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2016 DIGILAW 451 (GAU)

Minku Protim Dutta v. State of Assam through the Commissioner & Secretary Department of Health & Family Welfare, Government of Assam, Dispur, Guwahati

2016-05-24

MANOJIT BHUYAN

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JUDGMENT : Manojit Bhuyan, J. The disparity in remuneration amongst AYUSH Doctors and discrimination in posting out the petitioners to various Sub-Centres of the State, contrary to norms and guidelines, are the primary issues raised in this writ petition. For better appreciation, the following facts are noticed. 2. The National Rural Health Mission (now called National Health Mission), which was introduced in the year 2005, is an umbrella organization aimed at improving the deficiencies in the healthcare delivery system with focus on eighteen States including Assam. The effective healthcare programmes, with focus on the rural population, also include AYUSH, which is an abbreviation for Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy, which together constitutes the Indian System of Medicines. The Department of Indian Systems of Medicines and Homeopathy which was created by the Government of India in March 1995 was renamed as Department of AYUSH in November 2003. For the effective execution of the schemes under the NHM, there is a Memorandum of Understanding, executed by and between the Government of India and the State Government. Basically, the funding of all the key components is by the Government of India. 3. The petitioners herein are serving as Medical Officers (Homeopathy) under NHM and presently posted at various Sub-Centres in the State of Assam. Each of them has requisite qualification as a Bachelor of Homeopathic Medicine & Surgery (BHMS) and is Class-A Homeopathy practitioner registered with the Board of Homeopathy System of Medicines, Assam under the provisions of the Assam Homeopathic Rules, 1958. In the year 2010, the petitioners were appointed on contract basis as Medical Officers (Homeopathy) under the National Health Mission, Assam by orders issued under the hand of the Mission Director, NHM, Assam. On such appointment, they were posted at various Primary Health Centres, Block Primary Health Centres, State Dispensary, Subsidiary Health Centres, Community Health Centres etc., located in the various parts of Assam. For the purpose of employment, each of the petitioners had executed Agreement which defines the terms of their contractual appointment as well as the nature of their jobs and responsibilities as Medical Officers (Homeopathy). Although the period of contractual appointment initially covered a period of six months, they have continued to serve as Medical Officers (Homeopathy) until this date. 4. For the purpose of employment, each of the petitioners had executed Agreement which defines the terms of their contractual appointment as well as the nature of their jobs and responsibilities as Medical Officers (Homeopathy). Although the period of contractual appointment initially covered a period of six months, they have continued to serve as Medical Officers (Homeopathy) until this date. 4. The bone of contention is that the Medical Officers (Ayurveda), who come from the same stock, are being differently and benevolently put above par than the petitioners herein. Contention advanced is that the Medical Officers (Ayurveda) are persons having Bachelor Degree in Ayurvedic Medicine & Surgery (BAMS) and both the Homeopathic and Ayurvedic Medical Officers constitute one common class of AYUSH Doctors. The modes of appointment of the Medical Officers (Ayurveda) as well as the terms of their contractual employment are governed by the same terms and conditions, as in the case of the petitioners herein. In all, the Medical Officers under the umbrella of AYUSH, be it the Medical Officers (Homeopathy) or Medical Officers (Ayurveda), are one cohesive unit, shorn of any distinctions as regards status, nature of duties, mode of recruitment, minimum educational qualification etc. 5. In so far as the remuneration of the contractual employees under NHM are concerned, the Officer Order dated 11.01.2011 (Annexure P/11), issued from the Office of the Mission Director, NRHM, Assam had prescribed equal remuneration to both the categories. In both cases, the initial pay which stood at Rs.15,000/- per month was revised to Rs.22,000/- per month and same was extended pursuant to the approval given by the Ministry of Health & Family Welfare, Government of India and the State Health Mission. A paradigm shift in the remuneration between the Medical Officers of Homeopathy and that of Ayurveda was brought about by Order dated 02.08.2012, issued under the hand of the Mission Director, NRHM, Assam, whereby the Medical Officers (Ayurveda) were made entitled to draw fixed remuneration at Rs.30,500/- per month w.e.f. 01.04.2012. The enhanced remuneration was, however, not extended to the Medical Officers (Homeopathy). This is the first contentious issue raised in this writ petition alleging that the disparity in the remuneration is without any intelligible differentia and/or on any rationale and objective criteria. 6. The enhanced remuneration was, however, not extended to the Medical Officers (Homeopathy). This is the first contentious issue raised in this writ petition alleging that the disparity in the remuneration is without any intelligible differentia and/or on any rationale and objective criteria. 6. As regards the second issue involving posting of the Medical Officers (Homeopathy) to various Sub-Centres of the State, the gangplank of the challenge is that the Operational Guidelines of the Indian Public Health Standards do not provide for posting at Sub-Centres. Further, such posting is made only in respect of the Medical Officers (Homeopathy), by altogether leaving out the Medical Officers (Ayurveda). 7. Mr. P.K. Tiwari, learned senior counsel representing the petitioners submit that the Programme Implementation Plan (PIP), which has its genesis in the Memorandum of Understanding, executed by and between the Central Government and the State Government, is a Plan prepared at the State level for effective implementation of NHM programme with approval of the Central Government. The State PIP demonstrates that the budget approval for Medical Officers (Homeopathy) is in respect of their posting only in the Primary Health Centres. As such, in the absence of any approval of the Government of India towards posting of Medical Officers (Homeopathy) to any Sub-Centres of Assam, the action of the NHM, Assam is illegal. In the same breath, Mr. Tiwari submits that without approval of the Government of India, the marked disparity in the remuneration between the Medical Officers (Homeopathy) to that of the Medical Officers (Ayurveda) could not have been brought about. Alleging hostile discrimination, prayer is made for enhancing the fixed remuneration of the petitioners by bringing it at par with the Medical Officers (Ayurveda) under NHM, Assam w.e.f. 01.04.2012. As regards posting to Sub-Centres, prayer made is for quashing the order dated 01.08.2012 with further direction to the respondents to post the petitioners in District Hospitals, Primary Health Centres, Community Health Centres etc. as per the Operational Guidelines of the Department of AYUSH and also in conformity with the Programme Implementation Plan of Assam, 2011-12 and 2012-13, as approved by the Government of India. 8. On the issue of engagement of the petitioners at the various Sub-Centres of the State, a fear is also expressed that although they have been imparted with Skilled Birth Attendant (SBA) training, they are made to perform the work of Auxiliary Nursing & Mid-Wifery (ANM) in the Sub-Centres. 8. On the issue of engagement of the petitioners at the various Sub-Centres of the State, a fear is also expressed that although they have been imparted with Skilled Birth Attendant (SBA) training, they are made to perform the work of Auxiliary Nursing & Mid-Wifery (ANM) in the Sub-Centres. The Sub-Centres do not have any infrastructural facility or the basic equipments for proper child-delivery. As a result, there is an apprehension that things may come to such a pass that their job as Medical Officers (Homeopathy) may practically be rendered useless and if the state of affairs is allowed to continue, the same may seriously jeopardize their service career in NHM. 9. On the concept of equal pay for equal work, Mr. P.K. Tiwari relies upon the following judgments: (i) (1982) 1 SCC 618 – Randhir Singh v. Union of India (ii) 1985 (Supp) SCC 94 – P Savita & ors. v. Union of India, Ministry of Defence (iii) (1987) 4 SCC 634 – Bhagawan Dass & ors. v. State of Haryana (iv) (1986) 1 SCC 637 – Dhirendra Shamoli v. State of U.P. & ors. (v) (1988) 3 SCC 354 – Jaipal & ors. v. State of Haryana & ors. (vi) (1986) 1 SCC 639 – Surinder Singh & anr. v. Engineer-in-Chief, CPWD (vii) AIR 1987 SC 1281 – M/s Mackinnon Mackenzie and Co. Ltd. v. Audrey D’Costa. 10. Mr. J.M.A. Choudhury, learned counsel representing NHM begins by saying that the NHM is only the implementing agency and if the petitioners are aggrieved of any decision/action, a representation to that end could have been made to the State Health Society constituted by the Government of Assam in the Health & Family Welfare Department on 05.01.2006 and/or to the Committee constituted by NHM, Assam by Office Order dated 15.11.2014, so empowered to examine various issues including matters relating to enhancement of salary of NHM employees . As regards the alleged disparity in the remuneration between the Medical Officers of Homeopathy and Ayurveda, Mr. Choudhury refers to paragraph 10 of the affidavit-in-opposition of the respondent no. 3 to say that respective remuneration is being given considering the salary of regular Medical Officers of Homeopathy and Ayurveda, as granted by the Government of Assam. To buttress his argument, Mr. Choudhury refers to paragraph 10 of the affidavit-in-opposition of the respondent no. 3 to say that respective remuneration is being given considering the salary of regular Medical Officers of Homeopathy and Ayurveda, as granted by the Government of Assam. To buttress his argument, Mr. Choudhury submits that the gross salary received by a Medical Officer (Ayurveda), employed by the Government of Assam, receives a gross amount of Rs.36,018/-, whereas a Medical Officer (Homeopathy) under the Government of Assam receives a gross salary of Rs.22,736/-. Whereas, a Government Medical Officer (Ayurveda) is placed in Pay Band-4, a Government Medical Officer (Homeopathy) is placed in Pay Band-3. Accordingly, the remuneration of Medical Officers (Ayurveda) in NHM is fixed at Rs.30,500/- per month, made effective from 01.04.2012. 11. As regards the engagement of the petitioners at various Sub Centres, Mr. Choudhury refers to the affidavit-in-opposition and submits that both the Government of Assam and the NHM have taken a decision to make the Sub-Centres functional in respect of deliveries and OPD services. It is submitted that the number of deliveries conducted by the Medical Officers (Homeopathy) in their earlier places of posting was low and, as such, decision was taken to impart Skilled Birth Training to the Homeopathic Doctors under NHM before their posting to various Sub-Centres. As regards the allegations of infrastructural deficiencies, it is contended that orders have been placed for installation of required equipments at the Sub-Centres and installation thereof is awaited. Also, the Medical Officers (Homeopathy) would be provided with OPD services at the respective Sub-Centres. On the apprehension expressed by the petitioners that they are being made to perform the work of ANMs, it is stated that the trained Homeopathic Doctors are posted at the Sub-Centres only to conduct delivery cases and to perform OPD services as per Homeopathic system of treatment and not to perform the job of ANMs. 12. The submissions above have been noticed. At the outset, it is made clear that the issue with regard to engagement of the petitioners at various Sub-Centres of the State is not interfered with as the apprehensions expressed have been duly answered by the State respondents in their affidavit-in-opposition. It is said that India lives in the villages and, therefore, the endeavor to bring medical facilities to the doorstep of the rural populace is a constitutional obligation of the State. It is said that India lives in the villages and, therefore, the endeavor to bring medical facilities to the doorstep of the rural populace is a constitutional obligation of the State. The petitioners cannot be allowed to say that just because the Operational Guidelines do not provide for posting/engagement at Sub-Centres and that Medical Officers (Ayurveda) are being differently treated in this regard, is not sufficient to interfere with the action of the respondents. This submission of the petitioners does not inspire the confidence of the Court. 13. The submission of Mr. J.M.A Choudhury is that the NHM is an only implementing agency and not the final arbiter. The Officer Order dated 02.08.2012 enhancing the fixed remuneration of Medical Officer (Ayurveda) working under NHM, Assam to Rs.30,500/- per month w.e.f. 01.04.2012 is, ex facie, a decision taken by the NHM, Assam under the signature of the respondent no.3. The second submission with regard to no representation being filed by the petitioners either before the State Health Society or the Committee, the said submission also do not hold any water, in as much as, there are no records to show that the case of the petitioners with regard to enhanced remuneration is under process or under consideration so as to bring them at par with the Medical Officers (Ayurveda). Even in the affidavit-in-opposition, there is no statement to that effect. In the opinion of the Court, a direction to the petitioners to make representation and to the state respondents to consider and pass appropriate orders thereon, would only result in a time-consuming, non-effective exercise. 14. This brings us to the more contentious issue where claim is made for equal remuneration for equal work. There is no dispute that the entry qualification to be eligible for appointment to the contractual post, either as a Medical Officer (Homeopathy) or Medical Officer (Ayurveda), is a graduate degree. In the case of Medical Officer (Homeopathy) it is Bachelor in Homeopathy Medicine & Surgery (BHMS) and in the case Medical Officer (Ayurveda) it is Bachelor Degree in Ayurvedic Medicine & Surgery (BAMS). The mode of recruitment in both the categories under NHM is one and the same, as evident from the Order for Contractual Engagement enclosed to the writ petition. The mode of recruitment in both the categories under NHM is one and the same, as evident from the Order for Contractual Engagement enclosed to the writ petition. The nature of duties and functions of a Medical Officer (Homeopathy) and that of Medical Officer (Ayurveda) are delineated at Appendix-I of the Terms of Reference for the Post. Under the heading “Curative Works”, a Medical Officer (Homeopathy) in NHM is to attend to OPD duty regularly and also to perform laboratory services etc. as well as to impart education about nutrition, hygiene and very many responsibilities as exhaustively detailed in the said Terms of Reference. Job responsibilities also includes providing Maternal Health i.e. ante-natal care, natal care, post-natal care as well as providing Child Health care, Family Planning and various other control and eradication programmes. The job responsibilities of a Medical Officer (Ayurveda) is on similar lines, involving Curative Work, Maternal Health care, Child Health care, Family Planning etc. There appears to be no perceptible distinction in the nature of duties and functions between the Medical Officers (Homeopathy) and Medical Officers (Ayurveda). At least, the Appendix-I of the Terms of contractual employment do not disclose any staggering difference in the job responsibilities between the two. 15. In the case of Randhir Singh (supra), the Apex Court held that the principle of equal pay for equal work is not an extract doctrine but one of substance and although the said principle is not expressly declared as a fundamental right under the Constitution of India, it certainly is a constitutional goal. The principle of equal pay for equal work, enshrined in Article 39(d) of the Constitution, is deducible from Article 14 and 16 of the Constitution and the same can be applied to cases of unequal scales of pay based on no classification or irrational classification. This decision of the Apex Court has enlarged and exalted the principle of equal pay for equal work to the position of a fundamental right by reading it along with Article 14 of the Constitution. The ratio laid down in Randhir Singh (supra) was followed in P. Savita (supra) and /s Mackinnon Mackenzie (supra), so relied upon by Mr. Tiwari. This decision of the Apex Court has enlarged and exalted the principle of equal pay for equal work to the position of a fundamental right by reading it along with Article 14 of the Constitution. The ratio laid down in Randhir Singh (supra) was followed in P. Savita (supra) and /s Mackinnon Mackenzie (supra), so relied upon by Mr. Tiwari. In the case of Bhagawan Dass (supra), one of the points raised by the respondent State in resisting the claim for equal pay was that the Scheme under which Bhagawan Dass was employed is a temporary scheme, sanctioned from year to year basis and the scheme itself was temporary in nature. The Apex Court answered by expressing that it is unable to comprehend how this factor can be invoked for violating the doctrine of equal pay for equal work. The other cases relied upon by Mr. Tiwari are in similar lines following the decision in Randhir Singh’s case (supra). 16. On careful analysis of the available materials, undoubtedly, the minimum educational qualification, the mode of recruitment and the nature of duties and functions performed by both the Medical Officers (Homeopathy) and Medical Officers (Ayurveda) are similar to each other. The functions and duties of both the categories are primarily directed to advance the cause of health-care and to bring medical awareness among the people in the rural areas. The key players come under a common expression called AYUSH Doctors, who are sensitized and trained to monitor and to effectively implement the health-care programmes under NHM. 17. Having regard to the above, there is sufficient material to hold that the classification between the Medical Officer (Homeopathy) and Medical Officer (Ayurveda), in so far as difference in the fixed remuneration is concerned, is without any basis. The petitioners herein do the same work and perform the same duties, if not more stringent, and as such the ratio of the decision in Randhir Singh (supra) applies with greater force in the case in hand. This is a fit case requiring a direction to the State respondents to take steps for according the petitioners the same remuneration as are being granted to the Medical Officers (Ayurveda) in NHM. 18. This is a fit case requiring a direction to the State respondents to take steps for according the petitioners the same remuneration as are being granted to the Medical Officers (Ayurveda) in NHM. 18. Accordingly, a direction is made to the State respondents to fix the remuneration of the petitioners i.e. Medical Officers (Homeopathy) on a par with that of the Medical Officers (Ayurveda) employed under the National Health Mission. The effective date of enhanced remuneration at par with the Medical Officers (Ayurveda) shall be granted with effect from the date on which such benefit was extended to the Medical Officers (Ayurveda). The entire exercise, as indicated above, shall be completed by the State respondents within a period of 4 (four) months from today. 19. Writ petition stands allowed to the extent indicated above. Petitioners are permitted to furnish a copy of this order to the concerned respondents for their doing the needful in terms of this order. No costs.