Dr.
A.K. Sabhapathy Vs. State of Kerala & Ors [1992] INSC 114 (22 April 1992)
Agrawal, S.C. (J) Agrawal, S.C. (J) Fathima Beevi, M. (J)
CITATION:
1992 AIR 1310 1992 SCR (2) 653 1992 SCC Supl. (3) 147 JT 1992 (3) 66 1992 SCALE
(1)843
ACT:
Constitution
of India, 1950: Article 254-Seventh
Schedule-List-III-Entry 26-Medical Profession-Central Law- State law-Test for
determination of Repugnancy-What is- Conditions necessary for applicability of
Article 254 dis- cussed.
Doctrine
of occupied filed.
Travancore-Cochin
Medical Practitioners Act, 1953:
Section
38-First proviso-Medical Practitioner-Practice in allopathic system of
medicine-Qualifications and conditions for registration-Power of Government to
grant exemption from-First proviso, to the extent it relates to allopathic
system of medicine, held inconsistent with and repugnant to sections 15 and 21
of the Indian Medical Council Act, 1956.
Indian
Medical Council Act, 1956: Section 2 (f)- Expression "Modern scientific
medicine" refers to allopathic system of medicine-Object of the Act
explained.
HEAD NOTE:
Section
38 of the Travancore-Cochin Medical Practitioners' Act, 1953 provides that no
person other than a registered medical practitioner or a practitioner whose
name is entered in the list published under section 30 or in the list published
under Section 25 shall practise modern medicine, homoepathic medicine, ayurvedic
medicine, siddha medicine or unani tibbi medicine. It further provides that no
person who is not a registered practitioner of any such medicine shall practise
any other medicine unless he is also registered practitioner of that medicine.
First proviso to the said section empowers the State Government to grant
exemption from the application of the section by publishing a Notification in the
official gazette. In exercise of the power conferred by the said proviso the
Government of Kerala issued a notification dated May 4, 1977 directing that Section 38 shall not aply to persons holding
degree and diploma from Kerala University in Integrated Medicine (DAM) for practising 654 modern
medicine in the State. By an order dated September 28, 1978 Government of Kerala
also ordered that the Diploma in Medicine and Surgery (DMS) awarded by
Government of Bihar will be held at par with the integrated DAM of Kerala Uni- versity
and by its notification dated April 13, 1981 the Government directed that
section 38 shall not apply to holders of DMS awarded by Government of Bihar.
The
appellant challenged the validity of first proviso to section 38 and the Notifications
dated May 4, 1977 and April 13, 1981 issued there-under as well as the order
dated 28th September 1978 on the ground that the first proviso to Section 38 of
the Travancore-Cochin Medical Practitioners' Act, 1953, a State Act, was void
under Article 254 of the Constitution because it was repugnant to and
inconsistent with section 15 of the Indian Medical Council Act, 1956, a Central
Act.
The
High Court of Kerala did not go into the validity of notification dated May 4, 1977 but it upheld the validity of the first rpoviso and
the order dated September
28, 1978 as well as
the notification dated April
13, 1981 by holding
(a) that
the Central Act does not lay down any qualification for registration and all
that section 15 says is that a person whose name is not seen in the State
register shall not practise medicine;
(b)
the proviso to section 38 does not in terms say that a person whose name is not
on the rolls of the State register in one system can practise another system
and it only exempts practitioners who want to practise one system without being
in the concerned list from the operation of section 38;
(c)
that neither the Central Act nor the State Act contains any provision which
prohibits a person possessing the requisite qualification to practise two
systems from getting enrolled on two State rolls and a practitioner can be a
registered practitioner in two regis- ters and the Central Act does not place
an embargo on a State from recognising qualifications for the purpose of two
systems;
(d) that
the definition of medicine contained in section 2(f) of the Central Act would
not involve both Homoepathic and indigenous system of medicine and that the
Central Act concern itself only with the allopathic medicine and the modern
system contemplated by it is the allopathic medicine. Against the judgment of
the Kerala High Court appeal was filed in this court.
Allowing
the appeal in part, this court, 655
HELD:
1. In order that Article 254(1) of the Constitution may apply, two conditions
must be fulfilled. Firstly, provisions of the Provincial law and those of the
Central legislation must both be in respect of a matter which is enumerated in
the Concurrent List, and secondly, they must be repugnant to each other. It is
only when both these reguirements are satisfied that the Provincial law will,
to the extent of the repugnancy, become void. [661 B-C] A. S. Krishna v. State
of Madras, [1957] SCR 399, Hoechst
Pharmaceuticals Ltd. and Anr. etc. v. State of Bihar and Ors., [1983] 3 SCR 130, referred to.
2. In
the instant case the Central Act as well as the State Act are both laws made in
respect of the medical profession which is a matter relating to Entry 26 of the
Concurrent List. The field of operation of the State Act covers all the systems
of medicine, namely, allopathic, ayurvedic, siddha, unani and homoepathic
systems of medicine. Moreover it deals with recognition of qualifications
required for registration of a person as a medical practitioner in these
systems, conditions for registration of medical practitioners and maintenance
of register of practitioners for each system and constitution of separate
councils for modern medicine homeopathic medicine and indigenous medicine. [661
E, 665 C-D] As compared to the State ACt, the field of operation of the Central
Act is restricted and it is confined in its application to modern scientific
medicine, namely, the allopathic system of medicine only, wherein also it deals
with recognition of medical qualifications which may entitle a person to be
registered as a medical practitioner, consti- tution of the Medical Council of
India to advise the Central Government in the matter of recognition or
withdrawal of recognition of medical qualifications, to prescribe the minimum
standards of medical education required for granting recognised medical
qualifications by Universities or medical institutions in India and to appoint
inspectors and visitors for inspection of any medical institution, college or hospi-
tal. But the Central Act does not deal with the registra- tion of medical
practitioners in the States and it proceeds on the basis that the said
registration and the maintenance of State Medical Register is to be governed by
the law made by the State. It cannot, therefore, be said that the Central Act
lays down an exhaustive code in respect of the subject matter dealt with by the
State ACt. [665 E-H] 656
2.1
However it can be said that the Central Act and the State Act, to a limited
extent occupy the same field, viz, recognition of medical qualifications which
are required for a person to be registered as a medical practitioner in the
allopathic system of medicine. Both the enactments make provision for
recognition of such qualifications granted by the Universities or medical
institutions. [665 H, 666 A] Deep Chand v. State of Uttar Pradesh and Ors., [1959] suppl. 2 SCR 8,
relied on.
M. Karunanidhi
v. Union of India, [1979] 3SCR 254, referred to.
3. The
High Court erred in holding that the Central ACt does not lay down the
qualifications for registration of a medical practitioner. The provisions of
the Central Act contemplate that a person can practise in allopathic system of
medicine in a state or in the country only if he possesses a recognised medical
qualification. Permitting a person who does not possess the recognised medical
qualification in the allopathic system of medicine would be in direct conflict
with the provisions of the Central Act. [668 A, 668 C]
4. The
first proviso to Section 38 of the Travancore- Cochin Medical Practitioners'
Act, 1953 in so far as it empowers the State Government to permit a person to practise
allopathic system of medicine even though he does not pos- sess the recognised
medical qualifications for that system of medicine is inconsistent with the
provisions of Sections 15 and 21 read with Sections 11-14 of the Central Act.
The said proviso suffers from the vice of repugnancy in so far as it covers
persons who want to practise the Allopathic system of medicine and is void to
the extent of such repug- nancy.
Practitioners in allopathic system of medicine must, therefore, be excluded
from the scope of the first proviso and it must be confined in its application
to systems of medicines other than the Allopathic system of medicine. [668 C-E]
4.1.
The notification dated April
13, 1981, issued under
the first proviso to Section 38, which enables holders of DMS diploma to practise
modern medicine cannot be upheld and is set aside. However the order dated
September 20, 1978 treating the DMS diploma awarded by Government of Bihar at
par with Integrated DAM of the University of Kerala for the purpose of
continuing in profession only has not been issued under the 657 first proviso
to Section 38 of the State Act and it does not entitle the holders of DMS
diploma to get themselves regis- tered as medical practitioner in modern
medicine and prac- tise modern medicine. Consequently, it does not suffer from
the same infirmity as the notification dated April 13, 1981. [668 G-H, 669 A-B]
CIVIL
APPELLATE JURISDICTION : Civil Appeal No. 3847 of 1983.
From
the Judgment dated 14.10.1982 of the Kerala High court in O.P. No.3064 of 1981
C. M.A. Firoz for the Appellant.
J.
Ramamurthy, T.T. Kunhikannan, R. Mohan, M.K. Namboodry and K.R. Nambiar [N.P.]
for the Respondents.
The
Judgment of the Court was delivered by S. C. AGRAWAL, J. This appeal by special
leave is directed against the judgment of the High Court of Kerala dated October 14, 1982. It raises the question relating to
the validity of the first proviso to Section 38 of the Tranvancore-Cochin
Medical Practitioners' Act, 1953 (hereinafter referred to as 'the State Act')
and the order dated September 28, 1978 and notification dated April 13, 1981
issued by the Government of Kerala.
Section
38 of the State Act reads as under:
"38.
Persons not registered under this Act etc.
not to
practise:- No person other than (i) a registered practitioner or (ii) a
practitioner whose name is entered in the list of practitioners published under
Section 30 or (iii) a practitioner whose name is entered in the list mentioned
in Section 25 shall practise or hold himself out, whether directly or by
implication as practising modern medicine, homoepathic medicine, or ayurvedic
medicine, siddha medicine or such medicine shall practise any other medicine
unless he is also a registered practitioner of that medicine:
Provided
that the Government may, by notification in the Gazette direct that this
section shall not apply to any person 658 or class of persons or to any
specified area in the State where none of the three classes of practitioners
mentioned above carries on medical practice;
Provided
further that this section shall not apply to practitioner eligible for
registration under this Act who, after having filed the appli- cation for
registration, is awaiting the decision of the appropriate council or of the
Government in case of appeal.
Provided
also that this section shall not apply to a practitioner eligible for
registration under this Act until the period prescribed for applications under
Section 23 expires".
The
University of Kerala awards a degree as well as a diploma in Integrated
Medicine known as DAM. By notification dated May 4, 1977 issued by the
Government of Kerala under the first proviso to Section 38, it was directed
that Section 38 of the Act shall not apply to the degree holders of DAM and
diploma holders of DAM in practising modern medicine in the State. The
Government of Bihar through the Bihar State Board of Homoepathic Medicine
awards a Diploma in Medicine and Surgery called DMS. By order dated September
28, 1978, the Government of Kerala ordered that the said diploma (DMS) awarded
by the Government of Bihar will be held in par with the integrated DAM of Kerala
University for purpose of continuing in the profession only. The holders of DMS
approached the Government with a request to issue of notification similar to
notification dated May
4, 1977 to enable them
to practise Modern Medicine. The said request was earlier rejected by the
Government but ultimately it was acceded and a notification dated April 13, 1981
was issued by the Government of Kerala in exercise of the power con- ferred by
the first proviso to Section 38 of the State ACt whereby it was directed that
Section 38 shall not apply to holders of the DMS awarded by the Government of
Bihar. The aforesaid notifications dated May 4, 1977 and April 13, 1981 and order dated September 28, 1978 were challenged by the appellant
before the High Court of Kerala by filing a Writ Petition under Article 226 of
the Constitution. In the said Writ Petition it was submitted by the appellant
that after the enactment of the Indian Medical Council Act, 1956 (hereinafter
referred to as `the Central Act'), by Parlia- ment the first proviso to Section
38 of the State Act, being repugnant and inconsistent with the provisions of
Section 15 of the Central Act, has been rendered 659 void and ineffective and
the impugned notifications having been issued in exercise of the power
conferred by the said proviso are also void and ineffective. The validity of
the first proviso to Section 38 of the State Act was also challenged by the
appellant on the ground that it does not contain any guidelines for exercise of
the power conferred on the State Government and since it confers arbitrary
power on the State Government it is violative of the provisions of Article 14
of the Constitution.
The
said Writ Petition was contested by the State Government. On behalf of the
State Government it was submitted that since DAM of Kerala University had been
permitted practice of modern medicine, the Government did not see any reason
why the holders of DMS of Bihar Govern- ment should not practice and that the
order dated September 28, 1978 was passed by the Government after consultation
with the University of Kerala and the Director of Indigenous Systems of Medicine
and that due consideration was given by the Government to the allopathic
subjects taught in the Bihar DMS course. As regards the notification dated May 4, 1977 relating to DAM diploma holders and DAM diploma
holders of Kerala University, it was submitted that the challenge was highly belated.
The
High Court did not go into the validity of notification dated May 4, 1977
relating to DAM degree hold- ers and DAM diploma holders for the reason that no
one who would be affected by the invalidation of the said notifica- tion was
before the Court and in absence of any such person being impleaded as a party
to the Writ Petition, it was neither permissible nor lawful for the Court to
adjudicate upon the said question. While considering the validity of the other
two notifications relating to DMS Diploma holders of Bihar, the High Court
examined the provisions of the first proviso to Section 38 in the light of the
provisions contained in Section 15 of the Central Act. The High Court rejected
the contention urged on behalf of the State Govern- ment that the definition of
medicine contained in Section 2(f) of the Central Act would take in both Homoepathic
and indigenous systems of medicine and held that the Central Act concerns
itself with the allopathic medicine and the modern system that is contemplated
by it is the allopathic medi- cine. After examining the enactments the High
Court has observed that the State Act and the Central Act are both covered by
Entry 26 in List III of the schedule VII to the Constitution. The High Court,
therefore, considered the question whether the first proviso to Section 38 of
the State Act was repugnant to Section 15 of the 660 Central Act in the light
of the provisions contained in Article 254 of the Constitution. The High Court has
held that the Central Act does not lay down any qualification for registration
and all that Section 15 says is that a person whose name is not seen in the
State register shall not practise medicine. The High Court has also pointed out
that the proviso to Section 38 does not in terms say that a person whose name
is not on the rolls of the State register in one system can practise another
system. According to the High Court the proviso only exempts practitioners who
want to practice one system without being in the concerned list from the
operation of Section 38. The High Court was of the view that neither the
Central Act nor the State Act contains any provision which prohibits a person
who satisfies the authorities that he possesses the requisite qualification to practise
two systems from getting enrolled on two State rolls and a practitioner can be
a registered practitioner in two registers and the Central Act does not place
an embargo on a State from recognising qualifications for the purpose of two
systems, due regard being given to the course of study and subjects taught, for
such qualification and if that is possible, nothing prevents a State Government
from permitting a practitioner to be on two rolls. Although the High Court
found some repugnancy between the Central Act and the State Act, it was of the
view that the repugnancy was not one that was absolutely irreconcilable. The
High Court negatived the challenge to the validity of the first proviso to
Section 38 of the State Act on the ground to violation of Article 14 on the
view that the power conferred by the proviso vests in the State Government
which is a sufficient safeguard against arbitrary exercise of power. Since the
validity of the first proviso, Section 38 of the State Act was upheld the notification
dated April 13, 1981 issued under the said proviso was also upheld as valid by
the High Court.
The
appellant is assailing the validity of the first proviso to Section 38 of the
State Act on the ground of repugnancy under Article 254 (1) of the Constitution
which provides as under:
"254.
Inconsistency between laws made by Parliament and laws made by the Legislatures
of States -(1) if any provision of a law made by the Legislature of a state is
repugnant to any provi- sion of a law made by Parliament which Parliament is
competent to enact, or to any provision of an existing law with respect of one
of the matters enumerated in the Concurrent 661 List, then, subject to the
provisions of clause (2), the law made by Parliament, ,whether passed before or
after the law made by the Legislature of such State, or, as the case may be,
the existing law, shall prevail and the law made by the Legislature of the
State shall, to the extent of the repugnancy, be void".
In
order that Article 254(1) may apply, two conditions must be fulfilled:
"(1)
The provisions of the Provincial law and those of the Central legislation must
both be in respect of a matter which is enumerated in the Concurrent List, and
(2) they must be repugnant to each other. It is only when both these
requirements are satisfied that the Provincial law will, to the extent of the
repugnancy, become void".
A.S. Krishna v. State of Madras, [1957] SCR 399 Hoechst
Pharmaceuticals Ltd. & Another etc. v. State of Bihar & Others, [1983] 3 SCR 130.
In the
instant case the Central Act as well as the State Act are both laws made in
respect of the medical profession which is a matter relating to Entry 26 of the
Concurrent List. The question is : Are the provisions of the first proviso to
Section 38 of the State Act repugnant to any provision of the Central Act? This
question will have to be answered by applying the tests of repugnancy laid down
by this Court. In Deep Chand v. The State of Uttar Pradesh and Ors., [1959] Suppl. 2 SCR 8, this Court has laid down
that repugnancy between two statutes may be ascertained on the bases of the
following principles:
(1)
Whether there is direct conflict between the two provisions;
(2)
Whether Parliament intended to lay down an exhaustive code in respect of the
subject matter replacing the Act of the State Legislature; and
(3)
Whether the law made by Parliament and the law made by the State Legislature
occupy the same field". (P.43) 662 After considering the various decisions
construing the provisions of Article 254 this Court in M. Karunanidhi v. Union
of India, [1979] 3 SCR 254, the Court laid down following propositions:
"1.
That in order to decide the question of repugnancy it must be shown that the
two enactments contain inconsistent and irreconcilable provisions, so that they
cannot stand together or operate in the same field.
2.
That there can be no repeal by implication unless the inconsistency appears on
the fact of the two statutes.
3.
That where the two statutes occupy a particular field, there is room or possibility
of both the statutes operating in the same field without coming into collision
with each other, no repugnancy results.
4.
That where there is no inconsistency but a statute occupying the same field
seeks to create distinct and separate offences, no question of repugnancy
arises and both the statutes continue to operate in the same field".
[P.278] Keeping in view these principles, we will examine the provisions of the
State Act and the Central Act to ascertain the field of operation of the two enactments.
As
indicated in the Preamble the State Act is a law relating to medical
practitioners generally in the State of Travancore-Cochin (now Kerala) and it
has been enacted to regulate the qualifications and to provide for the
registration of the practitioners of modern medicine, homoe- pathic medicine
and indigenous medicine with a view to encourage the spread of such medicines.
In Clause (f) the expression "modern medicine" is defined to mean the
allo- pathic system of medicine. Clause (g) of Section 2 defines
"practitioner" to mean any person ordinarily engaged in the practice
of modern medicine or homoeopathic medicine or indigenous medicine as the case
may be. The expression "qualified practitioner" has been defined in
clause (i) to mean a qualification enumerated in the Schedule. The expres- sion
"registered practitioner" has been defined in Clause (i) of Section 2
to mean a practitioner whose name is for the time being entered in a register.
Under Clause (k), "register" means the 663 Register of practitioners
maintained under this Act. Section 3 makes provisions for establishment,
incorporation and constitution of Council of Modern Medicine, the Council of
Homoeopathic Medicine and the Counsel of Indigenous Medi- cine. Section 19
provides for appointment of a Registrar for each council and under Section
20(1) it is the duty of the Registrar to keep the registers. Section 20(2) lays
down that there shall be separate registers for modern medicine, homoeopathic
medicine, ayurvedic medicine, siddha medicine and unani-tibbi medicine. Section
23 lays down the condi- tions of eligibility for registration of a practitioner
and every holder of a recognised qualification is eligible.
Sections
28 and 29 make provision for removal of the name of a person from the register
of practitioners. Section 31(1) imposes a prohibition that no registered
practitioner, other than a qualified registered practitioner who has not under-
gone a course of practical training in surgery or obstetrics under modern
medicine to the satisfaction of that appropri- ate council, shall practise
surgery or obstetrics. Section 47 empowers the State Government to alter the
list of recog- nised qualifications mentioned in the Schedule to the Act on the
basis of the report of the appropriate Council. It would thus be seen that the
State Act governs the practitioners in the various systems of medicine
prevalent in the State by establishing separate councils for each system to
regulate the registration of such practitioners and also by prescrib- ing the
qualifications which shall be recognised for such registration.
The
Central Act has been enacted to provide for the reconstitution of the Medical
Council of India and the maintenance of medical register for India and for
matters connected therewith. The expression "medicine" is defined in
Clause (f) of Section 2 to mean modern scientific medicine in all its branches
including surgery and obstetrics but excluding veterinary medicine and surgery.
In Clause (h) the expression "recognised medical qualification" has
been defined to mean any of the medical qualifications included in the
Schedules. "State Medical Council" has been defined in Clause (j) to
mean a medical council constituted under any law for the time being in force in
any state regulating the registration of practitioners of medicine. Clause (k)
defines "State Medical Register" to mean a register maintained under
any law for the time being in force in any State regulating registration of
practitioners of medicine.
Section
3 provides for the constitution of the Medical Council of India Sections 11 to
14 deal with recognition of medical qualifications granted by universities or
medical 664 institutions in India as well as by medical institutions outside
India. Section 15 enables a person possessing the medical qualifications
included in the Schedule to be enrolled on any State Medical Register and it
prohibits a person other than a medical practitioner enrolled on a State
Medical Register to practise medicine in any State.
Section
16 prescribes that every university or medical institution in India which
grants recognised medical qualification shall furnish such information as the
Indian Medical Council may from time to time require as to the course of study
and examinations to be undergone in order to obtain such qualification, as to
the ages at which such course of study and examinations are required to be
undergone and such qualification is conferred and generally as to the
requisites for obtaining such qualification.
Section
17 provides for the appointment of medical inspectors for inspection of any
medical institution, college, hospital or other institution where medical
education is given. Under Section 18 the Medical Council of India has been
empowered to appoint visitors to inspect any medical institution, college
hospital or other institution where medical education is given or attend any
examination held by any university or medical institution for the purpose of
granting recognised medical qualification.
Section
19 provides for withdrawal of recognition of a medical qualification by the
Central Government on the basis of the representation by the Medical Council.
Section 19-A empowers the Medical Council of India to prescribe the minimum
standards for medical education required for granting recognised medical
qualifications by the universities or medical institutions in India. Section
20-A empowers the Medical Council of India to prescribe the standards of
professional conduct and etiquette and a code of ethics for medical
practitioners. Section 21 makes provision for maintaining a register of medical
practition- ers known as the Indian Medical Register, which shall con- tain the
names of all persons who are for the time being enrolled on any State Medical
Register and who possess any of the recognised medical qualifications. Section
34(1) provides for removal of the name of a person from the India Medical
Register if his name has been removed from the State Medical Register in
pursuance of any power conferred by or under any law relating to registration
of medical practi- tioners for the time being in force in any state. Section 27
provides that every person whose name is for the time being borne on the Indian
Medical Register shall be entitled according to his qualification to practise
as a medical practitioner in any part of India.
665
The High Court, in our opinion, has rightly held that the expression 'modern
scientific medicine' in Section 2(f) of the Central Act refers to the
Allopathic system of medi- cine and that the provisions of the Central Act have
been made in relation to medical practitioners practising the said system. This
view finds support from the fact that after the enactment of the Central Act,
Parliament has enacted the Indian Medicine Central Council Act, 1970 in
relation to the system of Indian medicine commonly known as Ayurveda, Siddha
and Unani and the Homeopathy Central Coun- cil Act, 1973 in relation to homoepathic
system of medicine wherin provisions similar to those contained in the Central
Act have been made in relation to the said systems of medi- cine.
From
the provisions of the State Act, noticed earlier, it is evident that the field
of operation of the State Act covers all the systems of medicine, namely,
allopathic, ayurvedic, siddha, unani and homoepathic system of medicine.
Moreover
the State Act deals with recognition of qualifications required for
registration of a person as a medical practitioner in these systems, conditions
for registration of medical practitioners and maintenance of register of
practitioners for each system and the constitution of separate councils for
modern medicine, homoepathic medicine and indigenous medicine. As compared to
the State Act, the field of operation of the Central Act is restricted and it
is confined in its application to modern scientific medicine, namely, the
allopathic system of medicine only, wherein also it deals with recognition of
medical qualifications which may entitle a person to be registered as a medical
practitioner, constitution of the Medical Council of India to advise the
Central Government in the matter of recognition or withdrawal of recognition of
medical qualifications, to prescribe the minimum standards of medical education
required for granting recognised medi- cal qualifications by universities or
medical institutions in India and to appoint inspectors and visitors for inspec-
tion of any medical institution, college or hospital. It also provides for
maintaining the Indian Medical Register and for enrolment of a person
possessing recognised medical qualification in the said register and for
removal of a person from the said register. The Central Act does not deal with
the registration of medical practitioners in the States and it proceeds on the
basis that the said registration and the maintenance of State Medical Register
is to be governed by the law made by the State. It cannot, therefore, be said
that the Central Act lays down an exhaustive code in respect of the subject
matter dealt with by the State Act. It can, however, 666 be said that the Central
Act and the State Act, to a limited extent occupy the same field, viz.,
recognition of medical qualifications which are required for a person to be
registered as a medical practitioner in the allopathic system of medicine. Both
the enactments make provision for recognition of such qualifications granted by
the universities or medical institutions. The third test of repugnancy laid
down in Deep Chand's case (supra) is, therefore, satisfied. Since the grievance
of the appellant is confined to the first proviso to section 38 of the State
Act, we would examine whether the provisions of the First Proviso to Section 38
of the state Act, are inconsistent with any of the provisions of the central
Act and whether it is possible to reconcile the provisions of the First Proviso
to Section 38 of the State Act with the provisions of the Central Act. The main
part of Section 38 prohibits a person other than those mentioned in the three
categories specified therein, namely, (i) a registered practitioner or (ii) a
practitioner whose name is entered in the list published under Section 30 or
(iii) a practitioner whose name is entered in the list published under Section
25 to practise or to hold himself out, Whether by directly or by implica- tion,
as practising modern medicine, homoepathic medicine, ayurvedic medicine, siddha
medicine or unani-tibbi medicine and it further lays down that no person who is
not a regis- tered practitioner of such medicine shall practice any other
medicine unless he is also a registered practitioner in that medicine. In other
words, the main part of Section 38 in- sists upon compliance with the
requirements of the provi- sions of the State Act prescribing the conditions
for regis- tration as a medical practitioner which includes holding a recognised
qualification, i.e., a qualification enumerated in the schedule to the State
Act, in respect of a particular system of medicine in which he wishes to practise.
The first proviso to Section 38 enables the State Government to dis- pense with
the requirements of the main part of Section 38 in relation to any person or
class of persons or in relation to any specified area in the State where none
of the three classes of practitioners mentioned above carries on medical
practice. As a result a person can be permitted to practise as a medical
practitioner even though he does not possess the recognised qualifications
which are necessary for a person to be registered as a medical practitioner in
a particular system of medicine. This provision in so far as it relates to the
allopathic system of medicine, runs con- trary to the provisions of the Central
Act. Under S.11(1) of the Central Act Medical qualifications granted by any uni-
versity or medical institution in India which are included in the First 667
Schedule of the said Act alone are the recognised medical qualifications and
under Section 11(2) a medical qualifica- tion granted by any university or
medical institution in India which is not included in the First Schedule can be
included in the said Schedule by the Central Government by a notification in
the Official Gazette after consulting the Medical Council of India. Similar
provisions are contained in Section 12 in relation to medical qualifications
granted by medical institutions outside India in connection with which there is
a scheme of reciprocity which qualifications are included in the Second
Schedule and Section 13 relating to medical qualifications granted by medical
institutions in India or outside India which are included in Part I and II of
the Third Schedule. Section 14 contains a special provi- sion empowering the
Central Government after consultation with the Medical Council of India to give
recognition to medical qualifications granted by medical institutions in any
country outside India in respect of which a scheme of reciprocity for the
recognition of such medical qualifica- tion is not in force. Section 15(1)
entitles a person having recognised medical qualification under the Act to be
en- rolled in any state medical register. Under sub-s.(2) of section 15 no
person other than a medical practitioner enrolled on a State medical register
shall practise medicine in any State. The object underlying these provisions in
the Central Act is that a person possessing a recognised medical qualification
alone is entitled to be registered as a medi- cal practitioner and it is the
Central Government alone which can declare a particular medical qualification
as a recognised medical qualification in accordance with the provisions
contained in Section 11 to 14 of the Act. More- over the Central Act, in
Section 19-A, empowers the Medical Council of India to prescribe the minimum
standards of medical education required for granting recognised medical
qualifications by universities or medical institutions in India. Section 16, 17
and 18 confer powers on the Medical Council of India to keep an eye on the
imparting of medical education by the universities and medical institutions in India and to appoint inspectors and
visitors for that pur- pose. Section 19 enables the Central Government to
withdraw the recognition to a medical qualification on the basis of the
representation by the Medical Council of India. These provisions indicate that
in enacting the Central Act the intention of Parliament was to ensure that only
persons having adequate knowledge of the allopathic system of medi- cine are
able to practise medical profession.
668 We
are, therefore, unable to agree with the view of the High Court that the
Central Act does not lay down the qualifications for registration of a medical
practitioner.
We may
in this context refer to sub-s.(1) of Section 15 which postulates the holding
of a recognised medical quali- fication by a person for being registered in the
State Medical Register so as to entitle to practise modern scien- tific
medicine in the state and sub-s.(1) of Section 21 which provides that the
Indian Medical Register that is required to be maintained by the Medical
Council of India shall contain the name of persons who are for the time being
enrolled in the State Medical Register and who possess any of the recognised
medical qualifications. These provisions contemplate that a person can practise
in allopathic system of medicine in a state or in the country only if he
possess- es a recognised medical qualification. Permitting a person who does
not possess the recognised medical qualification in the allopathic system of
medicine would be in direct con- flict with the provisions of the Central Act.
We are, there- fore, of the view that the first proviso to Section 38 of the
State Act in so far as it empowers the State Government to permit a person to practise
allopathic system of medicine even though he does not possess the recognised
medical qualifications for that system of medicine is inconsistent with the
provisions of Section 15 & 21 read with Sections 11- 14 of the Central Act.
The said proviso suffers from the vice of repugnancy in so far as it covers
persons who want to practice the Allopathic system of medicine and is void to
the extent of such repugnancy. Practitioners in allopath- ic system of medicine
must, therefore, be excluded from the scope of the first proviso and it must be
confined in its application to systems of medicines other than the Allopath- ic
system of medicine. We, however, wish to make it clear that we have not
considered the impact of the provisions contained in the Indian medicine
Central Council Act, 1970 and the Homoeopathy Central Council Act, 1973 on the provi-
sions of the said proviso to Section 38 of the State Act.
The
notification dated April
13, 1981 has been
issued under the first proviso to Section 38 and in express terms it enables
holders of DMS diploma of Government of Bihar to practise modern medicine in
the State of Kerala and makes them eligible for
registration as practitioners in modern medicine. Since the scope of the first
proviso has been restricted to exclude the system of modern medicine, the said
notification cannot be 669 upheld and must be set aside. The same, however,
cannot be said with regard to Order dated September 20, 1978 whereby the DMS diploma awarded by
Government of Bihar is to be treated at par with Integrated DAM of the University of Kerala for the purpose of continuing in profession only. The said
order has not been issued under the first proviso to Section 38 of the State
Act and it cannot be said that it entitles the holders of DMS diploma to get themselves
registered as medical practitioners in modern medicine and practise modern
medicine. The said order dated September 20, 1978, does not suffer from the same infirmity as the notifi- cation dated April 13, 1981.
In the
result, the appeal is partly allowed. The judgment and order of the High Court
of Kerala dated October
14, 1982 is set aside
and the Writ Petition filed by the appellant is allowed to the extent that the
notification (Ex.P8) dated April 13, 1981
is quashed. No order as to costs.
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