Association of Medical Super Specialityaspirants and Residents & Ors. vs Union of India & Others

Constitution of India: Art.14 – Notification issued by State Government for compulsory execution of bond at the time of admission of candidates to post-graduate courses and super specialty courses providing that they shall serve the State Government for certain stipulated period on successful completion of courses failing which they will be liable to recompense the State Government – Whether violated fundamental rights and is arbitrary – Held: Running medical colleges with post-graduate and super speciality courses requires huge infrastructure – However, the amount of fees charged from the students is meagre in comparison to the private medical colleges – The doctors are to paid reasonable stipend – Government hospitals run by the State are duty bound to extend medical assistance for preserving human life – Failure on the part of a Government hospital to provide timely medical treatment to a person in need of such treatment results in violation of his right guaranteed under Art.21 of the Constitution – Consequently, a policy decision taken by the State Governments to utilize the services of doctors who were beneficiaries of Government assistance to complete their education cannot be termed arbitrary. Constitution of India: Art.14 – Notifications issued by the State Governments imposing a condition of compulsory service and a default clause – Reasonableness of – Held: Notifications imposing a condition of compulsory service and a default clause are per se not unreasonable – However, the period of compulsory service and the exit should be reasonable – State Governments and Armed Forces Medical College are directed to consider imposing the condition of compulsory service period of two years in default of which the Doctors would recompense the Government by paying Rs. 20 Lakhs.

Constitution of India: Arts.19(1)(g), 19(6) – Right to life and liberty – Right to take decisions relating to profession – According to the Appellants, the right to carry on their profession guaranteed by Art.19(1)(g) is violated by the compulsory bonds and that any restriction on their right to carry on their profession by the State Government can be made only by a “law” as per Art. 19(6) of the Constitution – Held: The compulsory bond executed by the Appellants is at the time of their admissions into post-graduate and super speciality courses – Conditions imposed for admission to a medical college will not directly violate the right of an individual to carry on his profession – The right to carry on the profession would start on the completion of the course – At the outset, there is no doubt that no right inheres in an individual to receive higher education – Violation of a right guaranteed under Art.19(1)(g) does not arise in a case pertaining to admission to a college – The condition that is imposed has a connection with the professional activity of a doctor on completion of the course – However, the Appellants have, without any protest, accepted the admissions and executed the compulsory bonds – Appellants have not succeeded in their attempt of assailing the Notifications for being violative of Art.19(1)(g) of the Constitution.

Constitution of India: Arts.21, 47 – Right to life – Art.21 imposes an obligation on the State to safeguard the right to life of every person – Preservation of human life is thus of paramount importance – The Government hospitals run by the State and the Medical Officers employed therein are duty bound to extend medical assistance for preserving human life – In a welfare State, it is the obligation of the State to ensure the creation and the sustaining of conditions congenial to good health – Art.47 reiterates the constitutional obligation imposed on the State to improve public health.

Constitution of India: Art.21 – Right to live with dignity – Right to life enshrined in Art.21 cannot be restricted to mere animal existence – It means something much more than just physical survival – The right to life includes the right to live with human dignity and all that goes along with it, namely, the bare necessaries of life such as adequate nutrition, clothing and shelter, and facilities for reading, writing and expressing oneself in diverse forms, freely moving about and mixing and commingling with fellow human beings – Dignity is the core which unites the fundamental rights because the fundamental rights seek to achieve for each individual the dignity of existence – The State’s obligations are not satisfied solely by refraining from imposing limitations on the right to human dignity – State must also take action to protect human dignity and to facilitate its realization – The constitutional right to dignity is intended to ensure human beings’ political and civil liberties as well as their social and economic freedoms.

Constitution of India: Art.23 – Whether the conditions of the bond per se amount to ‘forced labour’ and thus violative of Art.23(1) – Appellants who are required to work for a short period on a decent stipend cannot complain that they are made to perform ‘forced labour’, especially after they took an informed decision to avail the benefits of admission in government medical colleges and received subsidized education – By no means, the service rendered by the Appellants in Government hospitals would fall under the expression of ‘forced labour’ – Art.23(2) enables the State Governments to require the Appellants to do compulsory service in the Government hospitals which is undoubtedly for the benefit of the public.

Constitution of India: Art.47 – Right to health is integral to the right to life –

Government has a constitutional obligation to

provide health facilities – Art.47 reiterates the constitutional obligation imposed on the State to improve public health – It is for the State to secure health to its citizens as its primary duty – No doubt, the Government is rendering this obligation by opening Government hospitals and health centers, but in order to make it meaningful, it has to be within the reach of its people, as far as possible, to reduce the queue of waiting lists, and it has to provide all facilities to employ best of talents and tone up its administration to give effective contribution, which is also the duty of the Government – The immediate need of the deprived sections of the society to have proper health care is the reason behind the Government policy of imposing a condition of compulsory service and a default clause – The objective of the policy is to ensure that specialist health care is extended to the have-nots also – The right that is claimed by the Appellants is to make an individual choice to carry on their profession which might be hindered by the policy decision of the Government – On the other hand, the basic idea behind the Government’s decision is larger public interest – Right to life guaranteed by Art.21 means right to life with human dignity – While balancing communitarian dignity vis-à-vis the dignity of private individuals, the scales must tilt in favour of communitarian dignity – The laudable objective with which the State Governments have introduced compulsory service bonds is to protect the fundamental right of the deprived sections of the society guaranteed to them under Art.21 – The contention of the Appellants that their rights guaranteed under Art.21 have been violated is rejected.

Specific Relief Act, 1963: s.14 – Contract of Personal Service – Prohibition of specific performance of contract for personal service – Held: s.14 of the Specific Relief Act prohibits the enforcement of contracts of personal service – It is trite law that Courts do not ordinarily enforce performance of contracts of personal character, such as a contract of employment – None of the State Governments made an attempt to enforce the contracts entered into by them with the appellants through the service bonds – Constitution of India.

Contract Act, 1872: s.27 – Restraint on Profession – Plea of the Appellants that compulsory bonds placed a restraint on their profession and thus, would be contrary to s.27 of the Contract Act – Held: A contract entered into by Appellants to serve the government for a few years under reasonable terms cannot be described as one in restraint of trade – The conditions of compulsory bonds for admission to post-graduate and super-Speciality courses in government medical colleges are not in violation of s.27 of the Contract Act – All the Doctors who have executed compulsory bonds shall be bound by the conditions contained therein – Taking note of the fact that certain State Governments have rigid conditions in the compulsory bonds to be executed by the Appellants and the felt need of uniformity in the matter pertaining to the compulsory bonds, suitable steps should be taken by the Union of India and the Medical Council of India to have a uniform policy regarding the compulsory service to be rendered by the Doctors who are trained in government institutions – Constitution of India.

Dismissing the writ petitions and appeals, the Court HELD: I. Jurisdiction of the State Government:

1. Entry 66 of List I of the 7th Schedule to the Constitution refers to coordination and determination of standards in institutions for higher education or research and scientific and technical institutions. Entry 25 of List III of the 7th Schedule deals with education, including technical education, medical education and universities, subject to the provisions of entries 63, 64, 65 and 66 of List I. Legislations can be made by the State Legislature relating to medical education subject to the legislation made by the Parliament. The Medical Council of India Act governs the field of medical education in this country. Admittedly, there is no provision in the Medical Council of India Act touching upon the subject matter of compulsory bonds. Therefore, the States are free to legislate on the subject matter of medical bonds. Executive authority of the State Government is co-extensive with that of the legislative power of the State Legislature. Even in the absence of any legislation, the State Government has the competence to issue executive orders under Article 162 of the Constitution on matters over which the State legislature has the power to legislate. The field of bonds requiring compulsory employment is not covered by any Central Legislation. Therefore, the submissions made on behalf of the Appellants that the States lacked competence to issue the notifications as the field is occupied are rejected. [Para 17] [1035-G-H; 1036-A-C] Violation of Fundamental Rights: Article 14 :

Arbitrariness and reasonableness

2.1 Huge infrastructure has to be developed and maintained for running medical colleges with post-graduate and super Speciality courses. The amount of fees charged from the students is meagre in comparison to the private medical colleges. Reasonable stipend has to be paid to the doctors. Above all, the State Governments have taken into account the need to provide health care to the people and the scarcity of super specialists in their States. Consequently, a policy decision taken by the State Governments to utilize the services of doctors who were beneficiaries of Government assistance to complete their education cannot be termed arbitrary. Also, Notifications imposing a condition of compulsory service and a default clause are per se not unreasonable. However, the period of compulsory service and the exit should be reasonable. The State Governments and the Armed Forces Medical College are directed to consider imposing the condition of compulsory service period of two years in default of which the Doctors shall recompense the Government by paying Rs. 20 Lakhs. [Paras 18-19] [1036-H; 1037-A-B, G-H] Article 19:

2.2 The compulsory bond executed by the Appellants is at the time of their admissions into post-graduate and super Speciality courses. Conditions imposed for admission to a medical college will not directly violate the right of an individual to carry on his profession. The right to carry on the profession would start on the completion of the course. At the outset, there is no doubt that no right inheres in an individual to receive higher education. Violation of a right guaranteed under Article 19(1)(g) does not arise in a case pertaining to admission to a college. There is no doubt, that the condition that is imposed has a connection with the professional activity of a doctor on completion of the course. However, the Appellants have, without any protest, accepted the admissions and executed the compulsory bonds. Execution of bonds is part of a composite package. The Appellants have not been able to succeed in assailing the Notifications for being violative of Article 19(1)(g) of the Constitution. [Para 20] [1038-C-E]

Article 21

2.3 Article 21 of the Constitution of India imposes an obligation on the State to safeguard the right to life of every person. Preservation of human life is thus of paramount importance. The Government hospitals run by the State and the Medical Officers employed therein are duty bound to extend medical assistance for preserving human life. Failure on the part of a Government hospital to provide timely medical treatment to a person in need of such treatment results in violation of his right guaranteed under Article 21 of the Constitution. Therefore, in a welfare State it is the obligation of the State to ensure the creation and the sustaining of conditions congenial to good health. Article

47 of the Constitution reiterates the constitutional obligation imposed on the State to improve public health. It is for the State to secure health to its citizens as its primary duty. No doubt the Government is rendering this obligation by opening Government hospitals and health centers, but in order to make it meaningful, it has to be within the reach of its people, as far as possible, to reduce the queue of waiting lists, and it has to provide all facilities to employ best of talents and tone up its administration to give effective contribution, which is also the duty of the Government. [Paras 21-22, 25] [1039-B-C, G; 1040-A]

Akhil Bharatiya Soshit Karamchari Sangh v. Union of India (1981) 1 SCC 246 : [1981] 2 SCR 185; Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996) 4 SCC 37 : [1996] 2 Suppl. SCR 331; State of Punjab v. Ram Lubhaya Bagga (1998) 4 SCC

117:[1998] 1 SCR 1120 ; Union of India v. Moolchand Khairati Ram Trust. (2018) 8 SCC 321 : [2018] 7 SCR 939; Kharak Singh v. State of U.P. AIR 1963 SC 1295: [1964] SCR 332 ; Vincent Panikurlangara v. Union of India (1987) 2 SCC 165: [1987] 2 SCR 468

- relied on.

2.4 Right to health is integral to the right to life. Government has a constitutional obligation to provide health facilities. The fundamental right to life which is the most precious human right and which forms the ark of all other rights must therefore be interpreted in a broad and expansive spirit so as to invest it with significance and vitality which may endure for years to come and enhance the dignity of the individual and the worth of the human person. The right to life enshrined in Article 21 cannot be restricted to mere animal existence. It means something much more than just physical survival. The right to life includes the right to live with human dignity and all that goes along with it, namely, the bare necessaries of life such as adequate nutrition, clothing and shelter, and facilities for reading, writing and expressing oneself in diverse forms, freely moving about and mixing and commingling with fellow human beings. Every act which offends against or impairs human dignity would constitute deprivation pro tanto of this right to live and the restriction would have to be in accordance with reasonable, fair and just procedure established by law which stands the test of other fundamental rights. To live is to live with dignity. The draftsmen of the Constitution defined their vision of the society in which constitutional values would be attained by emphasizing, among other freedoms, liberty and dignity. So fundamental is dignity that it permeates the core of the rights guaranteed to the individual by Part III of the Constitution. Dignity is the core which unites the fundamental rights because the fundamental rights seek to achieve for each individual the dignity of existence. The State’s obligations are not satisfied solely by refraining from imposing limitations on the right to human dignity. The State must also take action to protect human dignity and to facilitate its realization. [Paras 26-28] [1040-B-F]

State of Punjab & Ors. v. Mohinder Singh Chawla (1997) 2 SCC 83:[1996] 10 Suppl. SCR 279; Francis Coralie Mullin v. Administrator, Union Territory of Delhi, (1981) 1 SCC 608: [1981] 2 SCR 516

- relied on.

2.5 The positive obligation of the State to uphold the dignity of a larger section of the society is to protect the rights conferred on them by Article 21 of the Constitution. The immediate need of the deprived sections of the society to have proper health care was the reason behind the policy decision of the Government. The objective of the policy is to ensure that specialist health care is extended to the have-nots also. [Para 30] [1041-D]

K.S. Puttaswamy v. Union of India (2017) 10 SCC 1 : [2017] 10 SCR 569 - followed.

2.6. The right that is claimed by the Appellants is to make an individual choice to carry on their profession which might be hindered by the decision of the Government. On the other hand, the basic idea behind the Government’s decision is larger public interest. Private interest has to take a backseat when pitted against public interest. [Para 31] [1041-F]

Mr. X v. Hospital ‘Z’, (1998) 8 SCC 296 : [1998] 1 Suppl. SCR 723; Sayyed Ratanbhai Sayeed (D) thr. LRs & ORs.v. Shirdi Nagar Panchayat & Anr. (2016) 4 SCC 631 : [2016] 11 SCR 476 - relied on.

2.6 The Universal Declaration of Human Rights (UDHR) recorded in the Preamble its recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family as the foundation of freedom, justice and peace. The International Covenant on Economic, Social and Cultural Rights (ICESCR) recognizes the right of every person to the enjoyment of the highest attainable standard of physical and mental health. ICESCR mandates the States Parties to achieve full realization of the aforementioned right through the creation of conditions which would assure to all, medical service and medical attention in the event of sickness, inter alia. Right to life guaranteed by Article 21 means right to life with human dignity. Communitarian dignity has been recognised by this Court. While balancing communitarian dignity vis-à-vis the dignity of private individuals, the scales must tilt in favour of communitarian dignity. The laudable objective with which the State Governments have introduced compulsory service bonds is to protect the fundamental right of the deprived sections of the society guaranteed to them under Article 21 of the Constitution of India. The contention of the Appellants that their rights guaranteed under Article 21 of the Constitution of India have been violated is rejected. [Paras 32-33] [1042-C-F]

2.7 Whether the conditions of the bond per se amount to ‘forced labour’ and thus violative of Article 23 (1) of the Constitution. The Appellants who are required to work for a short period on a decent stipend cannot complain that they are made to perform ‘forced labour’, especially after the Appellants have taken an informed decision to avail the benefits of admission in government medical colleges and received subsidized education. By no means, the service rendered by the Appellants in Government hospitals would fall under the expression of ‘forced labour’. Article 23 (2) of the Constitution enables the State Governments to require the Appellants to do compulsory service in the Government hospitals which is undoubtedly for the benefit of the public. [Paras 35-36] [1043-A-C, E]

Robertson v. Baldwin 165 U.S. 275 (1897) ; Butler v. Perry (1916), 240 U.S. 328, 329 - referred to

3. Contract of Personal Service

Section 14 of the Specific Relief Act, 1963 prohibits the enforcement of contracts of personal service. It is trite law that Courts do not ordinarily enforce performance of contracts of personal character, such as a contract of employment. Specific performance of contract for personal service is not permissible under the Specific Relief Act, therefore, there cannot be a decree for specific performance of a contract of personal nature. None of the State Governments have made an attempt to enforce the contracts entered into by them with the Appellants through the service bonds. The compulsory bonds fall foul of the Specific Relief Act. [Paras 37-38] [1043-F; 1044-C]

Rigby v. Connol (1880) 14 Ch D 482 - referred to

4. Restraint on Profession

A contract entered into by Appellants to serve the government for a few years under reasonable terms cannot be described as one in restraint of trade. The conditions of compulsory bonds for admission to post-graduate and superSpeciality courses in government medical colleges are not in violation of Section 27 of the Indian Contract Act, 1872. All the Doctors who have executed compulsory bonds shall be bound by the conditions contained therein. [Paras 39-40] [1044-F-H; 1045-A]

Esso Petroleum v. Harper’s Garage (Stourport) Ltd. 1967 1 All ER 699 - referred to.

5. Uniform policy

Taking note of the fact that certain State Governments have rigid conditions in the compulsory bonds to be executed by the Appellants and the felt need of uniformity in the matter pertaining to the compulsory bonds, suitable steps should be taken by the Union of India and the Medical Council of India to have a uniform policy regarding the compulsory service to be rendered by the Doctors who are trained in government institutions. [Para 41] Harsh Pratap Sisodia v. Union of India (1999) 2 SCC

575 : [1999] 1 SCR 466; Anand Biji v. State of Kerala. (2001) 6 SCC 665 : [2001] 2 Suppl. SCR 1; Dr.

Pradeep Jain v. Union of India. (1984) 3 SCC 654: [1984] 3 SCR 942 ; Rai Sahib Ram Jawaya Kapur v. State of Punjab [1955] 2 SCR 225 ; Bhishambar Dayal Chandra Mohan v. State of Uttar Pradesh (1982) 1 SCC

39 : [1982] 1 SCR 113; Dr. Vinod Shankarlal Sharmaa & Ors. v. The State of Maharashtra & Anr. (2013) AIR Bom.1 ; People’s Union for Democratic Rights v. Union of India (1982) 3 SCC 235 : [1983] 1 SCR 456 ; Ch. Tikaramji v. State of Uttar Pradesh AIR 1966 SC

676 ; Modern Dental College and Research Centre v. State of Madhya Pradesh (2016) 7 SCC 353 ;

Esso Petroleum v. Harper’s Garage (Stourport) Ltd.1967

1 All ER 699 - referred to.