Compulsory Bond Service for PG, SS Doctors: Major SC judgment upholds Bond service, calls for uniformity

New Delhi: In perhaps the most elaborate judgement till date on the matter of compulsory bond service by doctors across the country, the Supreme Court in its decision touched upon the various aspects of the policy matter and concluded that all the Doctors who have executed compulsory bonds shall be bound by the conditions contained therein.

Taking note of the fact that certain State Governments have rigid conditions in the compulsory bonds to be executed by
the Appellants and the felt need of uniformity in the matter pertaining to the compulsory bonds, the court suggested that suitable steps be taken by the Union of India and the Medical Council of India to have a uniform policy regarding the compulsory service to be rendered by the Doctors who are trained in government institutions.

The bench was responding to a number of petitions filed by doctors. The controversy in these cases pertains to the compulsory bonds to be executed for admission to post-graduate medical courses and super speciality courses. The matter included various petition and previous decisions of the High court on the compulsory bond conditions, as imposed by various states in the PG and super-speciality courses by the States of Andhra Pradesh, Goa, Gujarat, Himachal Pradesh, Karnataka, Kerala, Maharashtra, Orissa, Rajasthan, Tamil Nadu, Telangana and West Bengal respectively. A further direction is sought for returning the original mark-sheets, certificates and other documents retained by the respective State authorities after the completion of the concerned speciality courses.

The counsel for the doctors argued that the doctors who have completed the post-graduate courses and super Speciality courses are national assets. Their services should be utilized in the best possible manner in places where there are facilities and they should not be wasted in rural areas. Their presence in institutions at the national level would be beneficial to society apart from providing an opportunity to them to hone their skills. He stated that additional conditions in the nature of bonds cannot be imposed by the State Government which would disturb the balance stipulated by the Medical Council of India Regulations. He submitted that the conditions imposed by the State Government are onerous and he commended for courts acceptance that a reasonable exit clause should exist.

Another council submitted that the post-graduate and super Speciality Doctors are not equipped to handle health needs in rural areas, and by not utilizing the skills of these specialists, the Government would bedoing disservice to the society. He referred to instances in which specialists in Cardiology, Pathology and Pediatrics were asked to take care of the primary medical health care. He
voiced his concern for the need to balance the academic career and personal incentives for Appellants with public interest.

The court, after listening to the arguments both presented by the various appellants as well as the counsel for various states and autonomous institutions, held the judgement in favour of compulsory bond service

The court made a point by point observations and decision The main points that were elaborated by the court included :

I. Jurisdiction of the State Government,
II. Violation of Fundamental Rights,
III. Contract of Personal Service, and
IV. Restraint on Profession.

Jurisdiction of the State government

On this issue, the court observed that The Medical Council of India Act governs the field of medical education in this country. Admittedly, there is no provision in the Medical Council of India Act touching upon the subject matter of compulsory bonds. Therefore, the States are free to legislate on the subject matter of medical bonds, the court held

Executive authority of the State Government is co-extensive with that of the legislative power of the State Legislature. Even in the absence of any legislation, the State Government has the competence to issue executive orders under Article 162 of the Constitution on matters over which the  State legislature has the power to legislate. The Notifications issued by the State Governments imposing a condition of execution of compulsory bonds at the time of admission to post- graduate courses and super Speciality courses cannot be said to be vitiated due to lack of authority or competence. The field of bonds requiring compulsory employment is not covered by any Central Legislation. Therefore, the submissions made on behalf of the Appellants that the States lacked competence to issue the notifications as the field is occupied are rejected.

 

Violation of Fundamental Rights:

It was argued by doctors that bond service is a violation of their fundamental rights. Referring to a previous judgement in the case Harsh Pratap Sisodia (supra), the court noted

The decision taken by the State Governments to impose a condition of compulsory bond for admission to post-graduate courses and super Speciality is on the basis of relevant material. Huge infrastructure has to be developed and maintained for running medical colleges with post-graduate and super Speciality courses. The amount of fees charged from the students is meagre in comparison to the private medical colleges. Reasonable stipend has to be paid to the doctors. Above all, the State Governments have taken into account the need to provide health care to the people and the scarcity of super specialists in their States. Consequently, a policy decision taken by the State Governments to utilize the services of doctors who were beneficiaries of Government assistance to complete their education cannot be termed arbitrary.

Having said that the court noted that there should be reasonableness while imposing the bond conditiond

Reasonableness is a ground that pervades through the submissions made by the counsel on both sides. In the State of West Bengal, the requirement of a compulsory bond was initially a service of one year in the State in default of Rs.10 Lakhs was to be paid. This was enhanced to three years and Rs.30 Lakhs by a Notification dated 09.10.2014. In the State of Tamil Nadu, the bond condition was that a doctor has to serve for ten years in the State and in default of which, the doctor was to pay Rs.2 Crores. This was reduced to two years and Rs.50 Lakhs. The Armed Forces Medical College imposes a condition of five years compulsory service in the Army for post-graduate and super Speciality doctors who prosecuted their study in the college. They have an option of not serving for five years by recompensing the Government by paying Rs.25 Lakhs.

The court further commenting on the reasonableness of the bond stated

The main contention of the counsel appearing for the Appellants is that the condition of a long period of service that is imposed is unreasonable. The basis for the submission is that they have already served the society by working in Government hospitals while undergoing their course. Further conditions imposed on them would impede the progress of their careers. Restrictions placed on their choice of place of work are also unreasonable according to them. An alternate submission made by the  counsel appearing for the Appellants is that the imposition of the condition of compulsory bond should be reasonable and the exit clause should be relaxed. Notifications issued by the State Governments imposing a condition of compulsory service and a default clause are per se not unreasonable. However, we are in agreement with the learned counsel for the doctors that the period of compulsory service and the exit should be reasonable.  The State Governments and the Armed Forces Medical College are directed to consider imposing the condition of compulsory service period of two years in default of which the Doctors shall recompense the Government by paying Rs. 20 Lakhs.

Violation of Article 19

According to the Appellants, the right to carry on their profession which is guaranteed by Article 19(1)(g) is violated by
the compulsory bonds. The court noted

The compulsory bond executed by the Appellants is at the time of their admissions into post-graduate and super Speciality courses.  Conditions imposed for admission to a medical college will not directly violate the right of an individual to carry on his profession. The right to carry on the profession would start on the completion of the course. At the outset, there is no doubt that no right inheres in an individual to receive higher education. Violation of a right guaranteed under Article 19(1)(g) does not arise in a case pertaining to admission to a college. There is no doubt, that the condition that is imposed has a connection with the professional activity of a doctor on completion of the course. However, the Appellants have, without any protest, accepted the admissions and executed the compulsory bonds. Execution of bonds is part of a composite package.

Article 21

The Appellants contended before the Calcutta High Court that their liberty is curtailed by the compulsory bonds. The court however observed

Article 21 of the Constitution of India imposes an obligation on the State to safeguard the right to life of every person. Preservation of human life is thus of paramount importance. The Government hospitals run by the State and the Medical Officers employed therein are duty bound to extend medical assistance for preserving human life. Failure on the part of a Government hospital to provide timely medical treatment to a person in need of such treatment results in violation of his right guaranteed under Article 21 of the Constitution. Therefore, in a welfare State it is the obligation ff the State to ensure the creation and the sustaining of conditions congenial to good health.1

The court observed that the next question that arises is whether there is a conflict between the rights of the community and the rights of the Appellants.

As stated earlier, the right that is claimed by the  Appellants is to make an individual choice to carry on their profession which might be hindered by the decision of the Government. On the other hand, the basic idea behind the Government’s decision is larger public interest. The above discussion leads us to the conclusion that right to life guaranteed by Article 21 means right to life with human dignity. Communitarian dignity has been recognised by this Court. While balancing communitarian dignity vis-à-vis the dignity of private individuals, the scales must tilt in favour of communitarian dignity. The laudable objective with which the State Governments have introduced compulsory service bonds is to protect the fundamental right of the deprived sections of the society guaranteed to them under Article 21 of the Constitution of India. The contention of the Appellants that their rights guaranteed under Article 21 of the Constitution of India have been violated is rejected.

 

Article 23

The Senior Counsel for the Appellants is that the conditions of the bond per se amount to ‘forced labour’ and thus are violative of Article 23 (1) of the Constitution. The court however noted

The Appellants who are required to work for a short period on a decent stipend cannot complain that they are made to perform ‘forced labour’, especially after the Appellants have taken an informed decision to avail the benefits of admission in government medical colleges and received subsidized education. By no means, the service rendered by the Appellants in Government hospitals would fall under the expression of ‘forced labour’.

 Contract of Personal Service

On the contention that such contracts violate the Specific Relief act, the court noted

Specific performance of contract for personal service is not permissible under the Specific Relief Act, therefore, there cannot be a decree for specific performance of a contract of personal nature. None of the State Governments have made an attempt to enforce the contracts entered into by them with the Appellants through the service bonds. We are not in agreement with the submission of Mr. Ahmadi that the compulsory bonds fall foul of the Specific Relief Act.

 Restraint on Profession

The argument advanced on behalf of the Appellants that compulsory bonds placed a restraint on their profession and
thus, would be contrary to Section 27 of the Indian Contract Act, 1872. The court however agreed with the Kolkata HC on the matter

the High Court concluded that a contract entered into by Appellants to serve the government for a few years under reasonable terms cannot be described as one in restraint of trade. We are in agreement with the findings recorded by the High Court of Calcutta. Therefore, we are of the considered opinion that the conditions of compulsory bonds for admission to post-graduate and super-Speciality courses in government medical colleges are not in violation of Section 27 of the Indian Contract Act, 1872.

Consequently, all the Doctors who have executed compulsory bonds shall be bound by the conditions contained therein, the court concluded

As a last remark the court noted the fact that certain State Governments have rigid conditions in the compulsory bonds to be executed by the Appellants and the felt need of uniformity in the matter pertaining to the compulsory bonds, the court suggested that suitable steps be taken by the Union of India and the Medical Council of India to have a uniform policy regarding the compulsory service to be rendered by the Doctors who are trained in government institutions.