21 August 2018
Supreme Court
Download

MEDICAL COUNCIL OF INDIA Vs THE PRINCIPAL KMCT MEDICAL COLLEGE

Bench: HON'BLE MR. JUSTICE S.A. BOBDE, HON'BLE MR. JUSTICE L. NAGESWARA RAO
Judgment by: HON'BLE MR. JUSTICE S.A. BOBDE
Case number: C.A. No.-008429-008429 / 2018
Diary number: 27174 / 2018
Advocates: GAURAV SHARMA Vs


1

Non-Reportable

IN THE SUPREME COURT OF INDIA CIVIL APPELLATE JURISDICTION

CIVIL APPEAL NO.8429  of 2018 (Arising out of Special Leave Petition (Civil) No.19919 of 2018)

Medical Council of India                  .... Appellant

Versus

The Principal KMCT Medical College  & Anr.             ….Respondent(s)

J U D G M E N T  

L. NAGESWARA RAO, J.

Leave granted.   

   1. The  High  Court  directed  the  Appellant  to

recommend grant of permission to the Respondent No.1

– College for admission of 150 seats in 1st year MBBS for

the  academic  session  2018-19.   By  the  impugned

judgment, the High Court also directed Respondent No.2

– Union of India to issue a letter of permission on the

1 | P a g e

2

basis of recommendation of the Appellant.  Aggrieved

thereby, the MCI has filed this appeal.   2. Respondent  No.1 (hereinafter  referred to  as  “the

College”)  was  granted  permission  to  start  a  medical

college for the academic year 2008-09 with an intake of

100  students.   Thereafter,  a  Notification  was  issued

under Section 11(2) of the Medical Council of India Act,

1956 granting recognition of the course.  The College

applied for enhancement of the intake of students from

100  to  150  for  the  academic  session  2016-17.   The

Appellant  recommended  for  grant  of  approval  to

increase  the  intake  which  was  accepted  by  the

Government  of  India.   The  application  for  renewal  of

permission with an enhanced intake of 150 students for

the  academic  year  2017-18  was  also  considered

favourably by the Appellant and Respondent No.2.

3. The College applied for renewal of permission for

the    3rd Batch  of  admissions  with  the  intake of  150

students  for  the  year  2018-19.   An  inspection  was

conducted on 18th/19th September, 2017.  The Executive

Committee  of  the  Appellant-MCI  considered  the

2 | P a g e

3

Assessment  Report  pursuant  to  the  inspection

conducted on 18th/19th September, 2017 and noted the

following deficiencies : “1. CT Scan is single slice against minimum 16 slice required.   2. Examination  Hall:  Out  of  2  Examination Hall  available,  1  is  actually  an  Auditorium which  cannot  be  considered  as  Examination Hall;  hence there is  deficit  of  1  Examination Hall. 3. Other  deficiencies  as  pointed  out  in  the assessment report.”   

4. In  view  of  the  above  deficiencies,  the  Executive

Committee  of  the  MCI  decided  to  recommend  not  to

renew the request for permission to admit 3rd Batch of

MBBS  students  against  the  enhanced  intake  of  150

students.   The  deficiencies  found  in  the  inspection

conducted  on  18th/19th September,  2017  were

communicated  to  the  College.   The  College  was

informed  about  a  hearing  to  be  conducted  on  19th

December,  2017.   A representation was made by the

College to the Hearing Committee which found that the

two  deficiencies  pointed  out  appear  to  have  been

rectified  on  the  basis  of  the  documentary  evidence

submitted  by  the  College.   The  Hearing  Committee

3 | P a g e

4

suggested that the Appellant “may review and make

revised  recommendation  without  any  need  for

compliance verification.” Respondent  No.2  referred

the  matter  back  to  the  Appellant  along  with  the

representation submitted by the College and requested

the Appellant to conduct a review.   

5. The  Appellant  directed  another  inspection  to  be

conducted on 14th March,  2018.   On the basis  of  the

inspection,  the  assessors  submitted  a  Compliance

Verification  Assessment  Report  noting  the  following

deficiencies:  “1. Deficiency of faculty is 7.75% as detailed in the report.  

2. Shortage  of  Residents  is  16.12%  as detailed in the report.  

3. Bed  Occupancy  at  10  a.m.  on  day  of assessment was 53.11%.

4. Patients: Many patients in different wards were admitted since two to three months.  In one male medicine ward 22 patients out of 34 were admitted since 29th January/  some from 30th January some from 31st January till  date. There  was  only  one  patient  in  Dermatology ward  rest  of  the  patients  as  per  the  HOD

4 | P a g e

5

Dermatology  were  shifted  from  Orthopaedics Ward.   Also  49 patients admitted in  different wards did not require admission were admitted for  minor  complaints  like  low  backache/ osteoarthritis/ vertigo etc.  One patient Mr. Raju with amputated leg with prosthesis explained himself  that  he  doesn’t  have  any  health problem.  Wards are not as per MCI norms.

5. There is no separate record of OPD & IPD patients in the laboratory.  

6. Number  of  Haematology  tests  in  the register/ in the system could not be shown to the assessors during visit.   

7. Cytopathology  workload  on  day  of assessment was only 3.  

8. Examination  Hall:  Capacity  of  1 Examination Hall is 227 against requirement of 250.

9. Other  deficiencies  as  pointed  out  in  the assessment report.”  

6. The  Executive  Committee  of  the  Appellant

considered  the  Compliance  Verification  Assessment

Report dated         14th March, 2018 along with the

previous Assessment Report of the inspection conducted

5 | P a g e

6

on  18th/19th September,  2017  and  the  photographs/

videography.  A decision was taken to recommend  not

to  renew  the  permission  for  admission   against  the

enhanced intake of  150.  The Executive  Committee  of

the Appellant further decided to invoke Clause 8(3)(1)(c)

of  the  Establishment  of  Medical  College  Regulation

(Amendment) Act, 2010.  The Appellant communicated

its  decision  of  disapproval  to  Respondent  No.2  which

was accepted.   Respondent No.2 directed the College

not  to  admit  more  than  100  students  in  the  MBBS

course for the Academic Session 2018-19.  The College

was  granted  liberty  to  apply  afresh  for  the  next

academic year in accordance with the provisions of the

Indian  Medial  Council  Act,  1956  and  the  Regulations

framed thereunder.   

7. The  College  challenged  the  said  decision  of

Respondent No.2 in the High Court of Kerala and sought

for a Mandamus to Respondent No.2 to take a decision

on  the  basis  of  the  earlier  inspection  conducted  on

18th/19th September, 2017.   

6 | P a g e

7

8. The  High  Court  allowed  the  Writ  Petition  and

directed the Appellant to recommend increase of intake

of students from 100 to 150 to Respondent No.2 -Union

of India, within a period of three days from the date of

the judgement.   There was a  further  direction to  the

Respondent No.2 - Union of India to issue the letter of

permission  within  three  days  thereafter.   The  Writ

Petition  was  allowed  solely  on  the  ground  that  the

Appellant  ought  to  have  made  a  recommendation

without any further verification.  The High Court was of

the opinion that the Appellant is bound to comply with

the direction given by Respondent No.2 - Union of India

and that the inspection conducted on 14th March, 2018

was unwarranted.  On the basis of the said conclusion,

the  High  Court  found  the  recommendation  for

disapproval made by the Appellant on 20th April, 2018

and  the  order  of  Respondent  No.2  accepting  such

recommendation by an order dated 31st May, 2018 to be

illegal and arbitrary.   

9. The contention of the Appellant is that there is no

fetter on the power of the Medical Council  of India to

7 | P a g e

8

conduct  an  inspection  for  the  purpose  of  verifying

compliance.  It is the further case of the Appellant that it

is not bound by the observations of the Union of India

regarding the manner of compliance verification.  In any

event, the observation of Respondent No.2 was only a

suggestion.   The  Appellant  finally  contends  that  the

High Court could not have issued a direction in favour of

the College after 31st May, 2018 which was the last date

for issuance of letter of permission.   

10. It was submitted on behalf of the College that the

intake was enhanced from 100 to 150 seats on the basis

of a recommendation made by the Appellant in the year

2016-17.  Thereafter, another inspection was conducted

for renewal of the enhanced intake for the year 2017-

18.   Permission  was  granted  to  the  College  to  make

admission to 150 seats for the year 2017-18.  The Ld.

Senior  Counsel  for  the  College  relied  upon  the

inspection conducted on 18th/19th September, 2017 for

the year 2018-19 to submit that only two deficiencies

were pointed out which, even according to Respondent

No.2,  have  been  rectified.   It  was  further  argued  on

8 | P a g e

9

behalf of the College that the Appellant was bound by

the direction issued by Respondent No.2 which is  the

final authority for grant of approval.  According to the

Ld. Senior Counsel for the College, another inspection

could not have been conducted in March, 2018.  The Ld.

Senior  Counsel  for  the  College  submitted  that  the

endorsement made by the Principal of the College on

the  inspection  report  would  clearly  show  that  the

inspection  was  not  conducted  in  a  proper  manner.

He contended that the findings of the assessors in the

inspection conducted on 14.03.2018 were without any

basis.       11. In  Royal Medical Trust (Registered) & Anr. v.

Union of India & Anr.1, this Court set out the steps to

be followed scrupulously by all the parties concerned in

the following terms: “31. ... ... ...  

(A) Initial assessment of the application at the first  level  should  comprise  of  checking necessary  requirements  such  as  essentiality certificate, consent for affiliation and physical features like land and hospital requirement. If an applicant fails to fulfil these requirements,

1 (2015) 10 SCC 19

9 | P a g e

10

the  application  on  the  face  of  it,  would  be incomplete and be rejected. Those who fulfil the basic requirements would be considered at the next stage.

(B) Inspection should  then  be  conducted  by the  Inspectors  of  MCI.  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 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 deficiencies, grant to the college concerned sufficient time to report compliance.

(D) If  compliance is  reported  and  the applicant  states  that  the  deficiencies  stand

10 | P a g e

11

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  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 deficiencies still persist  or  had  not  been  removed,  the applicant will stand disentitled so far as that academic year is concerned.”

12. The power of  the Appellant  to  conduct a second

inspection  was  considered  by  this  Court  in

Madha Medical College and Research Institute v.

Union of India & Anr.2 wherein it was held : “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

2 (2017) 15 SCC 791

11 | P a g e

12

inspection by an expert team of assessors is to verify  whether  a  medical  college  has  the requisite infrastructure and facilities  including faculty,  residents as well  as clinical  and non- clinical  material.  The  basic  purpose  of inspection  is  to  verify  whether  the  college possesses  the  wherewithal  and  resources  to provide quality legal education consistent with the statutory regulations which hold the field. 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  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. MCI is a custodian of public interest  and  acts  in  trust  for  the  welfare  of society.  Access  to  medical  care  requires  the

12 | P a g e

13

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 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 the powers of MCI.  In these circumstances,  we  find  no  merit  in  the submission.”

13. There  is  no  restriction  in  conducting  a  second

inspection limiting it only in respect of the deficiencies

pointed out earlier, as held by this Court in  I.Q. City

Foundation & Anr. v. Union of India & Ors.3 : “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  Trust  [Royal  Medical Trust v. Union  of  India,  (2015)  10  SCC  19  :  7

3 (2017) 16 SCC 249

13 | P a g e

14

SCEC 429], it would be inapposite to restrict the power of the 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.  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 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 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

14 | P a g e

15

of  reasons  makes  the  decision  sensitively susceptible.”   

14. The  conclusion  of  the  High  Court  that  a  second

inspection ought not to have been conducted by the MCI

is  contrary  to  the 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  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  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

15 | P a g e

16

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  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 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.   

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  permissible  only  when  the  colleges  demonstrate

16 | P a g e

17

jurisdictional  errors,  ex  facie perversity  or  mala  fide.

[See:-  Manohar Lal Sharma v.  Medical Council of

India4 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.

16. For the aforementioned reasons, the judgment of

the High Court is set aside and the Appeal is allowed.      

               .....................................J.                                                           [S.A. BOBDE]

             

               .....................................J.               [L. NAGESWARA RAO]

New Delhi, August 21, 2018.

4 (2013) 10 SCC 60 : 6 SCEC 578 5 (2016) 11 SCC 530  

17 | P a g e