Paramedic practising in rural area seeks registration of his clinic, gets slammed by Karnataka HC

Bengaluru: The Karnataka High Court recently observed that it is time to take action against people who are practising medicine without qualification. With this, the bench has dismissed a petition to quash an endorsement by the state authorities declining to issue a registration certificate under the Karnataka Private Medical Establishments Act to a man who pursued para-medical studies and was practising as a doctor for several years at his clinic.

Hearing a plea by an unrecognized medical degree holder seeking permission to get registered under the Karnataka Private Medical Establishment Act, 2007, the Karnataka High Court bench called it "strange" that the petitioner has been addressing himself as a practising doctor for so many years despite having no required qualification. 

The HC bench noted, "It is rather strange as to how the petitioner addresses himself as a practicing doctor for all these years. Time has come to pull the curtain down on such people who are practicing medicine without qualification and hoodwinking poor people in rural areas."

These observations were made by the High Court bench while considering a plea by a person, who claims to be a medical practitioner practicing in various forms of medicine, He has completed a community medical service course- C.M.S. course and has obtained CMS-ED certificate from the Central Paramedical Education Board, Mumbai, which according to the petitioner is under the World Health Organization (WHO) directive or guidelines.

He claimed in the plea that he took training in paramedical course at Delhi and on the strength of the concerned certificate he started a clinic named Sangeetha Clinic where claimed to have been practicing for several years.

Meanwhile, the Karnataka Private Medical Establishments Act, 2007 came into effect from 23.01.2008 and under this Act, a medical practitioner who wants to set up a private practice must apply under the Act and once registration is approved he would be entitled to practice. 

Therefore, the petitioner filed an application online for registration of his clinic under the Act. However, his plea was rejected by the authorities on the ground that the qualification of the petitioner does not permit registration under the 2007 Act. Challenging this endorsement dated 25.09.2023, the petitioner approached the Karnataka High Court bench.

The petitioner's counsel submitted that the petitioner is entitled to practice medicine based on his qualifications. It was submitted that the Act does not differentiate between medical practitioners but does define only medicine and not any form of medicine and as such private medical establishments can function. He contended that there are plethora of judgments rendered by co-ordinate benches of the HC where directions were issued to consider cases of those practitioners who are not in the main stream of medicine.

On the other hand, the Government Counsel refuted these submissions by contending that these doctors are practicing allopathy without any required qualification. It was further argued that every judgment produced by the petitioner are all cases in which the Court directed consideration of the cases of the petitioners who have submitted their applications online and no endorsement was issued upon the said applications. Further, the Government Counsel argued that those cases would not be applicable to the fact situation as an endorsement had already been issued stating that the petitioner is not entitled to registration of practice under the Act.

While considering the matter, the High Court bench referred to certain provisions of the Act and noted that while Section 2 deals with definitions, Section 2(k) defines who is a Medical Practitioner.

Defining who is a Medical Practitioner, the 2007 Act mentioned, "(k) ‘Medical Practitioner’ means a medical practitioner registered under the Homeopathic Practitioners Act, 1961 (Karnataka Act 35 of 1961), Ayurvedic, Naturopathy, Sidda, Unani or Yoga Practitioners Registration and Medical Practitioners Miscellaneous Provisions Act, 1961 (Karnataka Act 9 of 1962), Medical Registration Act, 1961 (Karnataka Act 34 of 1961), Indian Medicine Central Council Act, 1970 (Central Act 48 of 1970), Homeopathy Central Council Act, 1978 (Central Act 59 of 1973) and Medical Council Act, 1956 (Central Act 102 of 1956) to practice the system of medicine which he has studied, qualified and registered and includes a Dentist registered under the Dentists Act, 1948 (Central Act 16 of 1948)."

Further perusing the definitions of "Medical Treatment", "Nursing Home", "Private Medical Establishment"and its registration process, the bench noted, "There are several conditions stipulated for getting a private medical establishment registered which includes several standards to be maintained in terms of Section 9 or 9A of the Act."

Apart from this, the bench also referred to the endorsement through which the petitioner's application was rejected. Referring to this, the bench noted, "The endorsement narrates several orders passed by this Court, as the petitioner has been knocking at the doors of this Court time and again seeking consideration of his application. This Court has twice directed consideration of his application as the application cannot be kept pending for long under the Act. After the orders were passed by this Court, a notice comes to be issued to the petitioner on 08-09-2023 seeking production of all records and scrutiny of records leads to the endorsement supra."

Thereafter, the bench took note of the qualification of the petitioner, who has a Diploma in Community Medical Services with Essential Drugs. The bench considered his qualification by comparing it with the definition of a 'Private Medical Practitioner' and noted,

"This is a Diploma conferred by the Indian Council of Medico Technicals and Health Care, a society registered under the Societies Registration Adhiniyam, Kanpur. This is termed as CMS-ED certificate which is a Diploma in Community Medicine Services with essential drugs and the subject that the petitioner studied is Paramedical course. If the nature of the course that the petitioner has undergone is considered on the bedrock of the provisions noted hereinabove, it would become unmistakably clear that the qualification possessed by the petitioner does not make him a ‘Private Medical Practitioner’ as found in Section 2(k) of the Act, as paramedical study that the petitioner has undergone is not the one that is found in Section 2(k). Section 2(k) itself is exhaustive and elaborate in bringing within its sweep even physiotherapy as they are all Degrees or Diplomas obtained by those medical practitioners."

Declaring the petitioner to be a para-medical practitioner, the bench further observed,

"The petitioner is not a medical practitioner. He is a para medical practitioner. Being a para medical practitioner, he is not entitled to any registration under the Act, which is sine qua non for continuation of practice as a medical practitioner. He is not a doctor as defined under the Act. He is also not one of those practitioners as defined under the Act. Without being so, he claims to have practiced for ages now at Kolar and would obviously be even prescribing medicine. His practice as averred in the petition is allopathy as well and calls himself a doctor."

At this outset, the bench referred to the Karnataka High Court judgment in the case of Dr. M.R.MOHAN BHATTA v. STATE OF KARNATAKA AND OTHERS, where the High Court had held that the protection of the Public includes not only matters relating to the health, safety and wellbeing of the public but also the maintenance of public confidence in the medical profession and the maintenance of proper professional standards & conduct.

"It needs no research to know the possible ill consequences on public health, should persons who profess medical avocation be not disciplined by a Regulatory Body, whatever be its nomenclature. The impugned order inarticulately is animated with this view and therefore, does not call for our interference," the HC bench had held in the case of Dr. M.R.MOHAN BHATTA.

Relying on this judgment, the court dismissed the appeal of the petitioner holding that

"In the light of the aforesaid facts and the mandate of the statute, no fault can be found with the endorsement issued to the petitioner rejecting his application for registration under the Act. The endorsement also notices that the clinic of the petitioner would be seized and the seizure would be axiomatic, as it is a consequence of non-registration of the clinic by a doctor who has no qualification."

Taking note of the fact that the petitioner had been addressing himself as a practicing doctor for all these years, the court termed it to be "strange" and observed that the time has come to pull the curtain down on such people who are practicing medicine without qualification and hoodwinking poor people in the rural areas.

To read the order, click on the link below:

https://medicaldialogues.in/pdf_upload/karnataka-hc-order-228904.pdf

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