Posting most doctors in urban areas only perpetuates vested interests: Patna HC raps Bihar Govt for not incentivising doctors in rural areas

Observing that the State government was “neglecting rural areas” in terms of appointment of doctors, the Patna High Court recently directed the Chief Secretary to fill up doctor vacancies in rural areas and difficult terrains, either through transfers or recruitments “to the maximum extent possible.”.A Division Bench comprising of Chief Justice Sanjay Karol and Justice S Kumar ordered,."The Chief Secretary, Government of Bihar shall, with the normalization of the current Pandemic COVID-19, ensure that vacancies in the rural/ remote/ difficult areas are filled up to the maximum extent possible, either by transfer or expediting the process of recruitment."Patna High Court.It also expressed displeasure over the fact the percentage of vacancies of doctors in the rural areas is extremely high and grossly disproportionate as against the doctors in the urban area. .In this regard, it was noted that of 8,768 doctor vaccancies in Bihar, 5,674 vacancies were in rural, remote or difficult areas..The Bench added, ."... how does posting of majority of the doctors in the urban area help anyone, save and except perpetuate vested interests?"Patna High Court.Factual Background.The Court was dealing with petitions challenging the State Government’s decision to not give incentive marks to doctors who had served in rural or difficult areas, for the purposes of determining their merit in the National Eligibility and Entrance Test (NEET) PG examination..The provision in focus was a 2012 Regulation issued by the Medical Council of India (MCI). .As per the proviso to Regulation 9 (IV) of the MCI's 2012 Regulations, the State Government was given the discretion to extend incentive marks for those in-service doctors posted in rural or difficult areas. .Further, Regulation 9 (VII) extended a 50% reservation in PG Diploma courses for doctors who had served in such areas. .In April 2020, a single judge. of the High Court ruled in favour of doctors who had challenged the State's refusal to incorporate these incentives when drawing up merit lists for medical PG courses. The single judge held that Regulation 9 (IV) was mandatory. This ruling was challenged before the Division Bench. .What the Court held.The State had justified its decision stating that “the merit would stand compromised and would adversely affect the in service doctors posted at urban areas.”.However, the Division Bench disagreed, even remarking, "Can a Welfare State even adopt such a stand more so in the absence of any plea or material to indicate absence of doctors or higher percentage of vacancy of the posts in the urban areas?".The Court further observed, "Incentivizing posting of doctors/medical staff in the specified areas can only be in public interest and for public good and not the other way round. Under the Constitution all power must be exercised to subserve public interest, for public good and for a public cause. If only such benefits are accorded would the Doctors voluntary opt to serve the poor, the needy, the deprived and the marginalized ones living in the remotest corner of the State.".The Court went on to rule that Regulation 9(IV) is not mandatory, contrary to the single judge's finding on this aspect. .The grant of such incentives is still a matter of discretion depending on whether there exists a need to incentivise doctors to opt for rural areas in rendering their services, it was held. .Pertinently, the Division Bench opined that if the State Government has found that there are circumstances warranting the need for such incentives, "then the State could not and should not deny such incentive."."Undoubtedly discretion of according benefits, vests with the Government, but then, its exercise has to be based on some rational and not in an arbitrary and capricious manner. There is no logic of depriving the doctors posted in the rural areas of such benefits."Patna High Court.As far as Bihar was concerned, the Court found that the State had already demarcated difficult and remote areas through its own notifications. .It was noted further that, "In Bihar, it is an admitted fact that large number of posts in Rural Health Centres/Hospital is vacant as doctors are not willing to serve in such areas and for this reason, MCI provided incentive to motivate doctors to serve in such areas by adding weightage of 10% to 30% in marks of NEET.".The Court went on to pull up the Bihar Government for having admitted, through notifications issued in 2013 and 2014, that there were difficult/ remote areas in need of doctors on the one hand while denying to provide incentives to fill in these vacancies on the other. ."Strangely, if not collusively, it has taken a specious plea of interpreting such a Notification limited only to the identification of areas in terms of the Regulation and not taking a decision conferring benefits in terms thereof. Such a stand is both immoral and illegal."the Court observed..The Court added, "The power to grant incentive is discretionary, but then having done so, State cannot be allowed to turn around and contend to the contrary, notwithstanding as to whether such benefit was neither claimed nor conferred upon any individual. Mere non-enforcement of a right by an individual or its non-conferment upon by the State would also not be a reason for the State to adopt such a dubious plea.".The Court proceed to dismiss the State's appeals and issued the following directions:All candidates who have participated in the selection process, including the writ petitioners and are otherwise eligible, would be entitled to the benefit of 2013 and 2014 Notifications issued by the Government of Bihar;Provision in the prospectus to the contrary is held to be illegal and voidThe Bihar Combined Entrance Competitive Examination Board shall redraw the merit list strictly in accordance with law by granting benefit of 2013 and 2014 Notifications after accounting for the certificates/proof of eligibility, for grant of incentives in terms of Regulation 9(IV) issued by the MCI..Read Judgment here: