The Supreme Court today rebuffed the Government’s bid to renew permission to nine medical colleges across the country without clearance by the Medical Council of India (MCI). A bench headed by Justice Y K Sabharwal directed that the applications of those colleges for permission could be considered by the Government only after the MCI inspects their premises and gives its recommendations.But while his seven-month Bill to take over the regulation of medical education is still awaiting the Cabinet’s approval, Health Minister Anbumani Ramadoss has already overruled the findings of the MCI.On July 15, Ramadoss allowed a private medical college near Delhi to double the number of MBBS seats even though the last inspection done by the MCI, which is the statutory regulator of medical education, revealed that the college was not equipped to cater even to the existing strength of students.The MCI inspection done barely three months earlier exposed deficiencies in the Ghaziabad-based Santosh Medical College and Hospital, which had been admitting 50 students every year in the MBBS course for a decade.These include:• No patients in any of the wards• Labour rooms were locked• No patients in any of the pre-operative and post-operative wards and ICU• One patient in Paediatric ICU• Three patients in Casualty• Labs and pantries were not operative• No operations were being conducted in any of the operation theatres (OTs) and there was no OT list available for the day• Blood Bank had only two units of bloodIf Ramadoss could permit Santosh Medical College to increase its intake this year from 50 to 100 students despite such damaging findings by the MCI, it was, as he told The Indian Express, for two reasons: one, a judgment in favour of the college from the Allahabad High Court and, two, a fresh inspection done by another agency at the instance of the Health Ministry.The judgment was on a petition filed by the college challenging the legality of the inspection conducted by the MCI on March 29 as it was actually the second inspection done by it, that too in the same month.In the normal course, there should have been only one inspection by the MCI—an inspection done with prior intimation to the college to check whether it was equipped to train the proposed number of MBBS students. Such an inspection was carried out on March 21-22 and, two days later, the MCI’s executive committee decided to recommend enhancement of seats in Santosh Medical College.Yet, rather than sending that recommendation to the Government, the MCI conducted the second inspection on March 29 without notice because of a sting operation by TV channel Aaj Tak questioning the authenticity of much of what was shown by the college during the first inspection. The second inspection confirmed the news channel’s allegations and came up with findings contrary to those of the first one.But before the MCI could send its recommendation on the basis of the second inspection, the college obtained a stay order from the high court. And despite the MCI’s explanation for its departure from the norm, the high court finally directed it to send both the inspection reports to the Government.It was in such conditions that Ramadoss ordered a third inspection of the college on July 8 and it was conducted three days later by the Directorate General of Health Services.When asked why he allowed Santosh Medical College to double its MBBS seats without the MCI’s recommendation, Ramadoss said: ‘‘We acted on the orders of the Allahabad High Court which directed us to proceed on the basis of the available material.’’Why did Ramadoss order a separate inspection by the DGHS over the head of the MCI? ‘‘I did that on my own as a measure of abundant caution to leave no scope for anybody to allege that we decided the matter arbitrarily,’’ he said.A visit by The Indian Express revealed there are more locked rooms than patients.Among the rooms locked were: An emergency operation theatre; all minor operation theatres; blood bank registration room; opthalmology ward; CT scan, cytopathology and parasitology rooms.The microbiology lab had almost nothing inside and two of the three hospital gates were closed. There was not more than a handful of patients turning up at the various OPDs.Founder and Chairman of the Santosh Medical College and Hospital Dr P Mahalingam, however, denied charges that his hospital did not have the infrastructure to support 100 medical students. ‘‘In the last 10 years of our existence, we have produced meritorious students. This would not have been possible without having the infrastructure. I’m not a businessman, but a professional cardiologist.’’He regretted that the college was always at the receiving end of MCI’s ‘‘vindictive’’ actions.In its brief report, the DGHS team concluded that the infrastructure found in the college ‘‘meets the basic minimum requirement for 100 annual academic admissions.’’The DGHS clarified that it had given its finding on the infrastructure aspect not on the basis of any independent probe but ‘‘after verifying the hospital/college records, on the basis of facts provided by the hospital/college.’’The DGHS recommendation, however, is silent on two other criteria for determining the strength of the students: one, faculty, which includes teaching staff and resident doctors, and two, clinical material, which means the daily turnover of patients in various departments.This is despite the fact that the MCI regulations stipulate that to admit 100 students, the hospital should have, for instance, at least 500 beds for admitted patients with 80 per cent occupancy and daily OPD attendance of 800 patients.In contrast to the findings of the MCI’s surprise inspection, the DGHS report said the OPD was ‘‘significantly crowded’’. On the faculty issue, the DGHS report does not say whether their strength met the MCI stipulation for admitting 100 students. All it said was that ‘‘the physical verification of the faculty available in the hospital was carried out and the faculty on vacation was cross-checked.’’The MCI’s surprise inspection had disclosed a 34 per cent deficiency in the teaching faculty and 90 per cent deficiency in senior and junior residents. MCI regulations put the condonable deficiency of teaching staff at 5 per cent.
