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Unpardonable Breach

Medical colleges have often been found to flout norms and the orders of courts and increase the number of seats for admission. For defying court orders, the penalty is heavy and runs into crores.

On February 10, the Supreme Court disposed appeals filed by the National Medical Commission (NMC) and Medical Assessment and Rating Board (MARB) against a Bombay High Court order imposing Rs 2.5 crore penalty on Annasaheb Chudaman Patil Memorial Medical College for enrolling students despite a stay order.

The College was established in 1990 with an annual intake capacity of 100 seats for the MBBS course. The MBBS degree granted by the University was recognised under Section 11 of the Indian Medical Council Act, 1956, for 100 seats in 1997. The recognition had to be renewed every five years. However, for the academic years of 2017-18 and 2018-19, the College was not granted permission to admit students.

On November 30, 2020, the College submitted an application for increase of its intake capacity from 100 to 150 seats commencing from 2021-22. At the same time, the renewal of recognition became due in 2021. During the Covid-19 pandemic, no inspection could be conducted by the NMC. On May 10, 2021, an affidavit was filed on behalf of the Medical College stating that there were no deficiencies. The Undergraduate Medical Education Board of the NMC, bearing in mind the onset of Covid-19, granted renewal of recognition on July 15, 2021, for students admitted for the academic session 2016-17. 

The application submitted by the Medical College was then processed and a physical inspection carried out on 8/9 October, 2021, for increase of seats from 100 to 150. A letter of intent was issued on November 16, 2021, for approving the increase in intake, subject to the Medical College submitting the requisite undertaking and documents, together with the acceptance letter. 

This it did on November 23, 2021. On November 25, a letter of permission was issued after the application submitted by the College for increase in the intake capacity for 2021-22 was approved. This was subject to the condition that if during the course of a surprise inspection the College was found not maintaining minimum standards, the letter of permission would be withdrawn.

In the meantime, certain complaints were received by the Union health ministry alleging irregularities and deficiencies in the infrastructure of the Medical College. A team of inspectors was deputed to conduct a surprise physical inspection on 14/15 January, 2022. They found gross deficiency of faculty, residents and clinical material. After the receipt of the assessor’s report, a communication on January 19 was addressed to the Medical College withdrawing the letter of permission for increase in the intake capacity and directing the stoppage of admission for academic year 2021-22.

The Medical College appealed before the Aurangabad Bench of the High Court of Judicature at Bombay. The petition was disposed of by directing the appellants (NMC and MARB) to conduct an inspection of the Medical College by January 30, 2022, and a final decision was directed to be taken by February 3, 2022. The High Court upheld the order of the appellants dated January 19, 2022, and withdrew permission for 50 MBBS seats. However, the High Court held that the College was entitled to admit students for 100 MBBS seats for 2021-22 as no action was taken by the appellants for withdrawal of recognition.

The Supreme Court was apprised of the fact that after the judgment of the High Court, a notice to show cause was issued on March 7, 2022, to the Medical College. It asked why the recognition which was granted on July 15, 2021, and the permission to start and/or conduct postgraduate courses should not be withdrawn. The College was directed to stop admissions due to the deficiencies.

The top court stayed part of the judgment of the High Court permitting the Medical College to admit 100 MBBS students for 2021-22. The NMC and MARB were granted liberty to carry out a fresh inspection within two months for the purpose of determining whether any deficiencies in complying with the required norms continued to exist.

Thereafter, an inspection of the Medical College was carried out on 28/29 April 2022 for 2021-22. In view of the inspection report, the appellants permitted the Medical College to admit 100 students. But the fact remains that despite the orders of the top court granting stay, the Medical College continued to admit students for 2021- 22. No application was moved before the Court for variation of its order or for seeking permission to admit 100 students.

The bench of Chief Justice of India DY Chandrachud and Justice PS Narasimha and Justice JB Pardiwala observed that the High Court, while upholding the withdrawal of the permission to admit 50 students, allowed the Medical College to continue with the admission of 100 students. This order was stayed by the apex court on April 8, 2022, so the College should not have proceeded with the admission process. This is a breach of the directions of the top court. The subsequent inspection conducted in pursuance of the interim order of the Court did not entitle the College to take the law for granted. 

The Supreme Court order read: “On one hand, the Court has due regard to the consequences which will be faced by the students if their admissions are disturbed, at this stage. Equally, the sanctity of the judicial process has to be observed. We are, therefore, of the considered view in the exercise of the jurisdiction under Article 142 of the Constitution that the admissions which were granted to 100 students for 2021- 22 should not be disturbed conditional on the Medical College depositing an amount of Rs 2.5 crores within a period of four weeks. The amount shall be deposited with the All India Institute of Medical Sciences, New Delhi and a proof of receipt shall be furnished both to the appellants and to the Registry of this Court. The amount, upon deposit, shall be utilized at the discretion of the Director, AIIMS for meeting the requirements of poor and needy patients. The amount which has been directed to be deposited by the Medical College by way of penalty shall not be recoverable from the students in any manner, whether for the present year or thereafter.”

This is not the first time that medical colleges have flouted norms and been punished. In 2016, a two-member Supreme Court bench, comprising Justice Madan B Lokur and Justice NV Ramana, imposed a penalty of Rs 5 crore on Kalinga Institute of Medical Sciences for admitting an additional 50 students in violation of the order of the Medical Council of India. It was clarified by the Court that the Rs 5 crore deposited 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.

In 2021, a Supreme Court bench of Justices L Nageswara Rao and S Ravindra Bhat imposed a fine of Rs 5 crore on a private medical college in Unnao for granting admission to students in violation of the Medical Council of India regulations, noting that the College had admitted 132 students without seeking a nod from Director General Medical Education, Uttar Pradesh.

Similarly, the Madras High Court in March 2022 came down on a dental college and hospital in Kundrathur, Chennai, which had interpolated the attendance register of two students and not allowed them to complete their course since 2018. This was because they did not pay the excess fees demanded by the institution. The High Court imposed a penalty of Rs 3 crore on the college. 

—By Shivam Sharma and India Legal Bureau

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