1. The Assam Legislature enacted the Assam Rural Health Regulatory Authority Act, 2004, which came into effect from 18th September, 2004; in short hereinafter referred to as the ARHRA Act. The ARHRA Act envisages a medical course prescribing education and training for diploma in medical and rural healthcare. The medial of the course is defined to be allopathic and it does not include veterinary. The Act further contemplates that a person who passes out the course is eligible for a diploma certificate to be awarded by the Assam Rural Health Regulatory Authority (ARHRA), established under the ARHRA Act. Pursuant to provisions of the ARHRA Act an institute for training was also established at Jorhat. Persons who obtain diploma certificate are designated as rural h health practitioner and are permitted to practice only in rural areas. 2. Section 24 of the ARHRA Act deals with the powers and functions of the rural health practitioners, which is extracted hereunder for convenient reference: "The Rural Health Practitioners shall be eligible to practise Medicine and Rural Health Care subject to the following conditions, namely, - (a) they shall treat only those diseases and carry out those procedures which shall be outlined in the rules; (b) they shall prescribe only those drugs, which shall be outlined in rules; (c) they shall not carry out any surgical procedure, invasion, investigation or treatment, Medical Termination or Pregnancy, etc., but shall confine themselves to such medicinal treatment and perform such minor surgery as may be prescribed. (d) they shall practise only in rural areas as defined in the Act; (e) they may issue illness certificates and death certificates. (f) they shall maintain name/address, age, sex, diagnosis and treatment records of all patients treated by them; and (g) they shall not be eligible for employment in Hospitals, Nursing Homes and Health establishments located in urban areas as General Duty Physicians involved in patient care in OPD, Emergency and Indoor Services". 3. The Regulations of the Assam Rural Health Regulatory Authority (ART IRA) prescribes the following syllabus for the course. Indoor and outdoor patient services are also contemplated in the syllabus, apart from qualifications for faculty members to teach different subjects of the course. (i) Medicine - all branches. (ii) Surgery. (iii) Paediatrics, (iv) Obstetrics. (v) Oncology. (vi) Pathology. (vii) Radiology, etc. 4. Indoor and outdoor patient services are also contemplated in the syllabus, apart from qualifications for faculty members to teach different subjects of the course. (i) Medicine - all branches. (ii) Surgery. (iii) Paediatrics, (iv) Obstetrics. (v) Oncology. (vi) Pathology. (vii) Radiology, etc. 4. At the time when the advertisement was made inviting applications for admission to the course, this writ petition was filed by Indian Medical Association(IMA) by challenging the constitutional validity of the ARHRA Act on the following grounds. (i) The ARHRA Act is repugnant to the provisions of the Indian Medical Council Act, 1956, in short the IMC Act. The required permission to teach the diploma course in medicine is not obtained as contemplated under section 10A of the IMC Act, which was enacted by virtue of entry 66 of list I of the Constitution of India. (ii) The ARHRA Act, enacted on the basis of entry 25 of list III, is repugnant to the provisions of the IMC Act and that no Presidential assent was obtained as required under article 254 of the Constitution of India. (iii) The students who pass out the course and are issued with the diploma certificates would be ill-equipped (as doctors) to treat patients and there would be a risk to patients who require quality medical assistance and treatment. (iv) The provisions of section 24 of the ARHRA Act imposes illusory and unworkable restrictions on the practitioners who pass out the course. The restrictions that they should not practice in urban areas and at nursing homes are illusory and such restrictions cannot be effectively implemented. Besides, to make a distinction between the medical services for urban areas and rural areas amounts to a hostile and irrational discrimination, and the standard and quality of medical services required for persons in urban areas and in rural areas cannot be different and the standard has to be uniform for the health and welfare of the society. 5. On the basis of above submission it is strenuously contended that the ARHRA Act being repugnant to the Indian Medical Council Act, 1956 is to be struck down as ultra vires. 6. 5. On the basis of above submission it is strenuously contended that the ARHRA Act being repugnant to the Indian Medical Council Act, 1956 is to be struck down as ultra vires. 6. At the time when the writ petition was moved this court declined to stay operation of the ARHRA Act on the ground that arguments would be heard and the case would be decided at the earliest, therefore for admissions and starting of the course stay order was not granted. The state, in the absence of stay order from the court, proceeded with the admissions and started the course. 7. It appears that about 5 batches have passed out and around 500 students have been awarded with the diploma by the ARHRA and they are under the employment of the state agencies in different rural areas in Assam. 8. When the matter was taken up for hearing by this Bench the Additional Advocate-General raised some preliminary objections to the effect that the students who passed out are to be made party to the proceedings, because they would be adversely affected if the provisions of the ARHRA Act is struck down and the diploma certificates are derecognised. This court by order dated 19th September, 2014 overruled the objections. The matter is heard on merits. Written-argument on behalf of the state is also filed. The counter-affidavit (28.2.2008) is also filed in reply to the contentions raised by the petitioner. 9. Sri D Saikia, the Additional Advocate-General, apart from the contention in the additional-affidavit and the written-argument, relied on the decision of the Supreme Court in Offshore Holdings Private Ltd. v. Bangalore Development Authority and Others, (2011) 3 SCC 139 , to bring home the point that there is no repugnancy between the provisions of the Indian Medical Council Act and the Assam Rural Health Regulatory Authority Act. It is submitted that the state by virtue of powers under entry 25 of list III is fully competent to legislate the Act, to envisage a diploma course in medicine. In the context that merely because there are certain over lappings between the Indian Medical Council Act and the Assam Rural Health Regulatory Authority Act such overlappings have to be ignored and the pith and substance of both the enactments has to be considered in order to ascertain whether any repugnancy is there. 10. In the context that merely because there are certain over lappings between the Indian Medical Council Act and the Assam Rural Health Regulatory Authority Act such overlappings have to be ignored and the pith and substance of both the enactments has to be considered in order to ascertain whether any repugnancy is there. 10. It is submitted that the courses approved by the Indian Medical Council are degrees in medicine and other higher degrees, whereas the ARHRA Act envisages a diploma course with certain restrictions on the medical practitioners who obtain a diploma mainly with an intention to sec that the practitioners are trying to treat the common diseases that afflict rural people. The practitioners under the ARHRA Act are not entitled to operate major surgeries and they are permitted only to treat certain types of diseases and prescribe certain types of medicines. Therefore the persons who pass out diploma course are not fullfledged doctor; they are in a sense a paramedic. In that view it is argued that the ARHRA Act does not suffer from any infirmity or illegality so as to be struck down as ultra vires. 11. The Supreme Court in the case of State of Kerala and Others v. Mar Appraem Kurt Company Ltd. and Another, (2012) 7 SCC 106 makes a reference of paragraph 64 to the decision of the Supreme Court in M. Karunanidhi v. Union of India, (1979) 3 SCC 431 , wherein the following observations arc made regarding the concept of repugnancy: “35. On a careful consideration, therefore, of the authorities referred to above, the following propositions emerge: 1. That in order to decide the question of repugnancy it must be shown that the two enactments contain inconsistent and irreconcilable provisions, so that they cannot stand together or operate in the same field. 2. That there can be no repeal by implication unless the inconsistency appears oil the face of the two statutes. 3. That where the two statutes occupy a particular field, but there is room or possibility of both the statutes operating in the same field without coming into collision with each other, no repugnancy results. 4. That where there is ho inconsistency but a statute occupying the same field seeks to create distinct and separate offences, no question of repugnancy arises and both the statutes continue to operate in the same field.” 12. 4. That where there is ho inconsistency but a statute occupying the same field seeks to create distinct and separate offences, no question of repugnancy arises and both the statutes continue to operate in the same field.” 12. Upon, thoughtful consideration of the submission at the Bar and in the light of the ratio laid down by the Supreme Court in M. Karunanidhi case (supra) it is evident that the ARHRA Act is in conflict with the IMC Act more particularly section 10A of the IMC Act, which is enacted by virtue of entry 66 of list I which categorically declares by non-obstante clause that "notwithstanding anything contained in this Act or any other law for the time being in force no person shall be a medical college and no medical college shall open a new or higher course of study or training.” 13. Section 10A(1) of the IMC Act is extracted hereunder for convenient reference: "(1) Notwithstanding anything contained in this Act or any other law for the time being in force, - (a) no person shall establish a medical college; or (b) no medical college shall - (i) open a new or higher course of study or training(including a post-graduate course of study or training) which would enable a student of such course or training to qualify himself for the award of any recognised medical qualification; or (ii) increase its admission capacity in any course of study or training(including a post-graduate course of study or training), except with the previous permission of the Central Government obtained in accordance with the provisions of this section." 14. The restrictions in section 10A(b)(i) envisage injunction against medical colleges to open "a new or higher course". The words "open a new course" would definitely take in its sweep the diploma course contemplated under the ARHRA Act. It is necessary that even for opening a diploma course a previous permission of the Central Government is required. In the present case, no permission is taken. The words "no person" would also include the state. In the instant case, the state has ventured to introduce a new diploma course in medicine and rural healthcare - more particularly in the field of allopathy - without the necessary permission as contemplated under section 10A of the IMC Act. 15. In the present case, no permission is taken. The words "no person" would also include the state. In the instant case, the state has ventured to introduce a new diploma course in medicine and rural healthcare - more particularly in the field of allopathy - without the necessary permission as contemplated under section 10A of the IMC Act. 15. With regard to power and scope to legislate under entry 25 of list III is very limited: it is only in respect of unoccupied field that the state can legislate. In the present case, the Central legislation fully covers the field and places a total restriction on opening any "new course" in medicine without the permission from the Central Government. Therefore, to say that to open a new course of diploma in allopathic medicine the state has full scope and power is an untenable contention. Besides, to overcome the repugnancy the Presidential assent as required under article 254 of the Constitution of India is not taken. 16. It was strenuously argued by the Additional Advocate-General that the provisions which are found to be repugnant could be struck down by applying the doctrine of "severability" and rest of the ARHRA Act may be held as invalid in law. We are afraid to accept the argument. Section 24, extracted above, lays down the powers and functions of the rural health practitioners. It would be bizarre to say that the diploma-holders should practice in rural areas and not in urban areas and further to say that they are entitled to treat only certain diseases and prescribe certain medicines. The restrictions on paper are really unworkable on the field. There is no check and balance for the rural health practitioners, who violate the provisions of law. It is unfortunate that in our society the quacks are already unchecked and dominating. As a court we cannot say whether the so-called diploma-holders would be competent to function as doctor unless they are so declared and certified by the Indian Medical Council, which is indeed the competent authority. It is unfortunate that in our society the quacks are already unchecked and dominating. As a court we cannot say whether the so-called diploma-holders would be competent to function as doctor unless they are so declared and certified by the Indian Medical Council, which is indeed the competent authority. To allow the diploma-holders to function as rural health practitioner in the field of allopathy without judging and gauging their competency by the competent authority would have disastrous consequence in the rural healthcare, and to permit such, diploma-holders to practice in the field of allopathy in rural areas without a proper certification by the Indian Medical Council would not only be bad in law but would have a deleterious consequence in the matter of rural health! 17. The question of striking down section 24 of the ARHRA Act alone will not save the situation for the state because section 24 is the "soul" of the Act; if the soul is taken out, perhaps the rest of the Act will be lifeless and meaningless. 18. It was strenuously argued that the diploma-holders are only in the nature of paramedical force and they are not considered as fullfledged doctor, which is again an untenable contention and contrary to the provisions of section 24 of the ARHRA Act which empowers rural health practitioners to practice in the field of allopathy and treat patients including to conduct minor surgeries. 19. The Additional Advocate-General submitted that in fact the Central Government was very much enthused with the concept "rural health practitioner" envisaged under the ARHRA Act. The state of Chattisgarh has also formulated a similar legislation and awarding diplomas to the persons working as community health worker and the Central Government is also thinking of bringing in an "enactment" and introducing a course to train persons for community health services. In that view it is said that this court may declare diploma-holders (under the ARHRA Act) as, community health worker and they be saved from the disaster of being getting their diploma certificates invalidated consequently losing their job. 20. We have considered the submission made at the Bar and we are not persuaded to agree with the arguments of the Additional Advocate-General to declare these rural health practitioners as community health worker or paramedic because the ARHRA Act does not say anything like that and we cannot relegislate and declare that the diploma-holders as paramedic. 20. We have considered the submission made at the Bar and we are not persuaded to agree with the arguments of the Additional Advocate-General to declare these rural health practitioners as community health worker or paramedic because the ARHRA Act does not say anything like that and we cannot relegislate and declare that the diploma-holders as paramedic. Therefore, keeping in view the larger interest of the health and welfare of the society and in view of the serious lapses committed by the state in enacting a legislation without a proper approval from the Central Government and which is evidently in conflict with the provisions of the Indian Medical Council Act we hold the Assam Rural Health Regulatory Authority Act, 2004 unconstitutional. Accordingly the Assam Rural Health Regulatory Authority Act, 2004 is struck down. The petition is allowed.