SUPREME COURT HOLDS AYURVEDIC DOCTORS NOT ENTITLED TO SAME PAY AND BENEFITS AS THAT OF MBBS DOCTORS

A Two Judges Bench of the Supreme Court comprising of Justice V. Ramasubramanian and Justice Pankaj Mithal, passed a judgement dated 26.04.2023 in the matter of State of Gujarat & Ors. v. Dr. P. A. Bhatt & Ors., (Civil Appeal No. 8553-8557 of 2014) and held that allopathy and ayurvedic doctors do not perform equal work and therefore, the doctors practicing alternative medicine system are not entitled to the same pay and benefits as that of doctors holding MBBS degrees.

Facts

1) In the present case, a Memorandum of Settlement dated 21.08.1989 was executed between the Ministry of Health and Family Welfare and a Joint Action Council of Service Doctors Organisation.

2) A High-Power Committee chaired by Shri R.K. Tikku was formed on 03.05.1990 to enhance service conditions for Government doctors.

3) The said Committee held 30 meetings and presented recommendations in a Report dated 31.10.1990, thereby, addressing MBBS, post-graduate, super-specialty doctors, and teaching/non-teaching doctors.

4) Another High-Power Committee chaired by Shri R.K. Tikku was formed for career improvement of practitioners of Indian Systems of Medicine and Homeopathy.

5) The Government of India accepted the Tikku Committee’s Recommendations, and the State of Gujarat issued a Resolution on 17.10.1994 for allopathic doctors.

6) Thereafter, certain clarifications were sought for benefits in respect of non-MBBS medical officers.

7) The Respondent-Doctors practicing alternative systems of medicines such as Ayurveda, etc filed various Writ Petitions in the High Court of Gujarat, thereby, seeking benefits based on the Tikku Pay Commission’s Recommendations and seeking equal treatment as that of doctors holding MBBS degree.

8) The High Court allowed the said Writ Petitions vide Order dated 26.07.2012 and held that doctors practicing alternative systems of medicine would be treated at par with doctors holding MBBS degree.

9) Aggrieved by the High Court Order dated 26.07.2012, the State of Gujarat filed various Appeals before the Division Bench of the High Court in LPA-295-2013, SCA-11363-2009, LPA-965-2013 and so on, which were dismissed vide Order dated 17.01.2014, thereby observing that both MBBS and non-MBBS doctors form part of the same cadre and that there would not be any discrimination based on qualifications within the cadre.

Supreme Court Observations

Aggrieved by the Division Bench of the High Court Order dated 17.01.2014, the State of Gujarat filed Civil Appeals No. 8553-8557 of 2014 before the Supreme Court, which granted leave on 08.09.2014 and passed an interim order for compliance. Thereafter, various Contempt Petitions were filed against the State Government before the Apex Court for non-compliance and disobedience of the aforesaid Interim Order. The Supreme Court passed a judgement dated 26.04.2023 and made the following observations:

(1) The Bench formulated the following two questions of law:

(i) Can different pay scales be established for officers belonging to the same cadre, depending on their educational qualifications?

Addressing the first issue, the Bench made the following observations regarding whether individuals holding the same position within a cadre can be assigned different salary scales based on their educational qualifications:

(a) In The State of Mysore vs. P. Narasinga Rao (1968), AIR 1968 SC 349, a Constitution Bench of the Apex Court upheld the classification of two grades of tracers based on educational qualifications, with different pay scales. This decision was made in the context of the reorganization of states, where individuals previously receiving the same pay in the State of Hyderabad were later assigned different scales of pay in the new Mysore State. The Supreme Court found that this classification did not violate Articles 14 and 16 of the Constitution.

(b) In Mewa Ram Kanojia vs. All India Institute of Medical Sciences, (1989) 2 SCC 235, the Bench made observations regarding a person who was initially appointed as a teacher coordinator was later redesignated as a Hearing Therapist. When seeking parity with Speech Therapists and Audiologists in terms of pay, his claim was rejected. The Apex Court held that the State has the authority to classify employees based on qualifications, duties, and responsibilities of the respective positions. The Supreme Court further stated that the person’s contention of performing the same duties as Speech Therapists and Audiologists did not warrant granting equal pay.

(c) In Shyam Babu Verma vs. Union of India (1994) 2 SCC 521, the Apex Court provided a clear clarification that while the nature of work may be similar, there can be variation in the scale of pay, based on academic qualifications or experience, which serves as a valid justification for the classification. This perspective has consistently been upheld by Supreme Court.

(d) Therefore, it is clear that the classification based on educational qualification is not violative of Articles 14 and 16 of the Constitution. Hence, the Bench held that different pay scales can be established by the State for officers belonging to the same cadre, depending on their educational qualifications.

(ii) Can one consider allopathic doctors and doctors of indigenous medicine as performing “equal work,” thereby entitling them to “equal pay”?

Addressing the second issue, the Bench made the following observations regarding whether individuals holding degrees and post-graduate degrees in indigenous and non-Allopathic systems of medicine can be regarded as performing work equal to those holding degrees and post-graduate degrees in Allopathic systems of medicine, thereby deserving equal pay:

(a) That allopathy doctors have specific responsibilities that include emergency duties and providing trauma care. Due to the nature of their medical practice and the advancements in science and modern medical technology, the emergency services and trauma care they offer cannot be replicated by Ayurvedic doctors.

(b) Furthermore, Ayurvedic doctors are unable to assist surgeons in performing complex surgeries, a task that can be undertaken by MBBS doctors. However, the Bench noted that the same does not imply a superiority of one medical system over the other and that assessing the relative merits of these two medical sciences is beyond the scope and expertise of the Apex Court.

(c) Further, an extract from the Britannica records at Page 776 of Volume-23 (15th Edition) has been reproduced below:

“In surgery, ancient Hindu medicine reached its zenith. Operations performed by Hindu surgeons included excision of tumours, incision and draining of abscesses, punctures to release fluid in the abdomen, extraction of foreign bodies, repair of anal fistulas, splinting of fractures, amputations, cesarean sections, and stitching of wounds.

A broad array of surgical instruments was used. According to Susruta the surgeon should be equipped with 20 sharp and 101 blunt instruments of various descriptions. The instruments were largely of steel. Alcohol seems to have been used as a narcotic during operations, and bleeding was stopped by hot oils and tar. Hindu surgeons also operated on cataracts by couching or displacing the lens to improve vision.

(d) Thus, while acknowledging the significance of Ayurvedic doctors and the promotion of alternative/indigenous medicine, the Bench observed that it cannot be ignored that both groups of doctors do not perform equal work deserving equal pay. Therefore, the Bench held that allopathic doctors and doctors of indigenous medicine cannot be considered to perform “equal work” and hence, both groups of doctors cannot be entitled to “equal pay”.

Conclusion

Thus, based on the aforesaid observations, the Supreme Court held that the doctors practicing alternative systems of medicine cannot be treated at par with doctors holding MBBS degree and hence, the non-MBBS doctors would not be entitled to the benefits that the MBBS doctors are entitled to, as per the Tikku Commission. As a result, the Appeals filed by the State were allowed and the High Court Order dated 26.07.2012 and the Division Bench of the High Court Order dated 17.01.2014 that considered the MBBS and non-MBBS doctors to be treated at par, were set aside.

Udit Krishna

Associate

The Indian Lawyer & Allied Services