Ayurveda doctors do not perform complicated surgeries, not entitled to equal pay as MBBS doctors: Supreme Court

New Delhi: Referring to the difference in workload between the Ayurveda practitioners and the allopathic doctors, the Supreme Court on Wednesday opined that Ayurveda practitioners are not entitled to equal pay with the practitioners of modern medicine.

With this opinion, the top court bench of Justices V. Ramasubramanian and Pankaj Mithal set aside the Gujarat High Court order which had held that Ayurveda practitioners should be treated at par with doctors with MBBS degrees.

However, the top court bench referred to the fact that allopathic practitioners deal with a greater number of patients, they perform emergency duties and complicated surgeries, while this is not the case of the practitioners of Ayurveda.

"It is common knowledge that during out-patient days (OPD) in general hospitals in cities/towns, MBBS doctors are made to attend to hundreds of patients, which is not the case with Ayurved doctors," the top court bench noted.

The bench further observed,

"Allopathy doctors are required to perform emergency duties and to provide trauma care. By the very nature of the science that they practice and with the advancement of science and modern medical technology, the emergency duty that Allopathy doctors are capable of performing and the trauma care that they are capable of providing, cannot be performed by Ayurved doctors. It is also not possible for Ayurved doctors to assist surgeons performing complicated surgeries, while MBBS doctors can assist."

Also Read: HC upholds distinction between AYUSH, MBBS Doctors on basis of duties assigned for grant of honorarium

While the top court bench clarified that every alternative system of medicine may have its pride of place in history, it also noted that the practitioners of indigenous systems of medicine do not perform complicated surgical operations. A study of Ayurved does not authorise them to perform these surgeries. Similarly, a post-mortem or autopsy is not carried out by/in the presence of Ayurved doctors, pointed out the Apex court.

The apex court was hearing a batch of appeals challenging a 2012 Gujarat High Court order which had held that Ayurveda practitioners are entitled to be treated at par with doctors with MBBS degrees and that they are entitled to the benefits of the recommendations of the Tikku Pay Commission.

Challenging the order of the HC, the State approached the Supreme Court bench and contended that the recommendations of Tikku Pay Commission for enhancement of the scales of pay were applicable only to MBBS doctors. It was submitted that the revision of scales of pay in favour of Allopathy doctors was warranted by the perennial shortage of Allopathy doctors, since the State had to fulfil its constitutional obligation of providing adequate healthcare infrastructure to the citizens by recruiting qualified MBBS doctors.

However, the State could not attract sufficient talent due to the poor pay structure and on the other hand, the State was never running short of AYUSH doctors. Therefore, there was no necessity to lure qualified AYUSH doctors to come to service, submitted the counsel for the State.

While considering the matter, the Supreme Court bench discussed two questions- Whether different scales of pay can be fixed for officers appointed to the same cadre, on the basis of educational qualifications possessed by them, and if Allopathy doctors and doctors of indigenous medicine can be said to be performing “equal work” so as to be entitled to “equal pay".

Referring to the first question, the top court bench relied on previous orders and noted, "Therefore, it is clear that the classification based upon educational qualification is not violative of Articles 14 and 16 of the Constitution. Hence, our answer to Issue No.1 will be in favour of the State and against the respondents."

Regarding the second question i.e. the workload between the Ayurveda practitioners and practitioners of modern medicines, the Apex court bench noted that on 23.07.2013, the State Government of Gujarat had submitted an affidavit before the HC bench and provided a comparative chart discussing the workload between Allopathy doctors and Ayurveda doctors.

Apart from this, the counsel for the State had also submitted a comparative chart before the HC showing the various characteristics of Ayurvedic medicine and Allopathic medicine.. Referring to this, the top court bench noted, "Taking into consideration a comparative chart relating to the characteristics of both these types of medicine and not taking into consideration the comparative chart which we have extracted in paragraph 41 above, was the first mistake committed by the High Court in the impugned order."

Considering the comparative chart, the Apex court bench noted that allopathy doctors are required to perform emergency duties, provide trauma care, and they are also capable of providing emergency duty to the patients and assist surgeons performing complicated surgeries. However, all these tasks cannot be performed by the Ayurveda doctors.

However, the bench also clarified that it does not mean that one system of medicine is superior to other. At this outset, the bench noted, "We shall not be understood to mean as though one system of medicine is superior to the other. It is not our mandate nor within our competence to assess the relative merits of these two systems of medical sciences. As a matter of fact, we are conscious that the history of Ayurveda dates back to several centuries."

After discussing the history of Ayurveda, the bench further observed, "Therefore, we have no doubt that every alternative system of medicine may have its pride of place in history."

"But today, the practitioners of indigenous systems of medicine do not perform complicated surgical operations. A study of Ayurved does not authorise them to perform these surgeries," it further noted.

"Therefore, even while recognizing the importance of Ayurved doctors and the need to promote alternative/indigenous systems of medicine, we cannot be oblivious of the fact that both categories of doctors are certainly not performing equal work to be entitled to equal pay. Hence, Issue No.2 has to be answered in favour of the appellant-State and against the respondents," the apex court bench clarified in its judgment.

The matter concerning the difference of pay between the practitioners of Ayurveda and modern medicine had previously come up before the High Courts and Supreme Court bench. Earlier this year, while considering a similar matter, the Allahabad HC bench had observed that the distinction drawn between AYUSH and MBBS doctors on the basis of nature of work and duty hours for the purpose of payment of honorarium is reasonable.

However, addressing a similar kind of issue, last year, the Supreme Court bench of Justices Vineet Saran and J.K. Maheshwari had upheld the Uttarakhand High Court's order that Ayurvedic doctors are entitled to a salary that is in parity with the Allopathic Medical Officers and Dental Medical Officers under the National Rural Health Mission (NRHM/NHM) Scheme

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/supreme-court-ayurveda-vs-modern-medicine-208434.pdf

Also Read: Ayurveda Doctors to be paid equal to Allopathy Doctors: Supreme Court