ASSOCIATION OF MEDICAL SUPER SPECIALITY v. UNION OF INDIA & Ors.

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 B C D E F G H ASSOCIATION OF MEDICAL SUPER SPECIALITY ASPIRANTS AND RESIDENTS v.

UNION OF INDIA 1015 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:

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 A B C D E F G H 1016 SUPREME COURT REPORTS [2019] 12 S.C.R. A B C D E F G H 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] ASSOCIATION OF MEDICAL SUPER SPECIALITY ASPIRANTS AND RESIDENTS v. UNION OF INDIA 1017 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 A B C D E F G H 1018 SUPREME COURT REPORTS [2019] 12 S.C.R. A 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 B C D E F G H ASSOCIATION OF MEDICAL SUPER SPECIALITY ASPIRANTS AND RESIDENTS v. UNION OF INDIA 1019 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]