Medical Council of India Vs. Kalinga Institute of Medical Sciences (Kims) And Ors, on 6th May 2016, Supreme Court of India – Read Judgement

data-matched-content-ui-type="image_card_sidebyside" data-matched-content-rows-num="1" data-matched-content-columns-num="4"

                                                            REPORTABLE

IN THE SUPREME COURT OF INDIA
CIVIL APPELLATE JURISDICTION
CIVIL APPEAL NO. 4914 OF 2016
(Arising out of S.L.P.(C) No.9997 of 2016)

Medical Council of India                       .…Appellant

versus

Kalinga Institute of Medical Sciences        .…Respondents
(KIMS) & Ors.

J U D G M E N T

Madan B. Lokur, J.

1.     Leave granted.
2.     This appeal is yet another chapter in the sordid saga  of  admissions
to medical colleges. Undoubtedly, there is something rotten in the state  of
medical colleges.  Unless the concerned  Ministries  in  the  Government  of
India take a far more proactive role in ensuring that medical colleges  have
all the necessary facilities, clinical materials, teaching  faculty,  staff,
accommodation etc. the health of the people of our country will take  a  hit
in the coming  years  due  to  inadequately  educated  doctors.  Quality  in
medical education is equally important, if not more, than quantity.
3.     The respondent Kalinga  Institute  of  Medical  Sciences  (for  short
KIMS) is a  recognized  medical  college.   It  is  entitled  to  admit  100
students every year to the MBBS course.
4.     For the academic year 2014-15, it was granted permission to admit  an
additional 50 students over and above the 100 students that was already  its
entitlement.
5.     KIMS was desirous of granting admission to 100 plus 50  students  for
the academic year 2015-16. With a view to ensure  that  adequate  facilities
were available for the increased  number  of  students,  an  inspection  was
required to be carried out by the Medical Council of India (for  short  ‘the
MCI’) in accordance with the  Medical  Council  of  India  Establishment  of
Medical College Regulations, 1999.
6.     Consequently,  an  inspection  was  carried  out  on  27th  and  28th
January, 2015 by an Inspection Team of the MCI which revealed quite a  sorry
state of affairs. A large number of serious deficiencies  were  pointed  out
by the Inspection Team  and  communicated  to  the  MCI.  Thereafter,  in  a
communication sent by the  MCI  to  the  Dean  Principal  of  KIMS  on  31st
January, 2015 the deficiencies were indicated and KIMS was informed  that  a
show cause notice was proposed to be issued for  withdrawal  of  recognition
of the courses run by it. Be that  as  it  may,  the  MCI  took  a  decision
recommending to the Central Government through the Ministry  of  Health  and
Family Welfare (Department of Health and Family Welfare) to deny  permission
to KIMS to add 50 additional seats for the MBBS for the academic year  2015-
16.
7.     We enquired from learned  counsel  for  the  MCI  the  procedure  for
carrying out an inspection. Our attention was drawn by  learned  counsel  to
Page ‘J’ of the appeal paper-book wherein it  is  stated  (and  not  denied)
that an inspection is conducted by a team of three  neutral  Professors.  Of
these, one is a coordinator and the other two are  taken  from  an  approved
list of eminent medical  Professors  from  reputed  Government  institutions
only.  Some of the institutions mentioned are the  All  India  Institute  of
Medical Sciences, Post Graduate Institute, Chandigarh, Maulana Azad  Medical
College (Delhi), Safdarjung  College  (Delhi),  Medical  College  (Kolkata),
Madras Medical  College  (Chennai),  Osmania  Medical  College  (Hyderabad),
Grant Medical College (Mumbai), G.S.  Medical  College  (Mumbai),  Bangalore
Medical College (Bengaluru) etc.  There is therefore no doubt that not  only
are the medical colleges highly reputed but  it  is  also  stated  that  the
Professors from these  colleges  are  eminent  medical  Professors  randomly
selected by computer software from a list of coordinators and inspectors.
8.     Our attention was also  drawn  to  the  decision  of  this  Court  in
Manohar Lal Sharma v. Medical Council of India[1] wherein it was  held  that
since the inspection is taken by “doctors of  unquestionable  integrity  and
reputation, who are experts in the field, there is no reason to discard  the
report  of  such  an  inspection.”  In  the  present  appeal,  there  is  no
allegation made by KIMS of any mala fides of  the  Inspection  Team  or  any
perversity in the inspection report  and  hence  there  is  no  question  of
challenging the conclusions of a neutral, randomly selected Inspection  Team
in its assessment.
9.     As mentioned above, the inspection report and  the  decision  of  the
MCI were communicated to the Central Government.  On a consideration of  the
material made available, the Central Government sent a  communication  dated
15th June, 2015 to the Dean Principal of KIMS directing  the  institute  NOT
to admit any students in  the  second  batch  of  MBBS  course  against  the
increased intake from 100 to 150 seats for the academic year  2015-16.   The
text of the letter sent by the Central Government to the Dean  Principal  of
KIMS on 15th June, 2015 reads as follows:

“I am  directed  to  refer  to  MCI  letter  (s)  dated  01.04.2015  thereby
recommending to the Central Government  not  to  renew  the  permission  for
admission of 2nd batch of MBBS course against  increased  intake  i.e.  from
100-150 seats Kalinga Institute of Medical  Sciences,  Bhubaneswar  for  the
academic year 2015-16 and to say that the Central Government has decided  to
accept the recommendations of MCI.

2.  You are therefore directed NOT to admit any  student  in  2nd  batch  of
MBBS course against  increased  intake  i.e.  from  100-150  seats  for  the
academic  year  2015-16.   Admission  in  next  batch  of  students  against
increased intake for the year 2016-17 will be made only after obtaining  the
Central Government Permission.

3.  Any admission made in this regard  will  be  treated  as  irregular  and
action will be initiated as  per  the  provisions  of  IMC,  Act,  1956  and
Regulations made thereunder.

data-matched-content-ui-type="image_card_sidebyside" data-matched-content-rows-num="1" data-matched-content-columns-num="4"

4.  Further, the MCI has also informed to apply Clause 8(3)(1) (c) & (d)  of
Establishment of Medical College Regulation (amendment), 2010.”

10.    Feeling aggrieved by the adverse  decision,  KIMS  preferred  a  writ
petition in the High Court of Orissa being W.P. (C) No.15685 of  2015.   The
writ petition was taken up for consideration on 14th  September,  2015  when
the direction dated 15th June, 2015 passed by  the  Central  Government  was
set aside on the ground that no hearing was given to KIMS before that  order
was passed.  The  High  Court  then  directed  KIMS  to  appear  before  the
Secretary to the Government of India in the Department of Health and  Family
Welfare or any other authorized officer on 18th  September,  2015  with  all
documentary evidence. The said officer was directed to hear  KIMS,  consider
the compliance reports of KIMS and the  views  of  the  MCI  and  then  pass
necessary orders.
11. In obedience to the order passed by the High Court a hearing  was  given
to KIMS by a Hearing Committee. Thereafter, the  Central  Government  passed
an order on 24th September, 2015 which observed as follows:

“The college was  earlier  given  hearing  on  12.03.2015.   The  compliance
submitted by the college is same  as  the  last  time.  Though  the  college
claims to have rectified the deficiencies, it can only be  verified  through
physical assessment by MCI.

The deficiencies are non-condonable. The documents alone  submitted  by  the
college do not sufficiently inspire confidence as to  rectification  of  the
deficiencies.  Therefore,  this  Committee  has  considered  the  assessment
report of the MCI assessors dated  27th  and  28th  January,  2015  and  the
compliance report submitted  by  the  representatives  of  the  college  and
decided that the Ministry may accept recommendation of MCI.”

12.    On a consideration of the order passed by  the  High  Court  and  the
recommendations of the MCI, the Central Government decided not to renew  the
permission for admitting the second  batch  of  MBBS  students  against  the
increased intake that is from 100 to 150 for the academic  year  2015-16  at
KIMS.
13.    The writ petition was then taken up for  consideration  by  the  High
Court on 25th September, 2015.  The High Court considered the facts  of  the
case and placed reliance on  Rajiv  Memorial  Academic  Welfare  Society  v.
Union of India[2] (which appeal was decided  in  the  circumstances  of  the
case and was not a general direction) and a  decision  of  the  Kerala  High
Court and directed, inter alia, that  the  Central  Government  shall  grant
provisional permission to KIMS to conduct the course for the  additional  50
students in the academic year 2015-16.  While  giving  this  direction,  the
High Court noted that admission to  the  MBBS  course  was  required  to  be
completed by 30th September, 2015. The High Court made it  clear  that  this
interim order would  be  subject  to  further  orders  passed  in  the  writ
petition and it was also made  clear  that  neither  KIMS  nor  any  of  the
students would claim any equity on the  basis  of  the  approval  permission
granted by virtue of the orders of the High Court.
14.    Pursuant to the mandatory direction given  by  the  High  Court,  the
Ministry of Health and Family Welfare passed an  order  on  28th  September,
2015 granting provisional permission to KIMS to conduct the MBBS course  for
the second batch against the increased intake from 100  to  150  MBBS  seats
for the academic year 2015-16 subject to  certain  conditions.  One  of  the
conditions was to the effect that KIMS would make it clear to  the  students
who are admitted that their admission is subject to the result of  the  writ
petition. Consequent upon this decision, KIMS admitted 50  students  to  the
MBBS course for the academic year 2015-16. These  students  are  represented
before us in this appeal and have been heard.
15. At this stage, it may be mentioned that against the interim order  dated
25th September, 2015 passed by the High Court, the MCI preferred a  petition
in this Court which came up for consideration  on  13th  October,  2015.  In
that petition being SLP (C) No. 28312 of 2015, special leave to  appeal  was
granted and the order passed by the High Court on 25th September,  2015  was
stayed and status quo as on the date on which the impugned order was  passed
(25th September, 2015) was directed to be maintained.
16. Be  that  as  it  may,  when  the  appeal  filed  by  MCI  came  up  for
consideration on 4th November, 2015 it was  directed  that  the  High  Court
should endeavour to hear the pending writ petition  expeditiously.   It  was
also directed that the interim order earlier passed on  13th  October,  2015
would continue till the High Court decided the writ petition.
17. When the writ petition  was  again  taken  up  by  the  High  Court,  an
amendment application was filed by KIMS and the  amendment  allowed.  It  is
not necessary to go into the details of the  amendment  since  that  has  no
bearing in this appeal.
18. In any event,  when  the  writ  petition  was  taken  up  for  expedited
consideration by the High Court on 3rd December, 2015 it was noted  that  50
students had already been admitted by KIMS pursuant to the directions  given
by High Court  on  25th  September,  2015  and  the  provisional  permission
granted by the Central Government on 28th  September,  2015.  The  admission
was of course subject to the outcome of the writ petition.  The  High  Court
then directed that necessary affidavits be filed and in  the  meanwhile  MCI
was directed to constitute a fresh Inspection Team to inspect  KIMS  and  to
check up the purported  compliance  claimed  by  KIMS  of  the  deficiencies
pointed out in the earlier inspection. It  was  further  directed  that  the
Directorate of Medical Education and Training, Government  of  Odisha  would
also participate in the inspection and the report be submitted on or  before
23rd December, 2015.
19. Feeling aggrieved  by  the  order  passed  by  the  High  Court  on  3rd
December, 2015 requiring the Directorate of Medical Education and  Training,
Odisha to be a part of the Inspection Team, the MCI preferred a petition  in
this Court being SLP (C) No.34856 of 2015.  Special leave  was  granted  and
by an order dated 16th December, 2015 it was made clear by this  Court  that
the  Directorate  of  Medical  Education  and  Training,  Odisha  shall  not
participate in the inspection.
20. There appears to have been some dispute in this  Court  (which  was  not
resolved) with regard to the academic year for which  the  fresh  inspection
was required to be carried out.  According to learned counsel  for  the  MCI
the inspection was to be carried out for 2016-17 while this was  opposed  by
learned counsel appearing for KIMS.   This  Court  however  did  not  record
anything in this regard one way or the other.
21. A fresh inspection was in fact  carried  out  by  MCI  on  7th  and  8th
January, 2016 and the Inspection Team once again found a very  large  number
of deficiencies in the facilities available at  KIMS.   The  report  of  the
Inspection Team and the consequent resolution of the MCI  were  communicated
to the Central Government to the effect that the Central  Government  should
not renew permission for  admission  of  the  3rd  batch  of  MBBS  students
against the increased intake from 100 to 150 seats  for  the  academic  year
2016-17.
22. Thereafter, the pending writ petition was taken up for  hearing  by  the
High Court on 17th February,  2016  and  the  impugned  judgment  and  order
delivered on 4th March, 2016.
23. A perusal of the decision of the High Court clearly  indicates  that  it
considered the latest report of the Inspection Team as if it was hearing  an
appeal against the report. In doing so,  the  High  Court  went  into  great
details on issues relating to the number of teaching beds in  the  hospital,
the limitations in the OPD Department, the number of units available in  the
subjects of General Medicine, Pediatrics  etc.,  bed  occupancy,  number  of
Caesarean sections, discrepancy in  data  of  major  and  minor  operations,
computerization in the institution, number of patients in  the  ICU,  number
of  static  X-ray  machines,  deficiency  of  examination   halls,   lecture
theatres, library, students hostel, interns  hostel,  playground  etc.  etc.
Surely, this was not within the domain of the High Court in exercise of  its
jurisdiction under Article 226 of the Constitution.
24. The High Court did not appreciate that the inspection  was  carried  out
by eminent Professors from reputed medical institutions who were experts  in
the field and the best persons to give an unbiased report on the  facilities
in KIMS. The High Court under Article 226 of the Constitution was  certainly
not tasked to minutely examine the contents of  the  inspection  report  and
weigh them against the objections of KIMS in  respect  of  each  of  its  18
items. In our opinion, the High Court plainly exceeded its  jurisdiction  in
this regard in venturing into seriously disputed factual issues.
25. Learned counsels for KIMS and  the  students  submitted  that  the  High
Court was left with no option but to critically examine the  report  of  the
Inspection Team since it was factually erroneous and did not deserve  to  be
relied on either for the increase in intake of seats for the  academic  year
2015-16 or the academic year  2016-17.  We  see  no  reason  to  accept  the
submission of learned counsels.
26. Medical education must be taken very seriously and when an  expert  body
certifies that the facilities in  a  medical  college  are  inadequate,  the
Courts are not equipped to take a different view in the  matter  except  for
very cogent jurisdictional reasons such as  mala  fides  of  the  Inspection
Team, ex facie perversity in the inspection report, jurisdictional error  on
the part of the MCI etc.   Under  no  circumstance  should  the  High  Court
examine the report as an appellate body – this is simply  not  the  function
of the High Court. In the present case there was no ground made out  at  law
for setting aside the report of the Inspection Team.
27. The High Court was of opinion that the Inspection Team was  required  to
conduct the inspection with reference to the academic year 2015-16  but  the
report pertains to the academic year 2016-2017. If that  was  so,  the  High
Court could have passed an appropriate order  in  this  regard  rather  than
examine and scrutinize the inspection report prepared for the academic  year
2016-17  which  academic  year  was  not  at  all  the  subject  matter   of
consideration  or  discussion  before  it.  Moreover,  invalidation  of  the
inspection report for the academic  year  2016-17  would  not  automatically
invalidate  the  inspection  report   for   the   academic   year   2015-16.
Unfortunately, the High Court spent its energy on adjudicating a  non-issue.

28. It appears to us that both the  MCI  and  the  Central  Government  each
having twice considered the inspection report submitted by  neutral  medical
Professors, with the Central Government having given a personal  hearing  to
KIMS on the second occasion (and perhaps on the first occasion as well)  the
matter ought to have been given a quietus by the High  Court  at  least  for
the academic year 2015-16.
29. That apart, we are of opinion that the High Court  ought  to  have  been
more circumspect in directing the admission of students by its  order  dated
25th September, 2015. There was no need for the High Court to rush  into  an
area that the MCI feared to tread. Granting  admission  to  students  in  an
educational institution when there is  a  serious  doubt  whether  admission
should at all be granted is not a matter to be taken lightly. First  of  all
the career of a student is involved  –  what  would  a  student  do  if  his
admission is found to be illegal or is quashed? Is it not a  huge  waste  of
time for him or her? Is it enough to say that the  student  will  not  claim
any equity in his or her favour? Is it enough for student to  be  told  that
his or her admission is subject to the  outcome  of  a  pending  litigation?
These are all questions that arise and for which there is  no  easy  answer.
Generally speaking, it is better to err on the  side  of  caution  and  deny
admission to a student rather than have the sword of Damocles  hanging  over
him or her. There would at least be some certainty.
30. Whichever way the matter is looked at, we find no justification for  the
orders  passed  by  the  High  Court  particularly  the  order  dated   25th
September, 2015 and the order dated 4th March, 2016.
31. It was submitted by the learned counsel for the KIMS  that  the  Central
Government has decided to accept the decision of the High Court and  it  has
in fact issued an order dated 26th April, 2016  virtually  to  this  effect.
We have gone through the order dated 26th April,  2016  and  find  that  the
permission granted to continue with the studies  of  the  students  for  the
academic year 2015-16 is subject to the orders passed by this Court in  this
appeal.  Since we are allowing  the  appeal  and  setting  aside  the  order
passed by the High Court, the order dated 26th April,  2016  passed  by  the
Central Government is of no consequence and does not  come  to  the  aid  of
KIMS or the students.
32. Learned counsel for KIMS and the students  contended  that  unless  this
appeal is dismissed it will result in the students suffering a loss  of  two
years of their studies.  This may be so – but if such a situation  has  come
to pass, KIMS is entirely to be blamed. KIMS was specifically  told  not  to
admit students by the Central Government in  its  letter  dated  15th  June,
2015. Despite this KIMS persisted in litigation  to  somehow  or  the  other
accommodate  50  additional  students.  This  was  certainly  not   with   a
charitable motive. As an institution that should  have  some  responsibility
towards  the  welfare  of  the  students,  it  would  have  been  far   more
appropriate  for  KIMS  to  have  refrained  from  giving  admission  to  50
additional students rather than being  instrumental  in  jeopardizing  their
career.
33. However, for the fault of KIMS,  the  students  should  not  suffer  nor
should KIMS get  away  scot  free.  KIMS  must  pay  for  its  inability  to
introspect and venture into adventurist litigation. Accordingly,  we  direct
as follows:
The admission granted to the 50 students pursuant to the order of  the  High
Court dated 25th September, 2015 and the provisional permission  granted  by
the Central Government only on 28th September, 2015 shall not be  disturbed.
How the students will complete  their  course  of  studies  without  putting
undue pressure on them is entirely for the MCI and KIMS and other  concerned
authorities to decide.
Costs of Rs. 5 crores are imposed on KIMS for playing  with  the  future  of
its students and the mess that it has created for them. The amount  will  be
deposited by KIMS in the Registry  of  this  Court  within  six  weeks  from
today. The amount of Rs. 5 crores so deposited towards costs  shall  not  be
recovered in any manner from any student or adjusted  against  the  fees  or
provision of facilities for students of any present or subsequent batches.
KIMS is restrained from increasing the intake of students from 100  students
to 150 students for the MBBS course for the academic year 2016-17 and  2017-
2018. The MCI and the Central Government shall enforce strict compliance  of
this direction.
The MCI or the Central Government will proceed to take action  against  KIMS
(if deemed advisable) under Clause 8(3) of  the  Medical  Council  of  India
Establishment  of  Medical  College  Regulations,  1999  (as   amended)   as
mentioned  in  the  communication  of  15th  June,  2015  of   the   Central
Government.
During the hearing of the appeal, we were informed that there is  no  fixed,
set or laid down procedure prepared by the MCI for conducting an  inspection
or assessment as postulated by the Medical Council  of  India  Establishment
of Medical College Regulations, 1999.  Rather  than  every  Inspection  Team
following its own procedure for conducting an assessment, the MCI should  in
consultation with  the  Central  Government  prepare  a  Standard  Operating
Procedure for conducting an inspection as required by  the  Medical  Council
of India Establishment of Medical College Regulations, 1999.   The  Standard
Operating Procedure should be finalized within a period of  six  weeks  from
today and should be accessible on the website of the MCI.
To introduce transparency and accountability in the  medical  colleges,  the
report or assessment of the Inspection Team should be put up on the  website
of the concerned medical college as also on the website of the MCI  so  that
potential students are aware of what is likely to  be  in  store  for  them.
Similarly, the decision of the Central Government on the  report  should  be
put up on the website of the  concerned  medical  college  as  also  on  the
website of the MCI.
34. To ensure compliance of  Directions  2  and  5  and  for  an  update  on
Directions 4 and 6 list the appeal in the first week of July 2016.
35. The appeal is disposed of on the above terms.

……………………..J  (Madan B. Lokur)

………………………J   (N.V. Ramana)

New Delhi;
May 6, 2016

———————–
[1]  (2013) 10 SCC 60
[2]  2016 (3) SCALE 184

data-matched-content-ui-type="image_card_sidebyside" data-matched-content-rows-num="4" data-matched-content-columns-num="4"

Read Also: Case Brief – Medical Council of India Vs. Kalinga Institute of Medical Sciences (Kims) And Ors