayal Hospital & Dental
College v. Union of India & Ors. AIR 2014 SC 284 and Priyadarshini
Dental College and Hospital v. Union of India & Ors., 2011 AIR
SCW 2383= 2011 (4) SCC 623. At the time of renewal what is required
to be considered is whether the prescribed faculty and infrastructure is H
1048 SUPREME COURT REPORTS [2018] 10 S.C.R.
A available. There is some difference between the renewal and the
parameters prescribed for the establishment. The High Court has relied
upon the decision in D.M. Education and Research Foundation v.
Union of India [2016 KHC 171] in which a Division Bench of the High
Court of Kerala held that the principle of natural justice has to be strictly
adhered to. The stand taken by the MCI had been rejected and it was
B
observed that compliance once reported was required to be considered,
thus, the MCI ought to have reconsidered the matter. In the cases, the
recommendation to review had not been considered, lack of time could
not be accepted as an excuse to deny the petitioner the right claimed to
which they were entitled.
C 6. It was urged by learned senior counsel for the MCI that the
High Court has failed to consider the provisions contained in the Regulation
8(3)(1)(a) of the Regulations that was attracted in the matter of grant of
renewal/ recognition. If upon assessment the deficiencies had been found
to be gross as provided in the aforesaid regulation, the college was not
D entitled to seek liberty of compliance and further verification in the same
academic year. The decision of this court in Medical Council of India
v. Vedantaa Institute of Academic Excellence Pvt. Ltd. & Ors. 2018
(7) SCC 225 though referred to in the judgment, has not been discussed
but, the decision of the Division Bench of the High Court has been
preferred which was contrary to it. Similarly, the decision of this Court
E in Medical Council of India v. The Principal, KMCT Medical
College, and Anr. (Civil Appeal No.8429 of 2018) had not been adverted
to. In the matter of D.M. Education and Research Foundation (supra)
the compliance was reported by the college belatedly on 22.5.2018. Thus,
considering the time schedule, it was not possible to make the inspection
F again for verification of the compliance. Therefore, it was not legally
permissible to grant any relief for the academic session 2018-2019 to
the said college. However, it was the case of recognition where the
main provision of regulation 8 (3)(1) was applicable. For recognition, its
case would be considered and admissions can be made only in the next
academic session i.e. 2019-2020 if permitted.
G
7. Shri Neeraj Kishan Kaul, learned senior counsel appearing on
behalf of the two of the colleges contended that when the Government
of India/Hearing Committee had directed the MCI to review the
recommendation and consider the compliance reported, the order was
binding upon the MCI. It was necessary for the MCI to consider the
H
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1049
CHARITABLE TRUST [ARUN MISHRA, J.]
compliance that was reported and to conduct a fresh inspection for A
assessment, in case, it was so required and thereafter to take decision
afresh. Declining to review the earlier recommendation clearly indicate
that there was non-application of mind and subsequently Government of
India erred in accepting the stand of the MCI declining to review and
consider the compliance. Thus, the High Court was fully justified to
B
permit the colleges to admit the students subject to removal of the
deficiencies and liberty has been given to the MCI to inspect the colleges
and in case of deficiencies still subsist, to take appropriate action.
8. Mr. C.S. Vaidyanathan, learned senior counsel appearing on
behalf of the respondent college - P.K. Dass Institute of Medical Sciences
vehemently contended that the report of the Assessors was absolutely C
incorrect. The website portal of the college clearly indicated the number
of indoor patients occupying the beds in the hospital. The patients were
more than 500. The Assessors had wrongly reported the number of
indoor patients in their report. A large number of patients were in the
operation theatre, bathrooms, and other places. They have been illegally D
excluded. He further contended that somebody is required to consider
all these factual aspects. The High Court has also not considered the
explanation offered. At some level, somebody is required to consider
the compliance. Assessors cannot be said to be the final arbiter in such
matters when the report is ex-facie incorrect as apparent from the
explanation offered by the college. Thus, this court should look in the E
same and grant the relief to the college discarding the report of the
Assessor.
9. Shri Hufeza H. Ahmedi, learned senior counsel appearing on
behalf of D.M. Education and Research Foundation contended that the
case of the respondent falls for recognition and proviso (a) to Regulation F
8(3)(1) of Regulations was not attracted. The opportunity of compliance
was required to be given and by not giving opportunity the regulation has
been violated. Thus, the decision rendered by the MCI/Government of
India cannot be said to be appropriate. The MCI, thus, deserves to be
directed to take a decision afresh in the matter of college in question. G
No case for interference is made out in the matter of D.M. Education
and Research Foundation as the matter was with respect to the
recognition-cum-admission.
10. When we consider the report of the Assessors, in the case of
S.R. Educational and Charitable Trust, the physical inspection was carried H
1050 SUPREME COURT REPORTS [2018] 10 S.C.R.
A out on 6th and 7th November 2017. The question involved was of 3rd
Batch of 100 students for the academic year 2018-2019. A large number
of deficiencies were found as observed in the order dated 31.5.2018
passed by the Government of India:
1. Deficiency of faculty is 12.64% as detailed in the report.
B 2. Shortage of Residents is 15.21 % as detailed in the report.
3. OPD attendance at 2 p.m. on the day of assessment is 575 against
the requirement of 600.
4. Bed Occupancy at 10 a.m. on the day of assessment is 37%.
C 5. There was NIL Major Operation on the day of assessment.
6. There was NIL Normal Delivery on the day of assessment.
7. The workload of Histopathology was NIL on the day of
assessment.
8. OPD: Separate Registration counters for male/ female are not
D available. Registration counters for OPD/ IPD patients are not
separate.
9. Audiometry room is not air-conditioned. Speech Therapy is not
available.
10. Casualty: Separate Casualty for O.G. is not available.
E
11. O.T.s: They are under renovation.
12. ICUs: There was NIL patient in SICU and only 1 patient in
ICCU and 2 patients each in MICU, PICU/ NICU.
13. Radiodiagnosis department: Only 1 Mobile X-ray machine is
F available against the requirement of 2. Only 1 Static X-ray
machine is available against the requirement of 2.
14. C.T. Scan is not available.
15. CSSD: Receiving and Distribution points are not separate.
16. Central Research Laboratory is not functional.
G
17. Lecture Theaters: 2 Lecture Theatres are available against the
requirement of 3.
18. Central Library: Students Reading room (Outside) is not furnished.
2,968 books are available against the requirement of 3,000.
H 19. Central Photography section is not available.
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1051
CHARITABLE TRUST [ARUN MISHRA, J.]
20. Students’ Hostels: They are shared with BDS students. A
21. Residents’ Hostel: It is not available.
22. Residential Quarters: NIL quarters are available for Non-teaching
staff.
23. Pathology department: Audiovisual aids are not available.
B
Specimens are not available in the Museum. 4 Service
Laboratories are not available.
24. Microbiology department: Audiovisual aids are not available. The
museum is not available. 7 Service Laboratories were not
available. Media Preparation facility, Autoclaving are not available.
C
25. Pharmacology department: Audiovisual aids are not available.
The museum is not available. Clinical Pharmacology laboratory
is not available.
26. Forensic Medicine department: Audiovisual aids are not available.
Museum is not available. Cold storage is not available. Autopsy
D
block is under construction.
27. Community Medicine department: Audiovisual aids are not
available. Museum is not available. Practical Laboratory is not
available. It is not furnished.
28. RHTC: Cold chain equipment is not available. Survey/ MCH/ E
Immunization/ FW Register are not available.
29. CME: There was no CME activity during the year.
30. Other deficiencies are as pointed out in the assessment report.
11. In the matter of Al-Azhar Medical College and Super Specialty
Hospital the Government of India in its order dated 31.5.2018 has F
mentioned the deficiencies found by the Assessors in the inspection made,
in the matter of renewal of permission for 5th Batch of 150 seats in
MBBS course for the academic year 2018-2019. The deficiencies
mentioned are extracted herein:
1. Deficiency of faculty is 37.12% as detailed in the report. G
2. Shortage of Residents is 100 % as detailed in the report.
3. Residents and Assistant Professors are drawing more salary than
Professors and HOD. All Senior and Junior Residents have been
appointed with orders mentioning duty hours from 8 am to 4.30
pm. Hence, they have not been counted as SR/JR. H
1052 SUPREME COURT REPORTS [2018] 10 S.C.R.
A 4. OPD attendance up to 2 p.m. on the day of assessment is 592
against the requirement of 1200.
5. Bed Occupancy at 10 a.m. on the day of assessment was 46.15%.
6. Patients:
B (a) In Pediatric wards case sheets of 35 patients shows IV
Antibiotics going on but on cross verifying with patients, relatives
it was found that no injections were given. Also, none of such
patients had IV Cannulas inserted hence they were not counted.
(b) In Pulmonary Medicine Department, female ward 9 patients
C had a diagnosis of COPD, Bronchiectasis, Pneumonia etc. on
taking history and examining the patient, no corroborative clinical
findings were found. Also, none of the patients had Chest X-
rays done. Hence, they were not counted.
(c) In Orthopedics ward, 15 patients with complaints of Neck
D Pain, Leg pain under evaluation were not counted as they were
asymptomatic also did not have x-rays.
(d) In Ophthalmology female ward, 3 patients were kept with.
diagnosis of corneal opacity. On examination, no such findings
were seen. Hence not counted.
E 7. There were only 3 Major Operations on the day of assessment.
8. There was only 1 Normal delivery & NIL Caesarean Section on
the day of assessment.
9. Histopathology workload was only 4 & Cytopathology workload
was 2.
F
10. OPD: Plaster Cutting room is not available.
11. Casualty: Separate Casualty or O.G. is not available.
12. ICUs: There was only 1 patient in NICU & 2 patients each in
PICU, SICU on the day of assessment.
G
13. There was NIL issue of Blood on the day of assessment.
14. Residential Quarters: 24 quarters are available for faculty against
requirement of 26.
15. Anatomy Department: Band Saw is not available.
H
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1053
CHARITABLE TRUST [ARUN MISHRA, J.]
16. Physiology department: Mammalian Laboratory is not available. A
17. RHTC: Cold Chain equipment are not available. Immunization is
not available.
18. Dean has refused to sign the assessment report.
The provision contained in Regulation 8(3)(1)(a) of the Regulation B
had been invoked by the MCI and the decision had been taken not to
grant permission for admission in the academic session 2018-2019.
12. In the case of P.K. Dass Institute of Medical Sciences,
Palakkad, Kerala the matter pertains to the renewal of permission for
admission of 5th Batch of 150 seats in MBBS course for the academic C
year 2018-2019. On the basis of the report of the Assessors dated 31 st
October & 1st November 2017 the matter was considered and following
deficiencies were noted:
1. Deficiency of faculty is 9.2% as detailed in the report.
2. OPD attendance up to 2 p.m. is 1,060 against the requirement of D
1,200.
3. Bed Occupancy is 40.60 % at 10 a.m. on the day of assessment.
4. There were only 09 Major Operations on the day of assessment.
5. Central Kitchen: No register is available in the kitchen. E
6. Other deficiencies as pointed out in the assessment report.
13. Regulation 8(3)(1)(b) of the Establishment of Medical College
Regulation (Amendment), 2010, had been applied by the MCI as the
bed occupancy was less than 65%. As per the MCI, the compliance of
rectification of the deficiencies could not have been considered for renewal F
of the permission in the same academic year.
14. Regulation 8(3) is extracted hereinunder:
“8. GRANT OF PERMISSION:
(1) The Central Government, on the recommendation of the G
Council for Letter of Permission, may issue a letter to set up a
new medical college with such conditions or modifications in the
original proposal as may be considered necessary. This letter
can also include a clear-cut statement of preliminary requirements
to be met in respect of buildings, infrastructural facilities, medical
H
1054 SUPREME COURT REPORTS [2018] 10 S.C.R.
A and allied equipment’s, faculty and staff before admitting the
first batch of students. The formal permission may be granted
after the above conditions and modifications are accepted and
the performance bank guarantee for the required sums are
furnished by the person and after consulting the Medical Council
of India.
B
(2) The formal permission may include a time-bound program
for the establishment of the medical college and expansion of
the hospital facilities. The permission may also define annual
targets as may be fixed by the Council to be achieved by the
person to commensurate with the intake of students during the
C following years.
The following shall be added:
8(3)(1). The permission to establish a medical college and admit
students may be granted initially for a period of one year and
D may be renewed on yearly basis subject to verification of the
achievements of annual targets. It shall be the responsibility of
the person to apply to the Medical Council of India for purpose
of renewal six months prior to the expiry of the initial permission.
This process of renewal of permission will continue such time
the establishment of the medical college and expansion of the
E hospital facilities are completed and a formal recognition of the
medical college is granted. Further admissions shall not be made
at any stage unless the requirements of the Council are fulfilled.
The Central Government may at any stage convey the
deficiencies to the applicant and provide him an opportunity and
F time to rectify the deficiencies.
8(3)(1)(a) Colleges in the stage of Letter of Permission up to II
renewal (i.e.) Admission of the third Batch
If it is observed during any inspection/ assessment of the
institute that the deficiency of teaching faculty and/ or Residents
G is more than 30 % and/ or bed occupancy is <50% (45% in
North East, Hilly Terrain, etc.) compliance of rectification of
deficiencies from such an institute will not be considered for
issue of Letter of Permission (LOP)/ renewal of permission in
that Academic Year.)
H
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1055
CHARITABLE TRUST [ARUN MISHRA, J.]
(b) Colleges in the stage of III & IV renewal (i.e. Admission of A
fourth & fifth batch).
If it is observed during any inspection of the Institute that
the deficiency of teaching faculty and/ or Residents is more than
20% and/ or bed occupancy is <65%, compliance of rectification
of deficiencies from such an institute will not be considered for B
renewal of permission in that Academic Year.
(c) Colleges which are already recognized for award of
M.B.B.S. degree and/ or running Postgraduate courses.
If it is observed during any inspection/ assessment of the
institute that the deficiency of teaching faculty and/ or Residents C
is more than 10% and/ or bed occupancy is < 70%, compliance
of rectification of deficiency from such an institute will not be
considered for issue of renewal of permission in that Academic
Year and further such an institute will not be considered for
processing applications for Postgraduate courses in that Academic D
Year and will be issued show-cause notices as to why the
recommendations for withdrawal of recognition of the courses
run by that institute should not be made for undergraduate and
postgraduate courses which are recognized u/s 11(2) of the IMC
Act, 1956 along with direction of stoppage of admissions in
permitted postgraduate courses. E
8(3)(1)(d): However, the office of the Council shall ensure that
such inspection are not carried out at least 2 days before and 2
days after important religious and festival holidays declared by
the Central/ State Government.”
F
(2) The recognition so granted to an Undergraduate Course for
award of MBBS degree shall be for a maximum period of 5
years, upon which it shall have to be renewed.
(3) The procedure for ‘Renewal’ of recognition shall be same as
applicable for the award of recognition.
G
(4) Failure to seek timely renewal of recognition as required in
subclause (a) supra shall invariably result in stoppage of admissions
to the concerned Undergraduate Course of MBBS at the said
institute.”
H
1056 SUPREME COURT REPORTS [2018] 10 S.C.R.
A It is apparent from the aforesaid regulation that in the case of the
third batch, deficiencies of teaching faculty and/or residents are found
to be more than 30% and bed occupancy less than 50%, a college cannot
be given an opportunity for compliance in the same year.
15. In the case of the 4th and 5th batch as provided in regulations
B 8(3)(1)(b), if the deficiencies of teaching faculty and the residents is
more than 20% and bed occupancy is less than 65%, such college cannot
be given opportunity of reporting compliance during the same academic
year.
16. Considering the aforesaid deficiencies in case of S.R.
C Educational Trust, Regulation 8(3)(1)(a) was attracted. In Al-Azhar
Medical College and the college at Palakkad for 5th Batch deficiencies
found by the assessors were gross so as to attract the provisions contained
in amended Regulation 8(3)(1)(b).
17. Regulation 8(3)(1)(a) came up for consideration in the case of
D Vedantaa Institute (supra) and while upholding vires of the provisions,
precluding opportunity of re-verification, this court has observed:
“10. Though Regulation 8(3)(1)(a) was challenged in the Writ
Petition filed by Respondent No. 1 and 2, they did not press the
relief. They restricted their challenge to the manner in which the
E inspection was done and for a direction to the Appellant-Council
to carry out a fresh inspection. The interpretation of Regulation
8(3)(1)(a) by the High Court is patently erroneous in as much as
the High Court did not take note of the proviso to Regulation
8(3)(1). Without a proper examination of the provision, the High
Court fell in error in holding that Regulation 8(3)(1)(a) would be
F applicable only to the Colleges seeking second renewal i.e.
admissions of the third batch. Admissions up to the second
renewal i.e. admissions to the third batch would fall under
Regulation 8(3)(1)(a). In other words, the proviso is not restricted
only to second renewal cases. Even the first renewal is covered
G by proviso (a) to Regulation 8(3)(1) as the language used is “up
to second renewal”. We do not see any conflict between Section
10-A (3) and (4) of the Act on one hand and Regulation 8(3)(1)(a)
on the other. Regulation 8(3)(1) (a) is complementary to Section
10-A of the Act. Fixing minimum standards which have to be
fulfilled for the purpose of enabling a medical College to seek
H
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1057
CHARITABLE TRUST [ARUN MISHRA, J.]
fresh inspection would not be contrary to the scheme of Section A
10-A. In fact, Regulation 8(3)(1) provides that an opportunity
shall be given to the Medical College to rectify the defects. But,
the proviso contemplates that certain minimum standards are to
be satisfied i.e. there should not be a deficiency of teaching
faculty and/or residents more than 30 percent and/or bed
B
occupancy should not be less than 50 percent. This prescription
of standards for availing an opportunity to seek re-inspection is
not ultra vires either the Regulation or Section 10-A of the Act.
11. On perusal of the material on record, we are of the opinion
that the conclusion reached by the High Court regarding the
manner in which inspection was conducted is also not correct. C
Bed occupancy at 45.30 percent on random verification was the
claim of Respondent No. 1 and 2. However, the inspection report
shows that out of the required minimum of 300 patients only 3
were available at 10.00 am on 25th September 2017. This Court
in Kalinga (supra) has held that medical education must be taken D
very seriously and when an expert body certifies that the facilities
in a medical College are inadequate, it is not for the Courts to
interfere with the assessment, except for very cogent jurisdictional
reasons such as malafide of the inspection team, ex facie
perversity in the inspection, jurisdictional error on the part of the
M.C.I., etc. The submission relating to the cyclone being a reason E
for the number of patients being less is not acceptable. We are
in agreement with the submission made on behalf of the
Appellant that the Resident Doctors are required to be in the
hospital at all points of time.”
(emphasis supplied) F
18. In Medical Council of India vs. Principal, KMCT Medical
College and Anr. (Civil Appeal No.8429 of 2018) decided on August
21, 2018, this Court has again considered the provisions of Regulations
8(3)(1)(a) and the applicability of clause 8(3)(1)(c) and the submission
raised on the strength in Royal Medical Trust (Registered) & Anr. v. G
Union of India & Anr. 2015 (10) SCC 19. This Court after considering
the decision in Madha Medical College and Research Institute v.
Union of India & Anr. 2017 (15) SCC 791 and I.Q. City Foundation
and Anr. v. Union of India & Ors. 2017 (16) SCC 249 observed that
the recommendation of the Hearing Committee at best had the force of H
1058 SUPREME COURT REPORTS [2018] 10 S.C.R.
A observation for conducting the review. Physical verification of compliance
can be done only by the MCI. The manner of verification of the compliance
has to be necessarily left to the appellant-MCI. The Court observed:
“14. The conclusion of the High Court that a second inspection
ought not to have been conducted by the MCI is contrary to the
B law laid down by this Court in the judgments referred to supra.
We are also not in agreement with the High Court that the MCI
was bound to comply with the direction issued by Respondent
No.2 and that a recommendation ought to have been made by
the Appellant without verification. It is relevant to note that the
Hearing Committee was prima facie convinced that the
C deficiencies pointed out in the inspection conducted on 18th/19th
September 2017 appeared to have been rectified on the basis of
documentary evidence furnished by the College. Therefore, the
Hearing Committee suggested that the Appellant may review
and make a revised recommendation without any need for
D compliance verification. On the basis of such recommendation
of the Hearing Committee, the matter was sent back to the
Appellant by Respondent No.2. At best, the observation of the
Hearing Committee, as affirmed by Respondent No.2, is a
suggestion. Remand of the matter to the Appellant -MCI for
conducting a review is due to the fact that the physical verification
E for compliance can be done only by the Appellant - MCI. The
manner of verification of the compliance has to be necessarily
left to the Appellant -MCI. We are of the view that it is open to
the Appellant to choose the manner of compliance verification.
Remand by the Government of India to MCI for a review does
F not place any restriction of verification to only the deficiencies
pointed out earlier. MCI is competent to conduct the inspection
regarding the compliance of the minimum standards as prescribed
by the Regulations as well.”
(emphasis supplied)
G 19. In Royal Medical Trust (supra), the Court observed that when
verification is required, it should be before deadline fixed for taking a
decision:
“31. ... ... ... (A) Initial assessment of the application at the first
level should comprise of checking necessary requirements such
H
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1059
CHARITABLE TRUST [ARUN MISHRA, J.]
as essentiality certificate, consent for affiliation and physical A
features like land and hospital requirement. If an applicant fails
to fulfil these requirements, the application on the face of it, would
be incomplete and be rejected. Those who fulfill the basic
requirements would be considered at the next stage. (B) The
inspection should then be conducted by the Inspectors of MCI.
B
By very nature, such inspection must have an element of surprise.
Therefore sufficient time of about three to four months ought to
be given to MCI to cause inspection at any time and such
inspection should normally be undertaken latest by January.
Surprise inspection would ensure that the required facilities and
infrastructure are always in place and not borrowed or put in C
temporarily. (C) Intimation of the result or outcome of the
inspection would then be communicated. If the infrastructure
and facilities are in order, the medical college concerned should
be given requisite permission/renewal. However, if there are any
deficiencies or shortcomings, MCI must, after pointing out the
D
deficiencies, grant to the college concerned sufficient time to
report compliance. (D) If compliance is reported and the applicant
states that the deficiencies stand removed, MCI must cause
compliance verification. It is possible that such compliance could
be accepted even without actual physical verification but that
assessment be left entirely to the discretion of MCI and the E
Central Government. In cases where actual physical verification
is required, MCI and the Central Government must cause such
verification before the deadline. (E) The result of such verification
if positive in favour of the medical college concerned, the applicant
ought to be given requisite permission/renewal. But if the
F
deficiencies still persist or had not been removed, the applicant
will stand disentitled so far as that academic year is concerned.”
(emphasis supplied)
20. There can be a statutory prohibition on fresh inspection. Same
has been created by amending regulation of 1999 in 2016. In Madha G
Medical College and Research Institute (supra) this Court has observed:
“17. While considering the above submissions, we must make it
clear at the outset that we are not impressed with the argument
that MCI is prohibited from conducting a second or subsequent
inspection. The purpose of inspection by an expert team of H
1060 SUPREME COURT REPORTS [2018] 10 S.C.R.
A assessors is to verify whether a medical college has the requisite
infrastructure and facilities including faculty, residents as well as
clinical and nonclinical material. The basic purpose of the
inspection is to verify whether the college possesses the
wherewithal and resources to provide a quality legal education
consistent with the statutory regulations which hold the field.
B
The powers of MCI cannot be constricted by prohibiting it from
carrying out another inspection, even if it were to come close on
the heels of an earlier inspection. As an expert statutory body,
MCI may have legitimate reasons for seeking a reverification of
the observations contained in a prior inspection. There may be
C reasons to doubt the genuineness of the picture which has been
made out by the College during the course of an inspection. MCI
may have prima facie reasons to believe that the actual possession
of resources and infrastructure is at variance with what was
portrayed before its team of assessors. MCI has been conferred
with statutory powers to protect the cause of medical education.
D
MCI is a custodian of public interest and acts in trust for the
welfare of society. Access to medical care requires the presence
of qualified health professionals. Verification of the conditions
which prevail in medical colleges is central to the role discharged
by MCI. Hence, it would be manifestly contrary to public interest
E to restrict the powers of MCI to carry out a fresh inspection
even though in its considered decision, such an inspection is
necessary. This Court cannot sit in judgment over the wisdom of
an expert body and we find no basis to hold in law that there is a
prohibition in carrying out a fresh inspection. In the absence of a
statutory interdict, the court will not read such a restriction into
F
the powers of MCI. In these circumstances, we find no merit in
the submission.”
(emphasis supplied)
21. In I.Q. City Foundation vs. Union of India (supra) the Court
G has emphasized ‘objectivity’ in the decision-making process, it observed:
“31. On a reading of Section 10-A of the Act, Rules and
the Regulations, as has been referred to in Manohar Lal Sharma
[Manohar Lal Sharma v. Medical Council of India, (2013) 10
SCC 60: 6 SCEC 578], and the view expressed in Royal Medical
H Trust [Royal Medical Trust v. Union of India, (2015) 10 SCC 19:
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1061
CHARITABLE TRUST [ARUN MISHRA, J.]
7 SCEC 429], it would be inapposite to restrict the power of the A
MCI by laying down as an absolute principle that once the Central
Government sends back the matter to MCI for compliance
verification and the assessors visit the college they shall only
verify the mentioned items and turn a Nelson’s eye even if they
perceive certain other deficiencies. It would be playing possum.
B
The direction of the Central Government for compliance
verification report should not be construed as a limited remand
as is understood within the framework of Code of Civil Procedure
or any other law. The distinction between the principles of open
remand and limited remand, we are disposed to think, is not
attracted. Be it clearly stated, the said principle also does not C
flow from the authority in Royal Medical Trust [Royal Medical
Trust v. Union of India, (2015) 10 SCC 19 : 7 SCEC 429] . In this
context, the objectivity of the Hearing Committee and the role of
the Central Government assume great significance. The real
compliant institutions should not always be kept under the sword
D
of Damocles. Stability can be brought by affirmative role played
by the Central Government. And the stability and objectivity would
be perceptible if reasons are ascribed while expressing a view
and absence of reasons makes the decision sensitively
susceptible.”
22. The MCI has been established in order to streamline the E
standard of medical education. It has the power to supervise qualification
and eligibility standards for admissions into medical institutions, as
observed in State of Kerala vs. T.P. Roshna (1979) SCC 580:
“The Indian Medical Council Act, 1956 has constituted the
Medical Council of India as an expert body to control the F
minimum standards of medical education and to regulate their
observance. Obviously, this high-powered Council has power to
prescribe the minimum standards of medical education. It has
implicit power to supervise the qualifications or eligibility standards
for admission into medical institutions. Thus, there is an overall G
invigilation by the Medical Council to prevent sub-standard
entrance qualifications for medical courses.”
23. In Medical Council of India vs. State of Karnataka 1998
(6) SCC 131 the Court observed that the country does not want a half-
baked medical professional to come out of the medical colleges. The H
1062 SUPREME COURT REPORTS [2018] 10 S.C.R.
A college should be well equipped with faculty and competent doctors.
The Court has observed:
“A medical student requires grueling study and that can be
done only if proper facilities are available in a medical college
and the hospital attached to it has to be well equipped and the
B teaching faculty and doctors has to be competent enough that
when a medical student comes out, he is perfect in the science
of treatment of human beings and is not found wanting in any
way. The country does not want half-baked medical professionals
coming out of medical colleges when they did not have full facilities
of teachings and were not exposed to the patients and their
C ailments during the course of their study. ………”
The Court has further observed that the regulations of the MCI
are binding and mandatory. There cannot be any contrary State
enactment. The said view was affirmed by this Court in Dr. Preeti
Srivastava v. State of Madhya Pradesh & Ors. 1999 (7) SCC 120.
D
24. For effective implementation of provisions of Section 10 A of
the Indian Medical Council Act, 1956 (for short, “the Act”) requiring
prior permission from the Central Government for the establishment of
medical colleges, regulations have been made in exercise of powers
under Section 10 A read with Section 33 of the Act.
E
25. Consequently, the regulations of 1999 are binding with respect
to availability of teaching faculty, infrastructural and other facilities and
with the advancement of the batches this requirement become more
rigorous as there is more requirement in the faculty than the college is
recognized after fulfillment of all the conditions as apparent from the
F provisions contained in the Regulations. With the aforesaid objective,
the provisions contained in Regulation 8(3) have been carved out and
amended in 2016. In case there are gross deficiencies, more than
prescribed in regulation for the concerned batch then the compliance
verification would not be considered in the same academic year.
G Regulation 8(3)(1)(a) shall be applicable to an institution which has been
established and is at the stage of second renewal of permission and in
case deficiency of faculty and/or residents are found more than 30%
and/or bed occupancy is found less than 50%, institute shall not be given
opportunity to rectify such deficiency in same academic year. In case
discrepancies are less, then the opportunity is afforded to make
H compliance. In the case of recognition, an opportunity of compliance
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1063
CHARITABLE TRUST [ARUN MISHRA, J.]
has to be given as per Regulation 8(3)(1), once recognition is denied no A
admissions can be made.
26. Considering the aforesaid provisions and the deficiencies found
in the case of the aforesaid three medical colleges, we are of the
considered opinion that the recommendations made by the Hearing
Committee to review and to consider the compliance could not be said B
to be binding. The provisions of the regulations 8(3)(1)(a) and (b) are
binding upon the Hearing Committee/Government of India and the MCI.
It is only in a case when a report of the Assessors on the face of it,
makes out that the same is incorrect, a reconsideration or review is
called for. Otherwise, in the case of gross deficiency, the yardstick
contained in regulation 8(3)(1)(a) or (b) has to be applied by the Hearing C
Committee, Government of India or the MCI, as the case may be. It is
not open to the Government of India/ MCI or Hearing Committee to
depart in a few cases and in some other to take a different stand. They
have to scrupulously observe the provisions of regulations which are
binding on them. D
27. It is unfortunate that the High Court has made a passing
reference to the decision of this Court in Medical Council of India v.
Vedantaa Institute of Academic Excellence Pvt. Ltd. & Ors. (supra)
and Medical Council of India v. The Principal, KMCT Medical
College, and Anr. (supra). It was incumbent upon the High Court in E
pith and substance to follow the mandate of Vedantaa Institute of
Academic Excellence Pvt. Ltd. & Ors. (supra). The High Court has
relied upon other judgments which were not based upon the consideration
of the amended provisions of the regulation 8(3)(1). It could not have
relied upon its own decision of the Division Bench in D.M. Education
and Research Foundation v. Union of India (supra) which was clearly F
contrary to the aforesaid decisions of this Court.
28. It is high time for the MCI to ensure its functions well and
eradicate all the loop-holes and decide the case within a reasonable time
and not to lend the colleges in a situation with no legal remedy available
once case is decided at the fag end of the academic session on 31st G
May. We are constrained to observe that it would be appropriate that
MCI and Government of India take a decision in all the cases at an early
date and not by the end of May 2018. The next academic session has to
commence from first of July of the Gregorian calendar year as such at
least 3-4 months’ time should be available to seek judicial review of the H
1064 SUPREME COURT REPORTS [2018] 10 S.C.R.
A action or re-inspection, if any, so warranted by the MCI or Government
of India. We find that once a petition is filed and even if in some cases
we are inclined to grant a relief of re-inspection to a college, but due to
the lapse of the time schedule and the admissions having already been
made, it is not considered appropriate to disturb the uniform schedule of
various universities. In our opinion, it would be appropriate that the
B
MCI, as well as the Government of India, should take a final decision
after inspection, by the end of February or latest by the end of March.
29. Now, we consider the submission raised by Mr. C.S.
Vaidyanathan in the case of P.K. Dass Institute of Medical Sciences in
regard to the correctness of the report of the Assessors as to the
C occupancy of the bed, wherein bed occupancy had been found to be
40.60% at 10.00 am on the date of the inspection held on 31 October
and 1st November, 2017 for the purpose of renewal of permission for
admission of fifth batch of 150 seats in MBBS Course or 2018-2019.
The provisions contained in Regulation 8(3)(1)(b) had been applied.
D The Executive Committee on 16.01.2018 considered the representations
dated 5.1.2018 submitted by the college, forwarded to it by the Ministry.
The Hearing Committee had observed that attendance was counted till
2.00 p.m. the college has explained the deficiency of faculty and deficiency
of attendance in OPD, however, it was observed that the submission of
the college regarding bed occupancy was not entirely satisfactory. The
E case was referred to the MCI for review including considering the
imposition of Regulation 8(3)(1)(b). After considering the recommendation
decision was taken by the MCI, as the aforesaid regulation was applicable,
the decision was taken not to renew the permission for admission of 5 th
Batch of MBBS course.
F 30. It was further contended on behalf of the college that the
performance of the students and result of the examination was extremely
good and bed occupancy was more as shown on the college website.
With respect to the bed occupancy, it was reported by the Assessor that
there were 262 patients out of 650 required beds at 10.00 am on the first
G day. It was submitted by the learned senior counsel that there were
approximately 500 patients admitted as indoor patients as apparent from
the web portal of the college in question thus, the report of the Assessors
was absolutely incorrect and this aspect should be looked into by this
Court. It was contended that the Assessors had counted patients available
on the beds at that time. Assessors did not count patients who were
H
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1065
CHARITABLE TRUST [ARUN MISHRA, J.]
under investigation procedures and operation theatre and those who were A
in the washrooms, pantry etc. As per the Assessors, the bed occupancy
was 40.30% i.e. 262 patients out of 650 patients which were required.
Whereas college claimed that 493 indoor patients were there at 10.00
am on 31.10.2017. There was 80% bed occupancy on 30-31.10.2017
and 1.11.2017. The learned senior counsel has drawn support from the
B
website portal.
31. We have no hesitation in rejecting the submission as it has no
legs to stand. Whatever college says is not a gospel truth. There is no
case wherein college does not dispute the report of the Assessors and
contend that there were no such deficiencies. It is clearly disputed fact.
Firstly, the report of the Assessor cannot be lightly disbelieved. It is not C
open to examining the case set up by the college as facts are found by
Assessors are at great variance secondly, in the judicial review, the report
cannot be discarded relying on data put up by the college on self-serving
website portal. In our view, the High Court was right in discarding the
explanation offered by the colleges with respect to deficiencies. Even D
the Hearing Committee with respect to P.K. Dass Institute of Medical
Sciences did not doubt the report of Assessors as to bed occupancy.
This Court has considered the value of a website portal and such objections
in Medical Council of India v. N.C. Medical College & Hospital
and Ors. (Civil Appeal No.9519 of 2018) decided on 13.9.2018 in which
the decision of Medical Council of India vs. Kalinga Institute of E
Medical Sciences (KIMS) & Ors. 2016 (11) SCC 530 has been referred
to. The Court observed:
“18. On the one hand, the High Court has doubted the report of
inspection and for that surprisingly relied on the self-serving
contents of the website of the college. There is nothing to vouch F
for the authenticity of the website information. It is not what the
institution asserts on website but what is actually found on
inspection, that has to be considered by the court and while
exercising judicial review it is settled law that court cannot sit in
appeal over the report of the assessors as observed in Medical G
Council of India v. Kalinga Institute of Medical Sciences (KIMS),
(2016) 11 SCC 530 thus:
“21. 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 H
1066 SUPREME COURT REPORTS [2018] 10 S.C.R.
A 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
B
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 the exercise of its jurisdiction
under Article 226 of the Constitution. 22. The High Court did
C 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
D
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.”
(emphasis supplied)
E It was also observed that at the time of inspection faculty should
be present barring certain exceptions otherwise the very purpose of the
inspection would be defeated. The Report of the Assessors cannot be
lightly faulted and the court cannot sit in an appeal and go into disputed
facts. There were other deficiencies too but due to the aforesaid gross
deficiencies, the provisions of regulations 8(3)(1)(b) were clearly
F attracted.
32. In Medical Council of India v. The Principal, KMCT
Medical College (supra) it was contended that the inspection was not
properly conducted. The submission had been rejected thus:
G “15. We do not deem it necessary to deal with the submission
made on behalf of the College regarding the inspection not being
properly conducted. This Court has repeatedly said that a decision
taken by the Union of India on the basis of a recommendation of
an expert body regarding the inadequacy of facilities in medical
colleges cannot be interfered with lightly. Interference is
H permissible only when the colleges demonstrate jurisdictional
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1067
CHARITABLE TRUST [ARUN MISHRA, J.]
errors, ex facie perversity or mala fide. [See:- Manohar Lal A
Sharma v. Medical Council of India 4 and Medical Council of
India v. Kalinga Institute of Medical Sciences (KIMS) 5 ]. As
no case is made out by the College for interference with the
inspection report, we decline the request of Mr. Sibal for remand
of the matter to the High Court.”
B
(emphasis supplied)
In our opinion, in view of the aforesaid legal position, it is not open
to the court in judicial review to accept tenuous objections as to bed
occupancy in the absence of mala fide.
33. In view of the aforesaid discussion, we are of the considered C
opinion that the High Court has gravely erred in law while passing the
impugned judgment and order in quashing Government’s order, allowing
the admissions for the academic session 2018-2019 without there being
Government of India’s permission and the recommendation of the MCI.
The High Court has issued direction for fresh inspection and thereafter D
the MCI to consider the report after the grant of opportunity to remove
defects if any. Firstly, it could not have issued such a direction in view of
regulations and also the blanket direction that college should be permitted
to remove the deficiencies if any found. Deficiencies can be removed, if
found, within the permissible limits as provided in regulation 8(3), not in
a case Regulation 8(3)(1)(a) or (b) is attracted. Thus, such kind of E
general direction issued without considering the provisions of the
Regulations are wholly illegal and unwarranted and on inspection, the
decision has to be taken in accordance with law as per regulations.
Obviously, regulations would come into play as per outcome of an
assessment. It cannot be predicted in advance what would be the F
outcome of inspection to decide in advance opportunity of removal of
deficiencies. There may be a case where deficiencies are found by
Assessors to be gross as contemplated in the proviso to Regulation
8(3)(1), they cannot be removed in that year. Even otherwise, the Court
could not have at all ordered the admissions, as directed in the instant
matter. High Court at the same time has ordered inspection and if the G
deficiencies are found to exist then the MCI and Government of India
have been given liberty to take appropriate decision. Such orders may
ruin the entire career of the students. Once permission to admit students
is granted, it should not be such conditional one. Considering the
deficiencies, it would be against the efficacious medical education and H
1068 SUPREME COURT REPORTS [2018] 10 S.C.R.
A would amount to permit the unequipped medical college to impart medical
education without proper infrastructure and faculty, patients serve as
the object of teaching by such an approach ultimately interest of the
society would suffer and half-baked doctors cannot be left loose on
society like drones and parasites to deal with the life of patients in the
absence of proper educational training. It would be dangerous and against
B
the right to life itself, in case unequipped medical colleges are permitted
to impart substandard medical education without proper facilities and
infrastructure.
In re: D. M. Education and Research Institute of Medical
Sciences:
C
34. Coming to the case of recognition and admission in of D.M.
Education and Research Institute of Medical Sciences established by
D.M. Education Research Foundation Trust, it was a case of recognition
and admission. In the inspection dated 27.2.2018 and 14/15 March 2018
various deficiencies were found supported by photographs, videography
D etc. The deficiencies which were found as mentioned in the Government
of India order dated 31.5.2018 are extracted hereunder:
“The Executive Committee of the Council considered the
assessment report (27.2.2018) and 14th & 15th March 2018) along
with photographs/ videography and letters/ representation dated
E 15.03.2018 from Dean of the Institute with regard to Recognition/
Approval of DM Wayanad Institute of Medical Sciences, Kerala
and noted the following:
1. “Deficiency of faculty is 18.93% as detailed in the report.
F 2. OPD: On both days, at 09.40 a.m., most of the faculty &
residents were not available.
3. Bed Occupancy at 10 a.m. on the day of assessment was
61.69%; however about 15% of the patients were not
genuine reducing Bed Occupancy to 46%. Out of these,
most of the patients were admitted on a day prior to
G
assessment.
4. Patients: On verification of the patients on the beds (from
among the 401), the following patients were notified in most
of the wards, indicating the nongenuine patients. For
example:-
H
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1069
CHARITABLE TRUST [ARUN MISHRA, J.]
I. Mini C.K. WIMS No.258951, Gen. Med-3, was admitted on A
14.3.2018 at 9.40 pm when the institution was inspecting at
9.30 am on 14.3.2018. Nurses clinical chart was entered even
for 13th doctors notes too, thereby indicating that case sheets
with non-genuine patients are prepared in advance.
II. Raimanath – WIMS No.310182, OBG Ward, was admitted B
twice on 13.3.2018 and 14.3.2018. No case notes of the patient
in the case sheet and no treatment.
III. Mr. Sivan WIMS No.212033 – Gen Medicine Only admission
request form – entire inpatient case records including names
blank. C
IV. Prabhashini WIMS No.39575, OBG Ward 2 – admitted with
complaints of excessive bleeding PV, on enquiry, she gives a
history of no bleeding at all, but only pain abdomen. The same
was endorsed by the Resident in the ward on the case sheet.
No investigations and treatment were given. Taking this into D
account in the wards, around 15% of the patients were non-
genuine, taking the effective bed occupancy to around 46%.
Also apart from this, in the wards, more than 50% of the patients
were admitted on 13.3.2018, the day before the assessment.
5. Data of Radiological & Laboratory investigations given by E
the Institute include data of private patients & Super
specialties patients which is not permissible.
6. Wards: There is no signage of Unit-wise bed distribution,
no faculty & residents were available inwards during the
round. F
7. ICUs: There was only 1 patient in PICU on the day of
assessment.
8. 4 Mobile X-ray machines are available against the
requirement of 6.
G
9. Microbiology department: 6 Service laboratories are
available against requirement of 7.
10. Pharmacology department: There are NIL Specimen & NIL
Model in the Museum.
H
1070 SUPREME COURT REPORTS [2018] 10 S.C.R.
A 11. Forensic Medicine Department: Cold Storage is not
available.
12. RHTC: Cold Chain equipment are not available.
13. Residents’ Hostel: On verification, about 15-20% of
Residents are found to be not staying in the campus. Rooms
B allotted to them were closed on inspection by the assessors.”
35. The background facts indicate that the college was granted
permission for the academic sessions 2013-2014 and 2015-2016. For
the academic year 2016-2017, it was granted conditional permission on
the recommendation of the Oversight Committee to the effect that in
C case of failure to remove the deficiencies, it would be debarred for two
academic years. Thereafter, on inspection assessment that was made
on 5th and 6th December 2016, gross deficiencies were found and due to
that the MCI on 28.1.2017 recommended the Central Government to
debar the college for two academic years and to encash the bank
D guarantee. On 31.5.2017, Government of India accepted the
recommendations of the MCI. As the first batch admitted in the college
reached the final year, the application was filed by the college for grant
of recognition. The college, aggrieved by the Government of India’s
decision on 31.5.2017 filed Writ Petition (C) No.19753 of 2017 for
permission to admit fresh batch of 150 M.B.B.S. students for the
E academic year 2017-2018. The writ petition was decided by order dated
2.8.2017 the High Court directed Government of India to give a personal
hearing to the college and thereafter to pass a fresh reasoned order.
The Government of India after considering the recommendation of the
Hearing Committee decided on 14.8.2017 to confirm the conditional
F renewal of permission for the academic year 2016-2017 and that no
fresh batch for 2017-2018 may be allowed.
36. Writ Petition No.19753 of 2017 came to be filed for grant of
admission in 2017-18 in which interim order was granted by the High
Court on 25.8.2017. This Court set aside the interim order of the High
G Court on 6.9.2017, however, permitted the college to approach this court
under Article 32 of the Constitution of India. Thereafter, Writ Petition
(C) No.838 of 2017 was filed in this Court. This Court vide order dated
22.9.2017 while permitting the students admitted for the academic year
2017-2018 to continue, directed the college to remove the deficiencies.
The order was passed to safeguard the interest of the students already
H admitted pursuant to the interim order dated 25.8.2017.
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1071
CHARITABLE TRUST [ARUN MISHRA, J.]
37. In order to consider the case of the respondent – medical A
college for recognition, an inspection was carried out on 27.2.2018 and
14/15, March 2018. In the assessment report, various deficiencies as
noted above were found. The Executive Committee decided not to
recommend the recognition in regard to MBBS degree. It was also
recommended to the Central Government not to grant renewal of
B
permission for the admission of a fresh batch of 150 MBBS students for
the academic year 2018-19. The decision of the Executive Committee
was communicated to the Oversight Committee, which in turn vide order
dated 28.3.2018 approved the same.
38. The Executive Committee then vide letter dated 20.04.2018
communicated to the Government of India. At the same time, the MCI C
vide letter dated 20.04.2018 requested the respondent-Medical College
to rectify the deficiencies and submit compliance within one month for
further consideration of its case for grant of recognition. As against
recommendation made by the MCI, the college filed the Writ Petition
(C) No.15171 of 2017 before the High Court of Kerala. The High D
Court directed Government of India to grant a hearing and to pass final
order on or before 31.5.2018. The Government of India granted hearing
opportunity on 21.5.2018. The college reported compliance on 22.5.2018.
The MCI vide letter dated 25.5.2018 requested the Oversight Committee
to consider the matter. The Oversight Committee on 28.5.2018 directed
the MCI to follow the regulations. The Government of India was informed E
by the MCI on 28.5.2018 that last date to send recommendation by MCI
was up to 30.04.2018 which was already over, as such the case of the
college could not have been considered for admission for 2018-2019 and
the matter of the recognition was under consideration of the MCI and
shall be decided appropriately after considering compliance. The Central F
Government passed the impugned order on 31.5.2018 and in view of the
gross deficiencies decided not to grant renewal of permission admission
for the batch of 150 MBBS students in the academic year 2018-2019.
Aggrieved by the same, Writ Petition (C) No.19543 of 2018 was filed in
which prayer was made to grant recognition and to permit the students
to be admitted. The said writ petition had been allowed by the impugned G
common judgment.
39. For the purpose of recognition, the Regulations of 1999 contains
the provisions in Regulation 8(3)(1) wherein the process of renewal of
permission will continue till such time the establishment of the medical
H
1072 SUPREME COURT REPORTS [2018] 10 S.C.R.
A college and expansion of the hospital facilities are completed and a formal
recognition of the medical college is granted. Further admissions shall
not be made at any stage unless the requirements of the Council are
fulfilled. The Central Government may at any stage convey the
deficiencies to the applicant and provide him an opportunity and time to
rectify the deficiencies. It is the stand of the MCI also that the matter of
B
recognition is under consideration and shall be considered in terms of
said regulation after giving the opportunity to make good deficiency.
However, with respect to admissions in 2018-19, the recommendation
was made not to admit the students.
40. It is apparent that when the Hearing Committee has ordered
C on 21.5.2018 to consider the compliance and to make a fresh
recommendation, the MCI declined to do so on the ground that time to
make a recommendation was already over on 30.04.2018. The decision
of Mridul Dhar v. Union of India, 2005 (2) SCC 65, Priya Gupta v.
State of Chhattisgarh 2012 (7) SCC 433 and Royal Medical Trust
D (Regd.) & Anr. v. Union of India 2015 (10) SCC 19 were referred to.
It was clearly mentioned by the MCI in its letter dated 25.5.2018 that
the matter could not be considered for renewal of permission for admission
for the academic year 2018-2019, but compliance of the medical college
for the purpose of recognition/approval under section 11(2) of the Act
was under consideration of the MCI and compliance verification/
E assessment and recommendations of the MCI would be sent to Central
Government in due course of time. The matter was under consideration
before the MCI for recognition, renewal for permission for admission
had been declined by the MCI on 28.5.2018. Thereafter, the Government
of India has passed the order on 31.5.2018 declining admission for
F 2018-19.
41. In view of the deficiencies of faculty and of bed occupancy,
the decision not to grant permission for admission in the year 2018-2019
was appropriate. However, the compliance that had been submitted by
the college on 22.5.2018 will be considered for the purpose of recognition
G by the MCI as provided under the regulation 8(3). Let the MCI consider
the matter for the purpose of recognition duly considering the compliance
unfettered by the order passed by the Government of India on 31.5.2018.
The Government of India also to consider the matter of recognition in
accordance with the law. Let the decision be taken by the respondents-
MCI and Government of India as expeditiously as possible.
H
MCI v. CHAIRMAN, S.R. EDUCATIONAL AND 1073
CHARITABLE TRUST [ARUN MISHRA, J.]
42. Resultantly, the appeals are allowed. The impugned judgment A
and order are set aside. However, it would be open to the colleges to
stake their claim for permission for admission for next academic session
i.e. 2019-2020, in accordance with law. No costs.
Kalpana K. Tripathy Appeals allowed.
B
C
D
E
F
G
H
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