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New Delhi: A state assembly has no legislative competence to enact a law in respect of modern or allopathic medicine contrary to the standards determined by a central enactment, the Supreme Court said on Tuesday while upholding the Gauhati High Court order annulling an Assam law on managing rural healthcare.

The apex court struck down the Assam Rural Health Regulatory Authority Act, 2004, which provided for the establishment of a regulatory authority to register Diploma holders in Medicine and Rural Health Care (DMRHC) and to regulate their practice in rural areas.

The law also intended to regulate the opening of medical institutions to impart education and training for those with Diploma in Medicine and Rural Health Care.

The apex court said any variation between the standards of qualification required for medical practitioners who render services in rural areas and those offering services in urban or metropolitan areas must prescribe to constitutional values of substantive equality and non-discrimination.

A bench of Justices BR Gavai and BV Nagarathna upheld the decision of the Gauhati High Court which had held the state law as null and void.

The Gauhati High Court had said “…the Assam Rural Health Regulatory Authority Act, 2004, is declared to be null and void, in view of the Assam Legislature not having the legislative competence to enact the said Law.”

It had said the framers of the Constitution, in Article 47, have directed the Union and State Governments to regard the improvement of public health as their primary duty.

“These efforts must be made to progressively realize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, as acknowledged in international conventions and agreements,” it said.

The Supreme Court bench said while the State has every right to devise policies for public health and medical education, with due regard to peculiar social and financial considerations, these policies ought not to cause unfair disadvantage to any class of citizens.

“The citizens residing in rural areas have an equal right to access healthcare services by duly qualified staff. Policies for enhancing access to rural healthcare must not shortchange the citizens residing in rural areas or subject them to direct or indirect forms of unfair discrimination on the basis of their place of birth or residence,” it said.

The top court said deciding the particular qualifications for medical practitioners practising in disparate areas and in disparate fields, providing different levels of primary, secondary or tertiary medical services, is within the mandate of expert and statutory authorities entrusted with the said mandate by the Parliament.

Justice Nagarathna, who penned down the 139-page verdict, said in the instant case, it is held that the IMC Act, 1956 is a legislation made by Parliament for the purpose of coordination and determination of standards in medical education throughout the country.

The bench said this would imply that “no State Legislature has the legislative competence to pass any law which would be contradictory to or would be in direct conflict with the IMC Act, 1956 and the Rules and Regulations made there under”.

It said, “The State Legislature has no legislative competence to enact a law which is in conflict with the law setting the standards of medical education in the context of modern medicine or allopathic medicine, which has been determined by Parliamentary Legislation as well as the Rules”.

The bench said, “In view of the above conclusion, we hold that decision of the Gauhati High Court holding the Assam Act to be null and void, is just and proper”.

The top court, however, did not agree with the reasoning of the Gauhati High Court which had held that the state had no legislative competence to enact the Assam Act in view of Article 254 of the Constitution on the premise that the IMC Act and the rules and regulations made thereunder were holding the field.

“In view of the aforesaid conclusion, we are of the view that the said reasoning is incorrect. It is reiterated that the IMC Act and the Rules and Regulations made thereunder, which are all Central legislations, have been enacted having regard to Entry 66 of List I and would prevail over any State Law made by virtue of Entry 25 of List III of the Constitution,” the bench said.

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