Indian Association For Social ... vs Union Of India And Another
2015 Latest Caselaw 2966 Del

$~27.
*     IN THE HIGH COURT OF DELHI AT NEW DELHI
+        W.P.(C) No.3651/2015
         INDIAN ASSOCIATION
         FOR SOCIAL PSYCHIATRY                    ..... Petitioner
                       Through: Ms.Roma Bhagat, Adv.
                               Versus
         UNION OF INDIA & AND ANOTHER             ..... Respondents
                       Through: Mr.Amit Mahajan, Adv. for R-1/UOI.
                                Mr.T.Singhdeo, Adv. for R-2/MCI.
         CORAM:
         HON'BLE THE CHIEF JUSTICE
         HON'BLE MR. JUSTICE RAJIV SAHAI ENDLAW
                                ORDER

% 15.04.2015

1. The petitioner has preferred this petition under Article 226 of the

Constitution of India, as a Public Interest Litigation (PIL), pleading;-

(i) that as a professional body it has been greatly concerned about

the state of mental health in the country due to paucity of

trained manpower and the resultant lack of service delivery;

(ii) that even though mental health is an essential component of the

right to health, mental illness is not getting adequate attention

from the State in its health policy and programmes;

W.P.(C) No.3651/2015 page 1 of 8

(iii) that as a result, mentally ill people are deprived of their right to

treatment;

(iv) that on the basis of past surveys, 5-7% of the population of

India has some form of chronic mental illness and a further

15% of the population has some mild form of mental ailment;

(v) that there are only about 5,000 psychiatrists available in India;

(vi) there are only 42 mental hospitals in the country with the bed

availability of 20,893 in the government sector; in the private

sector, there are 5096 beds;

(vii) that as per the present curriculum, only 20 hours of theory

classes and two weeks of clinical posting are allotted to

psychiatry in MBBS and there is no separate examination in the

subject - per contra in the curriculum of B.Sc. (Nursing) there

is theory class for 120 hours and practical training for 360

hours in psychiatry leading to the conclusion that a person who

has completed 4 years B.Sc. (Nursing) is better trained in

psychiatry than an MBBS doctor;

W.P.(C) No.3651/2015 page 2 of 8

(viii) the dearth of psychiatrists in the country is leading to the rise in

the number of suicides and cases of addiction;

(ix) that even though most general hospitals have psychiatry wards,

but many of these are not functioning due to inadequate staff;

(x) that in other countries, the subject of psychiatry is allotted

about 7% of the total time in Graduate Medical Education;

(xi) that the curriculum of MBBS course ought to be modified by

giving equal, if not better prominence to psychiatry than

ophthalmology and ENT;

(xii) that a representation dated 13th May, 2011 was made to the

respondents no.1 & 2 i.e. Ministry of Health and Family

Welfare, Government of India and Medical Council of India

(MCI) in this regard;

(xiii) in response thereto, the curriculum of psychiatry for MBBS

course was modified by:-

(a) increasing the teaching hours from 20 to 40 hours;

W.P.(C) No.3651/2015 page 3 of 8

(b) increasing the clinical posting in psychiatry from 2

to 4 weeks;

(c) doubling of the marks to 20 in the theory paper for

medicine and by making the questions on

psychiatry mandatory;

(d) making internal assessment in psychiatry

mandatory for final examination;

(e) making psychiatry posting in internship mandatory

instead of elective;

(f) making the teaching of the subject in an integrated

manner;

(g) including certain other topics which were

suggested in the curriculum;

(h) covering important aspects of psychiatry with pre

/ para / clinical subjects in an integrated manner;

                             and,




W.P.(C) No.3651/2015                                                          page 4 of 8

(i) placing a foundation course in psychiatry at the

beginning of the year.

(xiv) however the said changes made are not sufficient.

Accordingly, the petition has been filed claiming the reliefs of

directing the Union of India and MCI to, (i) ensure at least 7% of clinical

teaching time in MBBS for psychiatry; (ii) to make provisions for

compulsory examination and evaluation in psychiatry; and, (iii) reserve at

least 8% of the beds in the medical college hospitals for psychiatry

department.

2. We have at the outset enquired from the counsel for the petitioner as

to how we can assess the claim of the petitioner when in pursuance to the

representation of the petitioner the MCI, a statutory body comprising of

experts in the subject, entrusted inter alia with medical education in the

country has after considering the representation of the petitioner deemed it

proper to though make changes but to the aforesaid extent only and not fully

as the want of the petitioner.

3. The counsel for the petitioner states that the assessment by the MCI is

erroneous and this Court in exercise of its power of judicial review ought to

W.P.(C) No.3651/2015 page 5 of 8 interfere in the same to protect the fundamental right of the citizens to

availability of mental health care in abundance in the country.

4. We however do not find the petitioner to have made out any case to

demonstrate that the decision taken by the MCI on the representation of the

petitioner is erroneous. We cannot be unmindful of the fact that ours is a

country of admitted deficiencies in health care. The Supreme Court in State

of Punjab Vs. Ram Lubhaya Bagga (1998) 4 SCC 117 in this context has

held that no State or country can have unlimited resources and provision of

facilities cannot be unlimited and that the Courts would not interfere with

any opinion formed by the Government. The direction for providing health /

medical care cannot be made without regard to the funds available with the

Government therefor. Similarly in State of Rajasthan Vs. Mahesh Kumar

Sharma (2011) 4 SCC 257 it was held that the Government having

formulated the rules permitting reimbursement of medical expenses in

certain situations and upto a certain limit, the Court could not give a

direction for reimbursement in other situations / beyond that limit also. We

also, recently in Fight for Human Rights Vs. Union of India

MANU/DE/3507/2014 have held that no direction for providing

W.P.(C) No.3651/2015 page 6 of 8 unlimited health care to all can be issued.

5. Though the petitioner claims that 7% of the time of MBBS course

should be allocated to psychiatry but without telling as to in what proportion

is the MBBS course time allocated to diagnosis and treatment of various

ailments. The petitioner has filed this petition with single minded approach

with respect to the field of psychiatry with which it is concerned and without

any regard to proportionality. The same cannot be permitted. Without all

such data, the relief as claimed by the petitioner qua its own field of

medicine only, disregarding the needs and requirements of the other fields of

medicine cannot be granted.

6. In fact the counsel for the MCI appearing on advance notice has

contended that this is a very dangerous trend and if allowed may lead to the

associations concerned with different fields of medicine approaching the

Courts for allocation of more time to their own field of medicine. He also

states that the MCI presently is in the process of having re-look at the

syllabus of the MBBS course and is holding consultations with all

stakeholders and will thereafter be making a recommendation to the Central

Government for effecting change in the Regulations on Graduate Medical

W.P.(C) No.3651/2015 page 7 of 8 Education.

7. In view of the aforesaid statement of the counsel for the MCI, we do

not deem it necessary to entertain the present petition at this stage and

dismiss the same.

No costs.

                                                  CHIEF JUSTICE



                                              RAJIV SAHAI ENDLAW, J

APRIL 15, 2015
'pp'




W.P.(C) No.3651/2015                                                page 8 of 8