Confusion and chaos at MMC

Shardul Nautiyal - Mumbai

The absence of a regular administrator at Maharashtra Medical Council (MMC) for the last five years has plagued settlement of medico-legal cases. According to the MMC Registrar’s office, the total number of cases pending at MMC is over 107. While the number of cases has shown a sudden increase since 2002, slow dispensation of justice, with cases pending for more than a year or two, necessitates a fully functional MMC body.

Suspended Animation

Maharashtra Medical Council (MMC) is a quasi-judicial body which hears cases of medical negligence with the help of legal assessors. Election and installation of a new MMC body has come to a halt as the election was stayed by the High Court based on a PIL filed in 1999 alleging that the 1999 MMC election was rigged. In 1999, the government appointed an ad hoc administrator as an interim arrangement.

According to MMC sources, despite the absence of a full-fledged council, 20 cases have been settled in a year’s time. Over five meetings are held every year as compared to around three in the past. Since MMC is now a one-man army, only administrative functions like registration, addition of qualification and certification work are being carried out.

Ad Hoc Administration

According to Dr Arun Bal, founder member of Association for Consumers’ Action on Safety and Health (ACASH) and a petitioner, “The ad hoc position is because, despite gazette notification amending the election procedure and abolition of postal ballot, the government has not declared the election as yet. The excuse given is that the litigation related to the election is pending before the court. However, this is not fully true, as the court had directed the government to amend the election procedure and revert to the court. The matter is subjudice. The government has to submit the gazette notification amending the rules and ask permission for the new election.”

"The law requires putting a democratically elected body in power within six months of the appointment of an administrator" -Dr Sudhakar Sane former President, MMC

However, respondents in the case beg to differ, saying that the petition has not been settled as yet by the honourable High Court. Dr Sudhakar Sane, former President, MMC and a respondent in the case says, “Election procedure cannot be made applicable retrospectively. The present petition has not been settled, to declare the election null and void. Such a declaration may be possible, when the petition is finally decided and disposed of.”

MMC; A One-Man Show

In 1999, the election results were declared but notification was not issued hence an administrator was appointed for one year, under the MMC Act. It became a one-man medical council. Ideally the MMC managing council has nine elected members, five nominated members and two ex-officio members—the Director, Medical Education, and the Director, Public Health, plus seven representatives from the medical universities and one representative from the college of physicians and surgeons. “The law requires putting a democratically elected body in power within six months of the appointment of an administrator,” says Dr Sane.

The point of contention, experts say, is that constitutionally MMC is supposed to be a democratically elected body. “Persistent deviation from democracy and substitution by a single person is definitely not a desirable option, especially when the body is to perform a quasi-judicial function,” argues Dr Ketan Parikh, former President, Association of Medical Consultants (AMC).

According to Dr Lalit Kapoor, Chairman, Medico-Legal Cell, AMC, “The State Government has accorded lowest priority to MMC.” Medico-legal experts feel that elections are not being held because of government indifference.

Petitioning For Justice

Two writ petitions were filed in 1992. The first petition was that the council should be dissolved and an administrator should be appointed. The second one was that there should be no postal ballot system. The election was set aside by the second writ petition filed within 30 days of the declaration of results of the election of 1999.

Dr Manohar Kamat, another petitioner in the case, alleged that postal ballot papers were rigged, and filed a writ petition for the first time 45 days before the elections in 1999.

The petitioner shared his experiences with Justice B N Shrikrishna, about the manner in which the election was rigged. The petitioner requested the high court to appoint observers to monitor the elections in the year 1999. The court appointed two observers for the election process.

Genesis Of The Case

ACASH made a plea to the High Court that elections were rigged in the year 1999. The High Court appointed observers representing the Ministry of Health. The observers found that the postal ballot signatures were allegedly forged. According to the report by the observers, ballot papers were brought in numbers and deposited in a box kept in the MMC office.

“This fact became known when the returning officer in the case, the registrar of the MMC, refused to tally the electoral rolls but invalidated all the duplicate ballot papers. The outcome was that the high court stayed the elections. The MMC is now in a state of suspended animation despite the fact that the election rule was amended and gazetted,” informs Dr Bal.

A respondent in the case told Express Healthcare Management, “It was observed that delivery boys brought postal ballot papers in bulk and not the candidates contesting the elections. However, nowhere in the MMC Act is this prohibited.

Reality Check

"Everything happened in a participatory way with the critics and a consensus was arrived at to dispense with the postal ballot" Dr SM Sapatnekar, former Administrator, MMC

“Everything happened in a participatory way with the critics and a consensus was arrived at to dispense with the postal ballot. Views were sought and a comprehensive plan for the ballot box method was prepared,” according to Dr SM Sapatnekar, former Administrator, MMC.

“The elections were not set aside but the petition was admitted for final disposal. An interim order prohibiting the government from issuing a notification was passed,” informs Dr Sane. “The case does not seem to be relevant with the petitioners, more so as the documents related to the PIL have also not been handed over to all the respondents,” he says.

There is more to it than meets the eye. Blaming the courts or subjudice status of the case is only an excuse. If there is political or monetary pressure, the government does not hesitate to even amend or violate court judgements. “The court observer in 1999 was amazed at the level of corruption and high-handedness. In fact one of the aspirants had the audacity to physically restrain another aspirant in front of the court observer during the counting session,” recounts Dr Parikh.

The respondents allege that the petitioners are mostly defeated and frustrated candidates. The election law provides an appeal facility to defeated candidates for alleged unfair election practices, defined in the MMC Act, 1965. “But defeated candidates preferred to go to the honourable High Court, invoking Article 226 of the Constitution instead of appeal under MMC law and rules,” says Dr Sane.

Article 226 empowers the High Court’s pecuniary jurisdiction to take up any issue where the allegations are of such nature that the provisions of law in any act related to election disputes appears not to be sufficient.

Experts also suggest the influence of private medical colleges behind the delay in the MMC election process. These colleges may suffer if independent minded ethical people are elected by correct ballot.

Court Directives

An interim judgement given by the court stated there were some irregularities as per the information given by the observers. The court maintained that elections might have been held in a manner not conducive to fair elections.

It was observed that some of the parties were alleged to have been intercepting the ballot papers. Therefore, this will be heard in the form of a long cause suit or petition. The court finally held that the voting process prima facie appears to be vitiated in this election.

The Department of Medical Education, Ministry of Health, framed new rules for holding of elections by direct ballot and asked the petitioners to withdraw the petition. The petitioner instead suggested the state government admit that the election was rigged. Amendments were made, according to which, the returning officer will not be a council employee. Instead, the elections would be conducted under the supervision of an officer of the Health Ministry of the rank of Assistant Secretary. There would be a personal ballot system in place at the district level and the council’s staff would not be a part of the election process.

Suggestions

MMC could be made autonomous and should not be dependent on the government for funds. “AMC has shown how MMC can become financially self-sufficient. Registration charges must be increased and renewal after five years must become mandatory,” suggests Dr Kapoor.

Others suggest that setting up regional councils will reduce the inconvenience to the petitioners and the respondents, but might lead to the dilution of the sanctity of the council’s decisions.

“The main council can have regional representatives, who can then take up minor issues at the regional level and only selected cases may come to the main council,” suggests Dr Parikh.

“Incidentally, election to bodies such as the Medical Council of India (MCI), State Nursing Council, Nursing Council of India, State Dental Council and Dental Council of India is through postal ballot,” points out Dr Sane, questioning the need for a ballot system at the district office and in person. He also questions the feasibility of such elections, which may deprive village doctors from exercising their votes without major expenditure.

What The Future Holds

“The future of MMC is bleak unless radical changes are made in the MMC Act,” feels Dr Kapoor. “It is difficult to foresee what the future holds for MMC. There is general apathy in medical profession and the feeling that “everybody is corrupt” is prevalent. However, in view of impending private healthcare insurance, proper regulation is mandatory and there will be no choice for the government except to properly revive MMC if it wants big players in the private sector to enter health insurance,” warns Dr Bal.

shardul.nautiyal@gmail.com