Supreme Court of India
NATIONAL MEDICAL COMMISSION & ANRversusANNASAHEB CHUDAMAN PATIL MEMORIAL MEDICAL COLLEGE & ORS
- Citation
- 2023 INSC 117
- Decided
- 10 February 2023
- Disposal
- Disposed off
- Bench
- D Y CHANDRACHUD
Holding
The Supreme Court held that the admission of 100 students shall not be disturbed, subject to the medical college depositing Rs 2.5 crore as a penalty with AIIMS, which is not recoverable from the students.
Summary
The Annasaheb Chudaman Patil Memorial Medical College, authorized for 100 MBBS seats, sought to increase its intake to 150 seats and was conditionally permitted by the National Medical Commission (NMC). A surprise inspection in January 2022 uncovered serious deficiencies in faculty, infrastructure, and patient records, leading the NMC to withdraw the permission for the increased intake and to order a stoppage of admissions for 2021-22. The High Court allowed the college to admit 100 students, but the Supreme Court stayed that order and directed a fresh inspection, which later found the college could admit 100 students. Despite the stay, the college admitted 100 students, violating the Court's direction. The Supreme Court, invoking Article 142, held that the admissions should not be disturbed but imposed a penalty of Rs 2.5 crore to be deposited with AIIMS, which cannot be recovered from the students. The penalty is to be used for the benefit of poor patients, and the Court emphasized the need to preserve both the students' interests and the sanctity of judicial orders. Consequently, the appeals were disposed of with the penalty condition.
Issues considered
- Whether the admission of 100 MBBS students for the 2021-22 academic year can be allowed despite the Supreme Court's stay order and identified deficiencies.
- Whether the Supreme Court can impose a monetary penalty on the medical college under its Article 142 jurisdiction as a condition for permitting admissions.
- Whether the imposed penalty can be recovered from the admitted students.
Legislation cited
Subjects
Medical educationMBBS admissionNational Medical CommissionRecognition withdrawalArticle 142Supreme Court stayPenaltyAIIMSStudent rights
Judgment
[2023] 1 S.C.R. 519 519
NATIONAL MEDICAL COMMISSION & ANR A
v.
ANNASAHEB CHUDAMAN PATIL MEMORIAL MEDICAL
COLLEGE & ORS
(Civil Appeal No. 966 of 2023) B
FEBRUARY 10, 2023
[DR. DHANANJAYA Y CHANDRACHUD, CJI,
PAMIDIGHANTAM SRI NARASIMHA AND
J B PARDIWALA, JJ.] C
Education/Educational institutions: MBBS courses –
Admission – Respondent-Medical College was established in 1990
with an annual intake capacity of 100 seats for the MBBS degree
course – The renewal of its recognition became due in 2021 – On
25 November 2021, a letter of permission was issued by which the D
application submitted by the Medical College for increase in the
intake capacity from 100 to 150 MBBS seats for 2021-22 was
approved, on a condition that it would be withdrawn if minimum
standard was not found to be maintained – On the basis of assessor’s
report (Inspection report), the letter of permission was withdrawn
resulting in stoppage of admission for academic year 2021-22 – E
Writ petition filed before the High Court – High Court upheld the
order of the appellants to the extent to which the letter of permission
was withdrawn qua 50 MBBS Seats and held that the Medical college
is entitled to admit students for 100 MBBS seats for 2021-22 – In
the instant appeal, this Court had stayed the operation of the F
operative direction contained in the judgment of the High Court
permitting the Medical College to admit 100 MBBS students for the
academic year 2021-22 –Despite the order of stay granted by this
Court, the Medical College continued to admit students for 2021-
22– The subsequent inspection conducted in pursuance of the
interim order of this Court did not entitle the Medical College to G
take the law for granted – Giving due regard to the fate of 100
students, while exercising jurisdiction u/Art.142, their admission
should not be disturbed on a condition that Medical college would
deposit an amount of Rs 2.5 crores as penalty within a period of
four weeks – The amount shall be deposited with the AIIMS Delhi –
H
519
520 SUPREME COURT REPORTS [2023] 1 S.C.R.
A The amount of penalty shall not be recoverable from the students in
any manner – Constitution of India – Art. 142 – Indian Medical
Council Act – s.11.
Disposing of the appeals, the Court
HELD : 1.When this Court was moved in these proceedings,
B
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
C 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
D
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
E the required norms continue to exist. 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. The position as it has emerged
before this Court is that despite the order of stay granted by this
F
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 seeking permission to admit 100 students. [Paras
5-7][523-G-H; 524-A-D]
2. Notwithstanding the above deficiencies, the High Court,
G
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,
H
NATIONAL MEDICAL COMMISSION v. ACPM MEDICAL 521
COLLEGE
the Medical College could not have unilaterally chosen to proceed A
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
B
acted in defiance of the order of this Court. [Para 11][525-H;
526-A-B]
3. 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
C
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. Therefore,
in the exercise of the jurisdiction under Article 142 of the
Constitution, the admissions which were granted to 100 students
for 2021- 22 should not be disturbed conditional on the Medical D
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. The amount, upon
deposit, shall be utilized at the discretion of the Director, AIIMS
for meeting the requirements of poor and needy patients. The
E
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.
[Para 13][526-C-F]
CIVIL APPELLATE JURISDICTION : Civil Appeal No. 966 of
F
2023.
From the Judgment and Order dated 04.03.2022 of the High Court
of Judicature at Bombay at Aurangabad in WP No.1280 of 2022.
With
G
Civil Appeal No.967 of 2023.
Nidhesh Gupta, Sr. Adv., Gaurav Sharma, Dhawal Mohan, Prateek
Bhatia, Avijit Mani Tripathi, Mrs. Preeti Sehrawat, Siddharth
Dharmadhikari, Aaditya Aniruddha Pande, Bharat Bagla, Ms. Kirti
Dadheech, Advs. for the appearing parties.
H
522 SUPREME COURT REPORTS [2023] 1 S.C.R.
A The Judgment of the Court was delivered by
DR. DHANANJAYA Y CHANDRACHUD, CJI.
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
B at Bombay.
3. Annasaheb Chudaman Patil Memorial Medical College1 was
established in 1990 with an annual intake capacity of 100 seats for the
MBBS degree course. The MBBS degree granted by the University to
which the Medical College was affiliated was recognized under Section
11 of the Indian Medical Council Act 1956 for 100 seats in 1997. The
C 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-
D
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
E 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
F 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
G 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.
1
H “Medical College”
522
NATIONAL MEDICAL COMMISSION v. ACPM MEDICAL 523
COLLEGE [DR. DHANANJAYA Y CHANDRACHUD, CJI.]
4. In the meantime, certain complaints were received by the Union A
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 B
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.
C
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 D
of hearing, without a counter affidavit being filed by the appellants. This
gave rise to the filing of a Special Leave Petition2 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 Petitions3 were instituted before
this Court by the Medical College. By a judgment dated 14 February E
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 March 2022, partially allowed
the writ petition. The High Court upheld the order of the appellants
F
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 G
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
2
SLP(C) No 1710 of 2022
3
SLP(C) Nos 2234-2235 of 2022 H
524 SUPREME COURT REPORTS [2023] 1 S.C.R.
A 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
B 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.
C 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
D admit students for 2021-22. No application was moved before this Court
for variation of its order or for 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.
E 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
F 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
G 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
H till 16.01.2022 (recorded on 14.01.2022).
NATIONAL MEDICAL COMMISSION v. ACPM MEDICAL 525
COLLEGE [DR. DHANANJAYA Y CHANDRACHUD, CJI.]
III. The patients admitted on 14.01.2022 were not genuine. They A
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 B
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 16th January; so also the treatment given to
C
have been 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 D
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
E
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 F
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, G
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 H
526 SUPREME COURT REPORTS [2023] 1 S.C.R.
A 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
B 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 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
C 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
D 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
E
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
F 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.
G
15. The appeals are accordingly disposed of.
16. Pending application, if any, stands disposed of.
Devika Gujral Appeals disposed of.
(Assisted by : Rakhi, LCRA)
H
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