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S.S. Subramani, J.—In all these Writ Petitions filed by the Associations and individuals, the common relief sought for is to regularise the practice of unqualified medical practitioner in modern medicine and to forbear the Respondents from in any way interfering with the Petitioners'' right to practice in modern medicine, subject to the limitation contained in Circular No. V.11016/3/82/H1(P) dated 8.7.1986, issued by the Ministry of Health and Family Welfare, Department of Health, Government of India, New Delhi.
I need only extract the facts in W.P. No. 7402 of 1998, since that covers all points for the disposal of all the Writ Petitions. The Petitioner therein is an Association, consisting of more than 185 members. The main reason for filing the Writ Petition is that recently a boy died because of some negligence caused by a person who represented to the public that he is a qualified Doctor. In fact, on investigation it is found that he is not a qualified medical practitioner, but impersonated himself as a qualified M.B.B.S. Doctor by using fake certificate. The death of a boy created panic among the members of public and the Government directed the police officials to arrest persons who are using fake certificates and impersonating as a qualified medical practitioner. Making use of Government''s direction, it is the case of the Petitioners and the Association, that the police are harassing them, though the direction of the Government has no application in so far as they are concerned. It is their case that they have never misrepresented to the public that they are qualified medical practitioners and the public also knew their qualification. It is their case that they have knowledge in Modern Medicine and the members of the Association are having minimum qualification of Matriculation and they are practising in Modern Medicine for the past more than ten years.
It is their case that qualified Doctors are not available in villages and because of their knowledge in Modern Medicine, the members of public in villages are taking their services and they have not caused any room for suspicion or complaint from the members of public. It is further said that more than the modern system of medicine, the conventional Indian System of medicine viz., Ayurvedic, Homeopathy, Siddha and Unani System of medicine are very popular and many people do not have belief in modern system of medicine. Though there are more than thousands of such practitioners and are rendering services to the public, their services are not regulated. The Central Government has issued circulars and notifications advising various State Governments to regularise such functions of unqualified medical practitioners and the last of such circular is dated 8.7.1986. The circular was intended only for the unqualified medical practitioner and it was issued only for the purpose of enabling such unqualified medical practitioner to practice in Modern Medicine on certain conditions. As per the said circular, these unqualified medical practitioners are not entitled to perform any surgery, obstetrics or radiation therapy and they should not be allowed to prescribe any medicine included in Schedules "G", "H" and "L" of the Drugs and Cosmetic Rules, 1945, and other drugs which are dangerous. On the basis of this circular issued by the Government of India, most of the States have issued Regulations, but not the State of Tamil Nadu.
The very same Association filed an earlier Writ Petition to implement the circular dated 8.7.1986. But the same was dismissed by this Court on 6.11.1995, against which W.A. No. 1384 of 1995 was filed and the same is pending. It is said that even though they are not graduates or qualified medical practitioners, the experience which they have earned for'' years together either under the training of well qualified medical practitioners or the knowledge which they have inherited from their fore-fathers are made use of by them to the service of mankind. But in view of the attitude of the police, they are not in a position to practice without fear. It is under the above circumstances, all these Writ Petitioners have filed these Writ Petitions for the reasons stated above.
When the matter came up for admission, learned Additional Government Pleader also took notice and argued the case on instructions. Learned Addl. Govt., Pleader also submitted that the entire Writ Petitions could be disposed of by giving necessary directions. In many cases, this Court issued interim directions against the Government not to initiate penal action against the Petitioners therein. Those Writ Petitions are still pending consideration by this Court.
At the time of argument, counsel for both the sides relied on the circular or notification issued by the Government of India in No. V.11016/3/82 Me (P), dated 8.7.1986. It is a letter issued by the Ministry of Health & Family Welfare, Govt. of India, to all the Health Secretaries of the State Governments/Union Territories. A reading of the said letter shows that it is intended to regulate the services of unqualified, medical practitioners and the Union Government wanted the various State Governments to enlist the existing unqualified medical practitioners under specified conditions and it also wanted to adopt a strict attitude towards them.
Government of India has taken notice of the fact that there are many persons practising in the medical field who are not qualified and who are in the profession from 1950 onwards and they are rendering medical care to the community, particularly in rural areas. The Government of India has also taken note of the fact that qualified medical practitioners are not available in rural areas. Even though they are practising without proper qualification, Government of India thought that their practice should be regularised and should be strictly regulated with the intention that they are able to continue to serve the people. The Central Government also did not think of putting an end to these unqualified medical practitioners, from doing the practice. Certain restrictions have been suggested on their practice, i.e., they should not be entitled to practise surgery, obstetrics or radiation therapy in any form and they should not prescribe any medicine included in Schedules "G" "H" and "L" of the Drugs and Cosmetics Rules, 1945, and other dangerous drugs. These unqualified medical practitioners are also directed to be treated as a distinct category, so that the Government can keep their records separately from those of the qualified medical practitioners. Government of India also thought that the State Governments are not taking serious steps, though such a direction has been given earlier to 1986. It also wanted that fresh unqualified medical practitioners should not be allowed to enter in the Register which the State Government is directed to maintain. As I said earlier, both parties agree that these Petitioners and members of the Petitioners'' Association can be allowed to do their practice on the basis of this notification and whatever conditions this Court may impose, they will obey. What they wanted was only a protection from harassment of the local police.
On the basis of the above submission, the members of Petitioners'' Association and the Petitioners in other Writ Petitions are allowed to practise in Modern Medicine and on the field in which they have been rendering services to the public on their complying with the following conditions:
(1) Petitioners shall not practise surgery, obstetrics or radiation therapy in any form;
(2) They shall not prescribe any medicine included in Schedule "G", "H" and "L" of the Drugs and Cosmetics Rules, 1945 and other dangerous drugs;
(3) They shall not use the word "Dr." or similar words used in local language before or after their names, instead, after their names, they shall add the words "Unqualified Medical Practitioner" or its translated version in the local language. The said direction is absolutely necessary, since the illiterate public may not confuse them as ''qualified doctors'' and the public should know that they are of "distinct category". Name-board with the above details will be placed in a conspicuous place of the building in which they intend to practice or are practising.
(4) They shall maintain a register of patients, for whom they are giving medical advice and treatment, the drugs which they have prescribed and also the ailment for which it was given; such register shall be open for inspection by the District Collector or any person duly authorised by him not below the rank of R.M.O.
(5) They shall inform the Collector of the District the place in which they are practising or intend to practise with full address and the field in which they have experience. They shall not practice in any other place except with intimation to the District Collector, which shall be sent by registered post acknowledgment due.
If the Petitioners/Members of the Petitioners'' Association comply with these directions, they will be allowed to practise as stated above. If such conditions are satisfied, the Director General of Police, Tamil Nadu and Pondicherry or any other Officer subordinate to them should not cause any obstruction in their discharging professional duties. All the Petitioners and Members of the Association are given two months time to comply with the above conditions and till then no penal action will be taken against them.
Even though in some of the Writ Petitions the relief sought for is to direct the Respondents to take necessary steps to regularise the practice of unqualified medical practitioners, I do not think that I will be justified in granting such a relief, in view of the pendency of Writ Appeal No. 1384 of 1995.
I also direct the Registry to publish the above conditions on which the Petitioners herein are allowed to practise in Modern Medicine, in local vernacular dailies, so that the general public may get necessary information about their qualification and the conditions on which they are allowed to practise.
The Writ Petitions are disposed of as above. No costs. Consequently, no orders are necessary in the connected W.M. Ps.
Order: These petitions having been posted this day for being mentioned in pursuance to the order of this Court dated 8.6.98 and made herein and taken up in the presence of the aforesaid Advocates, the Court made the following order:
I have disposed of the above batch of Writ Petitions as per my order dated 8.6.1998.
Today, the matter is posted under the caption ''for being mentioned''. The reason for such posting is that both sides wanted some more directions to be given.
After hearing learned Counsel for all the parties, I feel that the following conditions are also to be complied with.
After paragraph 8 and before paragraph 9 of my Order dated 8.6.1998, the following also shall be incorporated, as numbered below:
(6) Persons claiming themselves as unqualified medical practitioners and who intend to practise will inform the Collector of the District, who may take the assistance of either the Resident Medical Officer or District Medical Officer and get their qualification and experience assessed. It is for those Authorities to verify and take a decision whether the applicant is entitled to practise taking into consideration his knowledge through experience in the field of practice. In case it is found that the applicant is entitled to practise, they shall issue a Certificate to the applicant to do the practice at the place chosen by him. Without a Certificate issued by the Authority concerned, an applicant will not be entitled to practice, and the Certificate should also be displayed in a conspicuous place of the building in which the applicant intends to practise.
(7) It is only because qualified medical practitioners are not available in rural areas, the illiterate public are compelled to approach the unqualified medical practitioners. So, naturally, the right of such unqualified medical practitioners will be in existence only till a qualified medical practitioner is posted in that particular place. When sufficient number of qualified medical practitioners are available in rural areas, the Authorities are also fully competent to withdraw the permission granted to unqualified medical practitioners, either in respect of a portion or the entire area.
(8) Learned Government Pleader submitted that the unqualified medical practitioners, even if they are allowed to practise, they should not be permitted to give any injection. A blanket order of that nature cannot be given by this Court. This is also a matter which the authorities, while granting Certificates to the applicants shall consider the knowledge and experience and decide whether the applicant should be granted permission to give treatment in the nature of injection.
(9) The Authorities are also entitled to fix a minimum number of years of knowledge and experience before issuing Certificate to an applicant to practise.
(10) While an application is made to the District Medical Officer, Resident: Medical Officer, District Collector, as the case may be, it shall be disposed of within 30 days from the date of receipt of the same.
(11) For proper implementation of these directions, it is only proper on the part of the Authorities to inspect and verify the Registers maintained by various unqualified medical practitioners at least once in two months.
(12) I have given only an outline of the measures on the basis of which the conditions imposed by mo may be complied with. If the Authorities feel that for proper implementation of this Order, some more steps should be taken, this Order shall not stand in their way.