India is a federal country; The Indian Constitution distributes the legislative sphere of education between both the states and the union. Establishment (incorporation), regulation and winding up of universities is a special state subject. That power is not given to the Parliament.
Admission of students, appointment of teaching faculty, conduct of examinations, declaration of results, award of degrees, determination of syllabus are all included in the regulation of the university. “Coordination and setting of standards in higher education” is a special area awarded to the Association. The Union has to coordinate with the states before setting such standards. According to the Supreme Court, “the word co-ordination means not only evaluation, but also harmonization of relations for concrete action”. Without such consultation with the State Governments and treating them as equal partners, the Union cannot fix the standards on its own. Even after the 42nd Amendment, the legislative domain of “incorporation”, “regulation” and “abolition” of universities that were delinked from education remains with the states.
In 1984, when the demand for some courses exceeded the number of seats available, Tamil Nadu developed the Common Entrance Test (CET) for admission to engineering and medical institutions. Later, it was decided to abolish all entrance examinations through the “Tamil Nadu Admission to Professional Educational Institutions Act 2006” (Act 3/2007). Students were admitted on the basis of their performance in the qualifying examinations (Class XII marks) only.
From 1997, the central government showed its intent to control admissions in all medical institutions. On December 21, 2010 the Medical Council of India (MCI) and in 2012 the Dental Council of India (DCI) issued a notification prescribing a common entrance test for admission. The Supreme Court, in 2013, in Christian Medical College v Union of India, ruled that the MCI and the DCI have no such power to regulate the admission of students to medical institutions “as they have no powers to deny states, state-run universities”. In the review petitions filed by the MCI, the Supreme Court on April 11, 2016, “remembered” the judgment dated July 18, 2013.
Within days of this, Sankalp Charitable Trust filed a PIL, seeking a direction to make NEET mandatory for admission of students in all medical colleges. That case first appeared in court on April 27, 2016. The very next day, the writ of mandamus was issued as per the prayer. The SC gave the reason that the 2013 judgment was already withdrawn, hence “notifications dated December 21, 2010 are in force as of today”. Though education is a concurrent subject, NEET was made compulsory without any notice to any state. The SC failed to note that the area covered under Entry 25 List III (Concurrent List) is “Establishment and regulation of universities minus education”.
The MCI Act, Section 10D, empowers to regulate admission to medical colleges. It was inserted only in May 2016. In December 2010, there was no legislative authority to issue such notification. A valid notification was issued only on January 22, 2018. Presently, the MCI Act has been repealed; Only the National Medical Commission Act holds the area.
Laws are made for the people; People are not made for the law. The success of a law is determined by its consequences. If a law does not achieve the objective, the law has to be changed to ensure the desired result.
As per our study, NEET has reduced the number of class XII students taking admission in medical colleges. Only students who had attended coaching classes for two or three years could get admission. Very few “first generation” students were able to clear NEET. It shows that the rich and powerful have rigged the system of NEET to maintain their privilege. The professional classes have figured out how to pass on their benefits to their children, converting the meritocracy into a hereditary aristocracy. There can be no competition between a racehorse and a “carriage-pulling” horse. Rural and urban poor cannot spend lakhs of rupees to get coaching for NEET and cannot wait for two or three years just to prepare for the exam.
Conducting NEET and NEXT (National Exit Examination for MBBS) under the NMC Act is also tantamount to transferring the university regulation to the Union List. This amounts to changing the basic structure of the Constitution.
“Public health, hospitals and dispensaries” is a state subject. Therefore, there is a constitutional obligation on the state to ensure quality public health even in remote villages where facilities are not available in metro cities. The objective of starting more medical colleges in remote areas is to get qualified doctors in and around that area. The people of the metropolitan areas are rarely willing to serve in the remote villages.
Not every student entering medical colleges becomes an expert in their field. Not every patient needs such expertise in treatment. But the treatment of common ailments requires a qualified doctor. This can be achieved only by producing qualified doctors from all sectors within a state.
One of the consequences of NEET will be the drop in the number of such dedicated doctors willing to serve in remote areas. Till the 1960s, even in the city of Madras, the number of MBBS doctors was inadequate. Only RMP (Registered Medical Practitioner) and LMP (Licensed in Medical Practice) Diploma holders will treat the people. The same situation would have happened in Calcutta, Bombay and Delhi. That situation has changed today, only because of the continued focus on health reforms taken by the states. If admission of students on the basis of NEET continues, India will go back to the pre-independence era on public health. There may not be enough doctors available for rural public health centres. People will have to travel to metro cities even for simple ailments.
The Supreme Court in the early 1960s had suggested starting more rural universities to meet the needs of the rural people. Though this was in a matter related to reservation, this logic also applies to admission of students. In the end, students should only be tested on what they have learned over the years of schooling. Testing them through entrance examinations in areas they did not study is nothing but arbitrary.
The author is a former judge of the Madras High Court. He headed the Tamil Nadu government-appointed committee on the impact of NEET on medical admissions in the state
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