Policy deficit! SC considers formulating guiding principles on compulsory rural service for medical students
New Delhi: Noting the lack of clarity on the Union Government's stand, the Supreme Court today expressed its inclination to lay down some guidelines based on the constitutional principles for mandatory compulsory rural service by medical students across the country.
This oral observation was made by the Apex Court bench comprising Justices PS Narasimha and Alok Aradhe while hearing a writ petition that challenged the requirement of one year of compulsory public rural service for medical students in Karnataka. Issuing a notification, the Karnataka Government mandated that medical students fulfil this requirement to be eligible for permanent registration with the Karnataka Medical Council.
Medical Dialogues had previously reported that, in May 2024, the Apex Court bench, while issuing notice, had questioned why the medical students from private medical institutes should be exempted from working in rural areas.
Earlier this year, the Apex Court had suggested that there should be a uniform policy for the compulsory rural service to be rendered by medical students. Previously, in response to the Apex Court's recommendation, the Solicitor General had agreed to get instructions from the Centre regarding the proposal of such a pan-Indian policy.
According to a Live Law report, during the hearing of the case today (October 27), Additional Solicitor General Aishwarya Bhati submitted before the Supreme Court that there is a compulsory requirement for Postgraduate students on a rotation basis, but no such requirement at the undergraduate level. Further, ASG Bhati submitted that since health is a State subject, many States have issued bonds for such compulsory service. She also added that a Committee was constituted in this regard and it has recommended that such bonds may be uniformly adopted by all States.
Meanwhile, Senior Advocate Raju Ramachandran, who is the amicus in this case, suggested the top court bench to lay down appropriate guidelines to fill the legislative gaps based on Article 21 and Directive Principles of the State Policy.
On the other hand, ASG Bhati made a suggestion stating that the Union can pursue a consultative exercise and a mandate from the Court may not be there as it would impact the institutions across the country.
Taking note of these submissions, Justice Narasimha said that the matter was important, further adding that what they will decide today will impact the future of medical aid in India. Further taking note of that fact that the Union's stand is not clear, the bench termed it to be a "policy deficit".
"What is suggested is not a mandate. As a matter of principle, are the policy makers and constitutional requirements in sync with that principle that rural service across India for our doctors is a necessary measure or not for betterment of our health and national health? That is the short issue. After that, the second issue is, how it is to be implemented in the form of a bond or regulation, but as a principle, there is no clarity. You must reflect on this with the Secretary of Medicine or whoever is the policy maker; otherwise, on the basis of the constitutional interpretation, the right to health is a fundamental right, and the obligation of the State, it is necessary. In times to come, where access to hospitals will virtually be access to hospitals run by private institutions, moving away from catering to the needs of the rural areas," he submitted.
Ultimately, the bench listed the matter for further hearing next week. It also directed the Union to clarify whether it intended to formulate a policy and whom it will consult.
"We will formulate the constitutional requirement of it just as a guiding principle. The formulations will be by the State in consultation with the Commission," Justice Narasimha suggested.
Present Petition:
Under the Karnataka Compulsory Service Training by Candidates Completed Medical Courses Act, 2012, and subsequently framed Karnataka Compulsory Service Training by Candidates Completed Medical Course Rules, 2015, every MBBS graduate, Post-Graduate (Diploma or Degree), and Super Specialty candidate, who has pursued their education either in a government university or on a government seat in a private/deemed university, is mandated to render one year of compulsory public rural service.
The students are issued the requisite No-Objection Certificate (NOC) only after fulfilling this requirement, and thereafter they become eligible to get permanent registration from the Karnataka Medical Council.
This requirement was extended to the students enrolled in private seats in private/deemed universities as well through the notification issued on 28.07.2023.
Filing the plea, the students argued that the Candidates enrolled in private or deemed universities on private seats, who are pursuing their studies at significantly higher costs, constitute an intelligible differentia under Article 14 of the Constitution of India. Therefore, the petitioners argued that they are not to be subjected to compulsory service requirements.
The petitioners relied on the Supreme Court's decision in the case of Association of Medical Super Speciality Aspirants Residents & Ors. Vs Union of India & Ors. In this case, the Apex Court had rejected the challenge against the imposition of compulsory bonds to be executed at the time of admission to PG medical courses and Super Speciality courses.
However, at the same time, in this case, taking note of the rigid compulsory bond conditions in certain State Governments, the Apex Court had suggested the Union Government and the Medical Council of India to take steps to have a uniform policy regarding the compulsory service to be rendered by doctors who are pursuing their medical education in the government institutes.
Referring to this, the petitioners prayed to the Apex Court to issue a writ of mandamus or any other appropriate order directing the Commissionerate of Health & Family Welfare Services to issue the required NOC to the petitioners without subjecting them to any affidavit of compulsory rural service. They also urged the Court to direct the Karnataka Medical Council to accept their Permanent Registration.
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