Supreme court stops 100 MBBS admissions at Maharashtra Medical College, upholds power of NMC to take final call

Along with the stay on MBBS admissions, the top court has directed the NMC to conduct a fresh surprise inspection of the Annasaheb Chudaman Patil Memorial Medical College by the officers of Professor rank from AIIMS and Maulana Azad Medical College here within two months to see whether it complied with required norms or not.

The bench was hearing appeals filed by NMC and the medical college, which is situated in the Dhule district of Maharashtra, against the Bombay High Court order, which had directed a fresh inspection of the college by the commission and allowed the admission of students.

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Medical Dialogues had earlier reported that the Dhule-based Private medical college had faced a sudden tragedy as the NMC, the apex medical regulator had put it on the no-admission list after a surprise visit to the medical college.

Not only the Medical Assessment and Rating Board cancelled the recognition for the 50 new MBBS seats at Annasaheb Chudaman Patil Memorial Medical College, but it has also cancelled the institute's permission for 100 existing MBBS seats.

A bench of Justices DY Chandrachud and Aniruddha Bose, which had earlier likened the college to the movie 'Munna Bhai MBBS', said that it had earlier set aside the order of the Aurangabad bench of Bombay High Court and had remanded the matter back but it again reaffirmed its earlier findings.

"Prima facie at this stage it appears that the finding of the High Court with regard to the lack of the authority to issue an order for stoppage of admission does not appear to be correct in view of the provision of section 25, 26 (F) of the National Medical Commission Act. We accordingly order and direct that the operative direction contained in paragraph 37 of the impugned order of the High Court, permitting the institution to admit 100 MBBS students for the academic year of 2021-22 shall remain stayed, pending further orders", the bench said in its order.

The bench noted that the court is apprised of the fact that after the judgement dated March 4 of the Aurangabad bench of the Bombay High Court, a notice of show cause has been issued on March 7, 2022, by the NMC.

"The medical college is show caused as to why the recognition which was granted by letter dated July 14, 2021, and the permission to start post-graduate courses should not be withdrawn", the bench noted.

Considering the glaring deficiencies captured in a report pursuant to a surprise inspection conducted on 14-15.01.2022 a Bench directed the National Medical Commission ("NMC") and the Medical Assessment and Rating Board ("MARB") to carry out a fresh inspection within a period of two months to ascertain if the deficiencies continue to exist. It noted -

"The NMC and MARB would be at liberty to carry out a fresh inspection within a period of 2 months for the purpose of determining whether any deficiencies in complying with the required norms continue to exist."

It said that in the meantime, the medical college has been directed to stop admission in pursuance of the deficiencies which were noticed during the course of inspection which was conducted on January 14 and 15, 2022, with immediate effect.

The bench said that the High court has accepted the inspection report of the NMC panel but allowed the students to continue, which will seriously prejudice their future down the line.

"We cannot allow this situation to occur. The High Court has accepted the inspection report. A balance has to be made not in favour of the institution but in favour of the students. This kind of order causes serious prejudice. We have to protect the interest of the students otherwise six months down the line when the permission is withdrawn they will be nowhere. High Court has overstepped. In the earlier round, we set aside the order and sent it back to the High Court and it reaffirmed its own finding", the bench said.

The PTI report adds that the Senior advocate Nidesh Gupta, appearing for the medical college Annasaheb Chudaman Patil Memorial Medical College, which is situated in the Dhule district of Maharashtra, said that they had already made the admissions and students are studying there. "Allowing the appeal of the NMC would seriously jeopardise the interest of the students", he said.

The Bench noted, that on the contrary if the students are allowed to pursue the course and down the line in about six months if recognition is withdrawn, then the students will be left in the dark. It noted -

"If we allow this to continue then it would prejudice the students. 6 months down the line when permission is withdrawn they will be completely in the dark…We have to ensure that we maintain a balance not in favour of the institution but in the interest of the students. You might have to refund their money."

The bench further said, "Just understand where the medical education is going to go. You had healthy children in the paediatric ward, who were brought in without any ailments and by the evening they all went back to their homes. The nurses on January 14, had records of January 16 onwards what the blood pressure would be of patients and what other blood parameters would be. This is completely doctored data which was produced by the college".

The bench said that there were so-called patients who had their registration numbers 11111.. and 66666… and all the patients were healthy. Gupta said that the inspection was carried out on holiday and the officials who came to inspect were not from a random pool, quotes PTI.

"This college has been running for the past 30 years and had the same infrastructure but now they have problems with it. The real problem is that now a new trustee has come who had an association with the opposition party", he said.

The bench said that what it could make out from the inspection reports after reading between the lines, it appears that the college had prior information about the surprise inspection but it did not get time to prepare itself, and hence healthy children were brought in, who left by the evening. On February 14, the top court said it is like a Bollywood movie 'Munna Bhai MBBS' moment where patients in the wards were "hale and hearty" and "no serious in-patient was found in paediatric ward".

The NMC told the top court that permission for admission of additional students was cancelled as there were no operation theatre and no X-RAY machines in the college besides other deficiencies.

The top court had then set aside the orders of the Aurangabad bench and asked it to consider afresh.

It had noted that the medical college, which was established in 1992, has an intake capacity of 100 seats for the MBBS course.

The top court earlier noted that on January 14, 2022, a surprise inspection was conducted, and based on the report of the inspection, on January 19, 2022, the NMC withdrew the letter of permission for an increase in the intake capacity and directed stoppage of admission for 2021-2022.

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According to Livelaw, when a notice was issued by the authorities to the concerned college to show cause as to why their recognition granted by letter dated 15.07.2021 should not be withdrawn in view of the deficiencies noted during the surprise inspection, the college had been directed to stop admission for the year 2021-2022.

At the outset, Justice Chandrachud expressed concern with respect to the order of the High Court which, he opined, had failed to consider Section 26(f) of the National Medical Commission Act, 2019 ("Act") conferring power on the authority to issue order of stoppage of admission.

On this, Mr. Gupta informed the Bench that there are two categories of seats. For the first five years there is a provision for permitted seats, after which the seats get recognised. He submitted that MARB has absolute power to stop admission to the permitted seats, but for recognised seats MARB only has power to recommend withdrawal of recognition to NMC, which can pass an order under Section 38 of the Act. It was pointed out that the show cause notice was issued to the concerned college by MARB and not NMC, which is the appropriate authority to do so.

Justice Chandrachud remarked, "On the day when the inspection team came in, the data for a future date was recorded there. Patients are examined in the morning, but in the evening they all leave; children do not match up with records, they were all healthy."

Mr. Gupta argued that all the safeguards set out in the guidelines have been violated while conducting the inspection. To demonstrate the shortcomings of the inspection report, he submitted -

"For disapproving a professor, a reason has to be given. The name of the professor is only not mentioned in the report. Deficiency of infrastructure in college and hospital is left blank, deficiency of clinical material also left blank, this is because they can fill up later. Whether one can have a report of this nature is the question."

Mr. Gaurav Sharma appearing on behalf of NMC submitted that NMC is run by members who are ex-officio members of reputed medical institutions. In order to show that a third party agent can be hired to carry out inspection, he referred to Section 26(1)(c) of the Act.

"(c) carry out inspections of medical institutions for assessing and rating such institutions in accordance with the regulations made under this Act:

Provided that the Medical Assessment and Rating Board may, if it deems necessary, hire and authorise any other third party agency or persons for carrying out inspections of medical institutions for assessing and rating such institutions…"

He pointed out that there were independent assessors in the team that went for inspection, ""Here three doctors went, three director level offices, one teaching facility of Safdarjung also went. The inspection was photographed and videographed. Report runs into more than 250 pages. Signatures were taken. They cannot now say the inspection was wrong. We are ready for inspection by any agency if the report was right or not."

Further, Justice Chandrachud asked, "As a consequence of your order of stoppage they cannot admit any fresh 100 students for this year. What happens to the existing students?"

Mr. Sharma responded that time has been provided for compliance, after which they would re-inspect. If everything is in place then the recognition would continue.

Mr. Gupta then urged the Bench to provide for three independent assessors of its choice. The Bench stated, ""We will say that you will cause the inspection to be made by three professor level officers. Let there be someone from AIIMS and Maulana Azad College."

He asked the Bench to consider not passing the interim order as it would be in the nature of allowing the petition.

On this, Justice Chandrachud remarked, "Where will medical education go to? Doctored data is produced by college. The children were found to be completely healthy."

He further stated that it is imperative to set aside the order of the High Court, which had clearly overstepped: "We have to correct this kind of an order of the High court or else it would cause serious prejudice. The High Court had completely overstepped here."

Click here to view the Supreme Court order