If the admission of students to medical institutions continues to be done based on NEET, India will go back to the pre-Independence era on public health.
India is a federal country; the Indian Constitution distributes the legislative field of education among both states and the Union. The establishment (incorporation), regulation, and winding up of universities is an exclusive state subject. That power is denied to the Parliament.
Admission of students, appointment of teaching faculty, conduct of examination, declaration of results, conferment of degrees, fixation of syllabus are all included within the regulation of the university. “Coordination and determination of standards in higher education” is an exclusive field conferred on the Union. The Union has to co-ordinate with states before fixing such standards. According to the Supreme Court, “The word coordination does not merely mean evaluation but also harmonising relationship for concerted action”. Without such consultation with the state governments and treating them as equal partners, the Union cannot decide the standards by itself. Even after the 42nd Amendment, the legislative field of “incorporation”, “regulation” and “winding up” of the universities, carved out from education, remains with the states.
In 1984, when the demand for certain courses exceeded the number of seats available, Tamil Nadu evolved the Common Entrance Test (CET) for admission to engineering and medical institutions. Later, a decision was taken to abolish all entrance examinations through the “Tamil Nadu admission in professional educational institutions Act 2006” (Act 3 /2007). Students were admitted only on the basis of their performance in the qualifying examinations (Class XII marks).
From 1997, the Union government showed its intent to control the admissions to all medical institutions. The Medical Council of India (MCI) on December 21, 2010, and the Dental Council of India (DCI) in 2012, issued notifications prescribing a common entrance examination for admission. The Supreme Court, in 2013, in the Christian Medical College vs Union of India case ruled that MCI and DCI had no such powers to regulate the admission of students into medical institutions “since they have the effect of denuding the states, state-run Universities”. In the review petitions filed by MCI, the Supreme Court on April 11, 2016 “recalled” the judgment delivered on July 18, 2013.
Within a few days thereafter, the Sankalp Charitable Trust filed a public interest litigation, seeking a direction to make NEET compulsory for admission of students to all medical colleges. That case first appeared before the court on April 27, 2016. The very next day, the writ of mandamus was issued as prayed for. The SC gave the reason that the2013 judgment had already been recalled therefore, the “notifications dated December 21, 2010 are in operation as on today”. Though education is a concurrent subject, NEET was mandated without even giving notice to any of the states. The SC failed to note that the field covered by Entry 25 List III (Concurrent List), is “Education minus establishment and regulation of universities”.
The MCI Act, Section 10D, conferred power to regulate admissions to medical colleges. That was inserted only in May 2016. In December 2010, there was no legislative authority to issue such a notification. A valid notification was issued only on January 22, 2018. At present, the MCI Act has been repealed; only the National Medical Commission Act holds the field.
Laws are made for the people; people are not made for law. The success of a law is determined by its outcome. If a law does not achieve the object, the law has to be changed to ensure the desired outcome.
According to our study, NEET has reduced the number of Class XII students getting admitted to medical colleges. Only students who attended coaching classes for two or three years could get admission. Very few “first-generation” students could clear NEET. It shows that the wealthy and powerful have rigged the system of NEET to perpetuate their privilege. The professional classes have figured out how to pass their advantage to their children, converting meritocracy into hereditary aristocracy. There cannot be a competition between a race-horse and a “cart-pulling” horse. The rural and urban poor cannot spend lakhs of rupees to get coached for NEET and cannot afford to wait for two or three years only to prepare for the test.
Conducting NEET and NEXT (National Exit Exam for MBBS) under the NMC Act is also tantamount to shifting the regulation of university to the Union list. That amounts to altering the basic structure of the Constitution.
“Public health, hospital and dispensaries” is a state subject. Therefore, there is a constitutional obligation on the state to ensure quality public health even in remote villages, which do not have the facilities available in metro cities. The objective of starting more medical colleges in remote areas is to get qualified doctors in and around that region. Rarely are persons from metropolises willing to serve in remote villages.
Every student entering medical colleges does not become an expert in their field. Every patient does not require such expertise in treatment. But a qualified medical practitioner is required to treat common ailments. That can be achieved only by producing qualified doctors from all areas within a state.
One of the consequences of NEET would be the fall in the number of such dedicated doctors willing to serve in remote areas. Till the 1960s, even in Madras City, the number of MBBS doctors was inadequate. Only RMP (registered medical practitioner) and LMP (Licentiate in Medical Practice) diploma holders would treat people. This would have been the state of affairs even in Calcutta, Bombay and Delhi. That situation has changed today, only due to the sustained attention on the improvement of health taken by the states. If the admission of students continues to be done based on NEET, India will go back to the pre-Independence era on public health. There may not be enough doctors available for rural public health centres. Even for ordinary ailments, people would have to travel to metro cities.
The SC, as early as 1960, had suggested starting more rural universities to cater to the rural people. Though this was in a case relating to reservations, the rationale is applicable to admissions of students as well. Finally, students should be tested only on what they have learnt in their years of schooling. Testing them through entrance examinations in areas they did not study is nothing but arbitrary.
The writer is a former judge of Madras HC. He headed the committee appointed by the Tamil Nadu government on the impact of NEET on medical admissions in the state
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