Principal, Ruckmoni College of Nursing v. Kerala University of Health Sciences, represented by The Registrar
2017-07-28
SHAJI P.CHALY
body2017
DigiLaw.ai
JUDGMENT : 1. Captioned writ petitions are all in relation to the rejection of continuation of affiliation of Nursing Colleges and therefore, I heard them together and propose to pass a common judgment. The colleges are given initial affiliation to start the B.Sc Nursing Programme during the academic year 2008, 2006 and 2011-2012 respectively. 2. Facts and documents relating to W.P.(C) No.22280/2017 are discussed for disposing of all the writ petitions. 3. Petitioner is given approval and permission by the Indian Nursing Council and State Nursing Council for conducting B.Sc Nursing Programme as well as for Post Basic Nursing Programme. Following the said approval, affiliation is granted by the respondent University in terms of the provisions in the Statute under which the Governing Council of the University is required to function. According to the petitioner, the University is obliged to give regular affiliation when the initial affiliation granted is either with condition or without condition. It is the case of the petitioner that, those stages are over long back. Even then, the University is insisting for applying for continuation of affiliation contrary to the provisions contained in the Statutes. Inspection had been conducted in the college on application, however, according to the petitioner, a dishonest report is submitted, so as to decline the continued affiliation of the B.Sc Nursing Colleges. On issuance of notice, reply was given explaining the circumstances, however, a mechanical order is passed by the University without considering the explanation offered declining affiliation. That apart it is contended that, due to efficient management of the college, 100% pass is secured by the college and the students are passing out with significant percentage of marks. That apart it is contended that, there is no provision in the Statute enabling the University to insist for continuation of affiliation or compelling the institution for applying for continuation of affiliation, though the procedure provided is a source for generating income, which ultimately resulted in profiteering by the University. Though the University is obliged to grant permanent affiliation in terms of the Statute, they are continuing in the process of issuing provisional affiliation since the same is a regular source for income. That apart it is contended that, for the purpose of continuing the course, institution is required to obtain approval of the Indian Nursing Council every year for which application is required to be given. 4.
That apart it is contended that, for the purpose of continuing the course, institution is required to obtain approval of the Indian Nursing Council every year for which application is required to be given. 4. It is also contended that, the hospital run by the institution is the biggest hospital in Thiruvananthapuram District with all modern facilities excluding the Medical College and Sree Chithra Institute of Medical Sciences. As of now it is a 340 bed hospital and is in the process of upgrading as a medical college and is housed in a an extent of 22 Acres of land. That apart it is contended that, the regular patients attending the hospital would be around 300 to 400 per day during March 2017 and therefore, the consequential action cannot be sustained under law. The reasons assigned in Ext.P2 notice, according to the petitioner, are from unknown source secured for the purpose of submitting dishonest report. However, in spite of clear explanation offered, Ext.P5 order is passed, which according to the petitioner, is of a typical nature in respect of the petitioners in the other writ petitions also. Ext.P5 is dated 27.6.2017, which is corresponding in the other two writ petitions as Exts.P4 and P7 respectively. 5. Separate statements are filed by the respondent University in all the writ petitions refuting the allegations and claims and demands raised by the petitioners. Apart from other contentions, it is stated that, after scrutiny it was revealed that, several deficiencies existed in the college. It was found that, the bed occupancy in the hospital ward is very less against the required 75%. The availability of inpatient is a must to provide proper bed training to the nursing students. A study conducted by the University has revealed that, the deterioration in the standard of the nurses coming out of the nursing institutions in the State mainly relates to the lack of bedside training given to them. Taking note of the said fact, University took a decision to ensure that the institutions seeking affiliation have proper and adequate facilities to impart good training to the students. The norms prescribed by the Indian Nursing Council insists for 75% bed occupancy, and the availability of less than 16% bed occupancy in the college of the petitioner is a serious deficiency.
The norms prescribed by the Indian Nursing Council insists for 75% bed occupancy, and the availability of less than 16% bed occupancy in the college of the petitioner is a serious deficiency. The Indian Nursing Council permits the affiliated hospitals to meet the requirement of exposure of students to particular branches of treatments. It is not taken as a part of the parent hospital and the requirement of a particular percentage of bed occupancy in the parent hospital cannot be diluted on the ground that, the affiliated hospitals have required or more than required bed occupancy. 6. That apart it is contended that, even the documents produced by the petitioner show that the faculty was appointed after the date of inspection. The claim raised by the petitioner on the basis of photographs produced suggests that the claim made by the petitioner regarding bed occupancy and the outpatient are not correct and loneliness in the hospital is truly reflected in the photographs produced. That apart it is stated that, the pass percentage in the college is less than 50%. Again it is contended that, the provisional affiliation cannot be granted every year is not correct since neither the Act nor the Statute prohibits such an affiliation. The University can consider the issue of granting permanent affiliation only when it is satisfied of the performances of the affiliated institution and such stage has not reached in the petitioner's college. 7. It is also submitted that, the institution was inspected, the report was considered by the Scrutiny Committee, the matter was placed before the Governing Council and the college was issued with notice seeking their explanation and thereafter only the Governing Council took the decision. The wording found in Ext.PP5 does not suggest that the decision was in a mechanical manner even though similar sentences and terms are used in other orders because of the fact that those institutions are similarly placed. Other contentions with respect to the non-insistence by the University for the minimum requirement in State run Institutes are all denied. It is also stated that, some of the centers of the State Medical Education and Technology were closed down for the present academic year as discrepancies were found. So far as those institutions are concerned, the Taluk or District hospitals are their parent hospital and there is no dearth in bed occupancy in those hospitals.
It is also stated that, some of the centers of the State Medical Education and Technology were closed down for the present academic year as discrepancies were found. So far as those institutions are concerned, the Taluk or District hospitals are their parent hospital and there is no dearth in bed occupancy in those hospitals. Therefore, respondents seek dismissal of the writ petitions having not made out any case of arbitrariness or illegality on the part of the respondents. Similar contentions are raised in the other writ petitions and the statements are also similar in nature except differences in certain facts and figures with respect to the student ratio. 8. Heard learned counsel for the petitioners, learned counsel appearing for the University and perused the pleadings and the documents on record. 9. The question to be considered centers around the order passed by the University dated 27.6.2017, whereby continuation of affiliation is declined for the year 2017-2018 thus prohibiting the petitioners from admitting students for the said academic year. On a reading of the order, it is stated that, applications were submitted by the petitioner colleges for the continuation of provisional affiliation for the year 2017-2018 with necessary documents and required fee on the basis of which University conducted inspection at the college and the inspection commission submitted a report on 18.3.2017. It was verified by the Scrutiny Committee and the Committee pointed out major deficiencies that is to say, insufficient inpatient strength, faculty and infrastructure facilities as per its minutes dated 25.5.2017. The deficiencies pointed out by the Scrutiny Committee were placed before the Governing Council on 6.3.2017 and the Governing Council vide its decision dated 6.3.2017 decided not to grant provisional affiliation for the year 2017-2018 for the colleges in question since they are having only less than the minimum required inpatient strength on the date of inspection. Thereupon, the colleges were directed to submit their explanation in this regard and decided to place the same in the next Governing Council.
Thereupon, the colleges were directed to submit their explanation in this regard and decided to place the same in the next Governing Council. The Governing Council after noting the inpatient status compliance report and pass percentage of the college, decided to reject the requests of the six colleges seeking continuation of affiliation for the year 2017-2018 having inpatients less than 20%, and also having other deficiencies including poor pass percentage, and not to permit admission of students for the academic year 2017-2018 against all courses in six colleges including the petitioner colleges. 10. Learned counsel for petitioners vehemently argued that the reports drawn are all dishonest reports so as to decline the continued affiliation to the petitioner colleges. That apart it is contended that, the reply submitted to the notices issued, were not taken into account and the facts and figures mentioned in the notice in respect of the inpatient strength are all incorrect. Learned counsel has invited my attention to Statute 10 of Chapter XXI of the Kerala University of Health Sciences First Statutes, 2013 and contended that the provisions of the same shows that, once the affiliation is granted, the respondent University is only vested with power to rectify the defects occurring by issuing proper directions and it can never decline to grant affiliation, especially due to the fact that, all the colleges have provided sufficient infrastructure spending huge amounts. That apart it is contended that different standards are adopted by the respondent University in respect of the colleges in question and the medical institutions managed by the State Government. Therefore, according to the learned counsel, an efficient inspection team is to be constituted with Government Officials and if an inspection is conducted, it will prove that the report on which the respondents are relied on is a dishonest report made with the intention of declining continued affiliation. 11. On the contrary, learned Standing Counsel for the University submitted that, the grant of affiliation to the colleges are based on stringent stipulations which all the colleges are expected to maintain during the tenure of the affiliation in order to secure continued affiliation. Learned Standing Counsel has taken me through the provisions of Chapter 21, which deals with procedure adopted in granting affiliation. Pin pointedly learned Standing Counsel invited my attention to the Statute 9 of Chapter XXI, which read thus: “Conditional affiliation: The affiliation granted may be provisional.
Learned Standing Counsel has taken me through the provisions of Chapter 21, which deals with procedure adopted in granting affiliation. Pin pointedly learned Standing Counsel invited my attention to the Statute 9 of Chapter XXI, which read thus: “Conditional affiliation: The affiliation granted may be provisional. If provisional affiliation is granted for a fixed period, the length of the period and the conditions to be fulfilled by the college before the expiry of the period shall be specified in the order of the Governing Council granting the affiliation. If the conditions are not fulfilled by the end of the period fixed, the affiliation shall cease automatically. If the conditions are fulfilled, the Governing Council shall have the power to confirm the affiliation at the end of the period.” 12. Therefore, according to the learned counsel, in order to have the continued affiliation, one must maintain the standards specified while granting affiliation, which is normally spelt out in Statue 10 itself and if they are not maintaining the same, the authority is vested with ample powers to decline permanent affiliation till it attains the satisfaction, the colleges are capable of maintaining requisite standards in accordance with the provisions of the Statute. Learned Standing Counsel has also invited my attention to Statute 11, whereby the Governing Council is vested with powers at any time after due enquiry to withdraw or suspend for a definite period the affiliation granted to a college. The only mandatory requirement, the counsel contends is that, before taking such action the Governing Council has to inform the management of the colleges concerned, of the finding after the enquiry and shall allow it an opportunity of making such representations as it may deem fit and shall record its opinion on the representations so made. In this regard learned Standing Counsel has invited my attention to the judgment of the Apex Court in Maa Vaishno Devi Mahila Mahavidyalaya v. State of U.P. and others [ 2013 (2) SCC 617 = 2012 KHC 4748] and specifically to paragraphs 57 and 58 and canvassed for the proposition that, if any laxity or relaxation is shown in the matter of maintenance of institutions, it will cause disastrous consequences in respect of the standards demonstrated by such nurses passing out from such institution. Therefore, no manner of concession or relaxation can be granted to any institution which is not maintaining the standards.
Therefore, no manner of concession or relaxation can be granted to any institution which is not maintaining the standards. That apart judgment of the learned Single Judge in W.P.(C) No.15368/2016 dated 14.7.2016 is brought to my notice, in which case the learned Single Judge had occasion to consider a report of the three member committee constituted by the University to look into the requirements of clinical facilities to commence a nursing college in Kerala. After going through the report, it is held in paragraph 11 as follows : 11. The figures in the extracted paragraphs speak for themselves and indicate that the nursing professionals passing out from the institutions in the State are far in excess of their requirement. That, by itself, would not have created any problem since, as has been noticed by the Committee, the nurses brought out by the State were in demand in the other States and even outside the Country. The Committee has looked into the syllabus of the Indian Nursing Council, which specifies the academic objectives and requirements, on a reference of which, the Committee evaluated the present requirements as prescribed by the University. The chart appended to the report indicates that earlier, the norms prescribed a nursing college to have at least 500 beds with the requirement of occupancy of not less than 80%. The said requirement was diluted to 120 to 150 beds, with a requirement of not less than 75% occupancy. The student-patient ratio, which existed earlier, was 1:5, which was also lowered to 1:3. The relaxation in the norms was also declared by the Indian Nursing Council, to be, for meeting the man power requirement by increasing the output of trained professionals anticipating the requirement for the coming ten years. However, such relaxation, according to the Committee, has resulted in the output having far extended the demand and also occasioned drastic deterioration of quality of nurses. This has also led to exploitation of those sent out to an already crowded job market and resulted in decline of the professional competence; two sides of the same coin, which holds out little hope in improving the standards of patient care.” 13.
This has also led to exploitation of those sent out to an already crowded job market and resulted in decline of the professional competence; two sides of the same coin, which holds out little hope in improving the standards of patient care.” 13. Even though learned counsel for petitioners has invited my attention to the judgment of a Division Bench of this court in Clarist Medical Trust of the S.H. Province v. Secretary to Government [ 2017 (1) KLT 679 ], the consideration therein was in respect of exemption for building tax claimed by a trust. It is true certain facets of the infrastructural requirements were discussed in paragraph (9), however, I do not think that, it will be proper on my part to rely on the said decision since the factual circumstances are entirely different . 14. Having evaluated the respective submissions made by the counsel on either side, the question requires to be considered is whether, any manner of interference is warranted to the order passed by the University declining continued affiliation specifically mentioned above. The summary of the discussion would make it clear that, the basic reason for declining continued affiliation is insufficient percentage of inpatients in the hospitals concerned. According to the learned Standing Counsel for University, the same is less than 20% when the Nursing Council of India insists for 75% of bed occupancy. In my considered opinion, the student - patient ratio of 1:3, which is a basic requirement to have a continued affiliation, is materially interfered with consequent to very less percentage of bed occupancy in W.P.(C) No.22583/2017. It is pointed out that, the bed occupancy of the said institution is less than 20%, which is a serious deficiency. If the petitioners, is to establish a case with respect to the dishonest report prepared by the Inspection Committee, petitioner should have controverted the same by producing requisite documents at least before this court to show that, it had sufficient bed occupancy in accordance with law by providing the details of the inpatients. Various other material documents would be available with the institution, if the situation is in accordance with the pleadings made by the petitioner to justify their statements. None of the material documents in respect of proof for inpatients in the hospital are provided by the petitioners.
Various other material documents would be available with the institution, if the situation is in accordance with the pleadings made by the petitioner to justify their statements. None of the material documents in respect of proof for inpatients in the hospital are provided by the petitioners. The photographs produced show so far as the petitioner in W.P.(C) No.22280/2017 is concerned that, it is having substantial buildings but it is not an established proof to show it had at the time of inspection sufficient inpatient bed strength vis-a-vis the ratio to be maintained with the student community, as pointed out by the Judgments of the Apex Court and this court cited supra, in order to ensure employment to the nurses and quality nurses to be produced by the institutions. Nurses are vital requirements of hospitals almost akin to the doctors since the patient care is to be undertaken by the nurses with more care and caution on the instructions imparted by the doctors. Therefore, training provided to the nurses in the colleges by the bed side, is a vital component in the educational career of such students. 15. Viewed in that circumstances, it is explicit and evident that, the rigorous and convincing considerations put forth by the respondent University is with any oblique or illegal motive. So also in view of Statute 9, the affiliation granted may be provisional only. The University is vested with power to cancel or withdraw the initial affiliation provided, if the conditions required to be fulfilled by the colleges are not undertaken, and the conditions are not fulfilled in accordance with the requirements of the Statute. Statute 9 makes it imperative that “affiliation shall cease automatically” and if the conditions are fulfilled in fact, Governing Council of the University shall have the power to confirm the affiliation at the end of the period. Even though petitioners have advanced a contention that, once provisional affiliation is granted, the University is vested with powers only to direct rectification of defects, I am of the considered opinion that, extreme power conferred on the University for withdrawal or suspension as per the Statute, is to ensure strict adherence to the requirements under law. Moreover, no manner of convincing reasons are established by the petitioners to have any grudge or ill will for the University to deliberately exclude the petitioners.
Moreover, no manner of convincing reasons are established by the petitioners to have any grudge or ill will for the University to deliberately exclude the petitioners. That apart mere bed strength or mammoth size of the hospital is that what matters, but actual physical occupation by patients so as to enable the students to have sufficient training by the bed side is the requirement, which is also a necessary corollary to satisfy the student - patient ratio of 1:3. Moreover, I do not find any force in the contention by the learned counsel for the petitioners that, surprise inspection by the respondent is not justified. On the other hand, University has a formidable duty to ascertain the requirements maintained by the colleges resorting to such methods, which would also avoid any manipulation, in the patient requirement and the documents maintained by the institutions and hospitals. 16. The conspectus of fact circumstances discussed above, and reckoning the law, I have no hesitation or doubt in to hold that, the action of the University declining continued affiliation to the petitioner colleges is in any manner illegal, arbitrary or unfair justifying interference of this court under Article 226 of the Constitution of India. 17. Resultantly writ petitions fail, accordingly they are dismissed.