National Medical Commission & Anr. vs Annasaheb Chudaman Patil Memorial Medical College & Ors.

Reportable IN THE SUPREME COURT OF INDIA CIVIL APPELLATE JURISDICTION

Civil Appeal No 966 of 2023 (Arising out of SLP(C) No 5623 of 2022)

National Medical Commission & Anr .... Appellant(s)

Versus

Annasaheb Chudaman Patil Memorial Medical College & Ors ....Respondent(s)

WITH

Civil Appeal No 967 of 2023 (Arising out of SLP(C) No 6345 of 2022)

JUDGMENT

Dr Dhananjaya Y Chandrachud, J

1 Leave granted.

2 These appeals arise from a judgment dated 4 March 2022 of a Division Bench at

the Aurangabad Bench of the High Court of Judicature at Bombay.

3 Annasaheb Chudaman Patil Memorial Medical College 1 was established in 1990 Signature Not Verified Digitally signed by with an annual intake capacity of 100 seats for the MBBS degree course. The Sanjay Kumar Date: 2023.02.13 15:27:05 IST Reason: MBBS degree granted by the University to which the Medical College was

affiliated was recognized under Section 11 of the Indian Medical Council Act

1 “Medical College” 2

1956 for 100 seats in 1997. The recognition was liable to be renewed every five

years. For the academic years 2017-18 and 2018-19, the Medical College was

not granted permission to admit students. On 30 November 2020, the Medical

College submitted an application for increase of its intake capacity from 100 to

150 seats commencing from the academic year 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 appellants. On 10 May 2021, an affidavit

was filed on behalf of the Medical College stating that there were no

deficiencies. The Undergraduate Medical Education Board of the first appellant,

bearing in mind, the onset of the Covid-19 pandemic granted renewal of

recognition on 15 July 2021 for the batch of students admitted for the academic

session 2016-17. The recognition was for the academic year 2021-22, subject to

the condition that the continuance of recognition would be done in accordance

with law. The application submitted by the Medical College was thereupon

processed and a physical inspection was carried out on 8/9 October 2021 for

increase in the intake capacity from 100 to 150 seats. A letter of intent was

issued on 16 November 2021 for approving the increase in the intake capacity,

subject to the Medical College submitting the requisite undertaking and

documents, together with the acceptance letter. The Medical College furnished

the requisite documents/ undertaking, together with the letter of acceptance, on

23 November 2021. On 25 November 2021, a letter of permission was issued by

which the application submitted by the Medical College for increase in the intake

capacity from 100 to 150 MBBS seats for 2021-22 was approved. This was

subject to the specific condition that if during the course of surprise inspection,

the Medical College was found not maintaining minimum standards, the letter of

permission would be withdrawn.

3

4 In the meantime, certain complaints were received by the Union Ministry of

Health and Family Welfare 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. During the

course of the inspection, gross deficiency of faculty, residents and clinical

material, among other aspects, were found by the assessors. After the receipt

of the assessor’s report, a communication dated 19 January 2022 was addressed

to the Medical College withdrawing the letter of permission for increase in the

intake capacity from 100 to 150 seats and directing the stoppage of admission

for academic year 2021-22 in view of the gross deficiencies found during the

course of the surprise inspection.

5 The Medical College instituted a writ petition under Article 226 of the

Constitution before the Aurangabad Bench of the High Court of Judicature at

Bombay. The petition was disposed of by directing the appellants to conduct an

inspection of the Medical College by 30 January 2022 and a final decision was

directed to be taken by 3 February 2022. The petition was, thus, disposed of on

25 January 2022, on the first date of hearing, without a counter affidavit being

filed by the appellants. This gave rise to the filing of a Special Leave Petition 2 on

29 January 2022. An application for modification of the order of the High Court

was thereafter filed by the Medical College. The High Court having declined to

modify its judgment, Special Leave Petitions 3 were instituted before this Court by

the Medical College. By a judgment dated 14 February 2022, this Court set

aside the judgments dated 25 January 2022 and 2 February 2022 and restored

the writ petition to the file of the High Court. Thereafter, a counter affidavit was

filed on behalf of the appellants. The Division Bench, by its judgment dated 4

2 SLP(C) No 1710 of 2022 3 SLP(C) Nos 2234-2235 of 2022 4

March 2022, partially allowed the writ petition. The High Court upheld the order

of the appellants dated 19 January 2022 to the extent to which the letter of

permission was withdrawn qua 50 MBBS seats. However, the High Court held

that the Medical College is entitled to admit students for 100 MBBS seats for

2021-22 as no action was taken by the appellants for withdrawal of recognition.

When this Court was moved in these proceedings, an order was passed on 8

April 2022 issuing notice. This Court was apprised of the fact that after the

judgment of the High Court, a notice to show cause was issued on 7 March 2022

to the Medical College to show cause as to why the recognition which was

granted on 15 July 2021 and the permission to start and/or conduct post

graduate courses should not be withdrawn. In the meantime, the Medical

College was directed to stop admissions in pursuance of the deficiencies which

were noted during the course of the investigation which was carried out on

14/15 January 2022. This Court stayed the operation of the operative direction

contained in paragraph 37 of the judgment of the High Court permitting the

Medical College to admit 100 MBBS students for the academic year 2021-22.

The National Medical Commission and the Medical Assessment and Rating Board

were granted liberty to carry out a fresh inspection within a period of two

months for the purpose of determining as to whether any deficiencies in

complying with the required norms continue to exist.

6 In pursuance of the directions of this Court, 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 have permitted the Medical College to admit 100 students.

7 The position as it has emerged before this Court is that despite the order of stay

granted by this Court, the Medical College continued to admit students for 2021-

22. No application was moved before this Court for variation of its order or for 5

seeking permission to admit 100 students.

8 We have heard Mr Gaurav Sharma, counsel appearing on behalf of the

appellants and Mr Nidhesh Gupta, senior counsel appearing on behalf of the

Medical College.

9 The material which has been placed on the record indicates that serious

deficiencies were noted during the course of the inspection which was carried

out initially, resulting in the withdrawal of permission by the appellants for the

academic year 2021-22.

10 At this stage, it may not be necessary to recapitulate in detail the specific

deficiencies which were found, save and except from paragraph 34 of the

judgment of the High Court, which is extracted below:

“I. Out-patients are only about 22 by 2 PM and in-patients are only about 39% (bed occupancy rate), even the patients admitted appear healthy and without any significant clinical symptoms, most of the patients were sent out of hospital by 5 PM. There are no surgeries and no deliveries conducted. There were only three X-rays and two ultrasounds done in the hospital on the day of assessment.

II. The nurses' charts had pre-recorded vitals of the patients and also treatment instructions as administered in advance till 16.01.2022 (recorded on 14.01.2022).

III. The patients admitted on 14.01.2022 were not genuine.

They were looking healthy and gave evasive replies. Case records of many patients were not available. In the available records case history and treatment in many patients were not signed by any doctor or consultant. Nature of symptoms did not seem to merit admission. Orthopaedic wards had 'admissions' for physiotherapy for knee pain. Basic and essential parameters were not recorded in the case files and the assessors suspected the genuineness of the records. Patients were aferbrile and no record of fever was found in the files. In some files the temperature was recorded in advance till 16 th January; so also the treatment given to have been 6

administered in advance till 16th January.

IV. The doctor on duty in the surgical ward, Dr. Swati Patil was having BHMS degree, and she was not a regular employee of the hospital.

V. In the pediatric ward there were 13 admitted patients of whom 10 were admitted on the day of inspection 14.01.2022. Assessors opine that the children were looking apparently well and were having their lunch.

Symptoms reported did not match with the records. The children said they were not given medicines though the case files recordedIV fluids and medicines being given. When the assessors revisited this ward at 5 o'clock, nearly all patients admitted on 14.01.2022 were not found in the ward. At 5.00 p.m. the orthopedics ward had no patients who were admitted in the morning for physiotherapy.

VI. Census reports of medical, surgical, pediatric and orthopedic wards had even more serious errors. Daily census reports were entered using pencil. The census report of obstetrics and gynecology ward in the last five days had new admissions ranging between three and thirteen. However, on 14.01.2022, there were already 32 admissions till 5 p.m. In admission list of 14.01.2022 at 11.30 a.m. there were no contact details of the patients with numbers like 1111111111, 6666666666, etc., suggesting that the patients were not genuine."

11 Notwithstanding the above deficiencies, the High Court, while upholding the

withdrawal of the permission to admit 50 students, permitted the Medical

College to continue with the admission of 100 students. This order was stayed

by this Court on 8 April 2022. Once the order of the High Court permitting the

Medical College to admit 100 students for 2021-22 was stayed, the Medical

College could not have unilaterally chosen to proceed with the admission

process. This is plainly in breach of the directions of this Court. The Medical

College has made an attempt to overreach the process of the Court. The

subsequent inspection conducted in pursuance of the interim order of this Court

did not entitle the Medical College to take the law for granted. It plainly acted in 7

defiance of the order of this Court.

12 The position as it obtains at present is that the Medical College was permitted to

admit 100 students following the inspection which took place and it has

accordingly admitted 100 students for the subsequent academic year.

13 The issue which now remains is as regards the admission which was granted to

100 students for 2021-22 in breach of the order of stay passed by this Court. 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.

14 The admission of the students is not being disturbed, particularly having regard

to the fact that they were admitted through central counselling in terms of the

list which was furnished by the State of Maharashtra.

15 The appeals are accordingly disposed of.

8

16 Pending application, if any, stands disposed of.

..…..…....…........……………….…........CJI.

[Dr Dhananjaya Y Chandrachud]

…..…..…....…........……………….…........J. [Pamidighantam Sri Narasimha]

…..…..…....…........……………….…........J. [J B Pardiwala]

New Delhi;

February 10, 2023

-S-

9

ITEM NO.32 COURT NO.1 SECTION IX

S U P R E M E C O U R T O F I N D I A RECORD OF PROCEEDINGS

Petition(s) for Special Leave to Appeal (C) No(s).5623/2022

(Arising out of impugned final judgment and order dated 04-03-2022 in WP No. 1280/2022 passed by the High Court of Judicature at Bombay at Aurangabad)

NATIONAL MEDICAL COMMISSION & ANR. Petitioner(s)

VERSUS

ANNASAHEB CHUDAMAN PATIL MEMORIAL MEDICAL COLLEGE & ORS. Respondent(s)

(WITH IA No. 46898/2022 - EXEMPTION FROM FILING C/C OF THE IMPUGNED JUDGMENT, IA No. 46899/2022 - PERMISSION TO FILE LENGTHY LIST OF DATES)

WITH SLP(C) No. 6345/2022 (IX)

(WITH IA No. 52270/2022 - EXEMPTION FROM FILING C/C OF THE IMPUGNED JUDGMENT, IA No. 52271/2022 - PERMISSION TO FILE ADDITIONAL DOCUMENTS/FACTS/ANNEXURES)

Date : 10-02-2023 These petitions were called on for hearing today.

CORAM :

HON'BLE THE CHIEF JUSTICE HON'BLE MR. JUSTICE PAMIDIGHANTAM SRI NARASIMHA HON'BLE MR. JUSTICE J.B. PARDIWALA

For Petitioner(s) Mr. Gaurav Sharma, AOR Mr. Dhawal Mohan, Adv.

Mr. Prateek Bhatia, Adv.

Mr. Nidhesh Gupta, Sr. Adv.

Mr. Avijit Mani Tripathi, AOR Mrs. Preeti Sehrawat, Adv.

For Respondent(s) Mr. Nidhesh Gupta, Sr. Adv.

Mr. Avijit Mani Tripathi, AOR Mrs. Preeti Sehrawat, Adv.

Mr. Siddharth Dharmadhikari, Adv. Mr. Aaditya Aniruddha Pande, AOR Mr. Bharat Bagla, Adv.

10 Ms. Kirti Dadheech, Adv.

UPON hearing the counsel the Court made the following O R D E R

1 Leave granted.

2 The appeals are disposed of in terms of the signed reportable judgment.

3 Pending application, if any, stands disposed of.

(SANJAY KUMAR-I) (SAROJ KUMARI GAUR) DEPUTY REGISTRAR ASSISTANT REGISTRAR

(Signed reportable judgment is placed on the file)