A cloud over the MCI

Medical Council of India President Ketan Desai steps down after the Delhi High Court indicts him on charges of corruption.

THE Medical Council of India (MCI), entrusted with the responsibility of maintaining standards in medical education and in the medical profession, is under a cloud. On November 23, the Delhi High Court asked its president Ketan Desai to step down and pulled up the Central government for not having taken steps to correct the alleged irregularities in the functioning of the MCI and maintain its representative character. A Professor of Urology at B.J. Medical College, Ahmedabad, Ketan Desai, who resigned the presidentship on December 3, was also the chairman of the staff selection committee at the All India Institute of Medical Sciences (AIIMS), New Delhi, and a member of its governing body and institute body.

Even before the court gave its order, Ketan Desai was under pressure from the AIIMS faculty to quit his posts at the institute. A prima facie case was established against him in December 2000 following investigations by the Income Tax Department, which had raided his house. Ketan Desai and the Union of India have filed a Special Leave Petition in the Supreme Court challenging the High Court order.

The MCI's powers have expanded over the years with the increase in the number of medical colleges. Set up under the Indian Medical Council Act, 1933, the MCI was initially vested with powers to ensure uniform standards in medical education and grant recognition to medical degrees awarded in India and abroad. The Act was amended in 1956 so as to empower the MCI to derecognise degrees given by medical institutions in India and abroad. The MCI had the responsibility not only to fix academic standards for various medical courses but also to ensure that medical colleges have proper infrastructure for education and training. It can depute teams to inspect medical colleges and act on their reports. Any negative report could lead to the derecognition of the college concerned. Medical colleges require the MCI's permission to increase the number of seats. Given the wide-ranging powers of the MCI, any irregularities in its functioning are bound to affect the entire medical system in the country.

It is in this context that the allegations against Ketan Desai acquire importance. Harish Bhalla, a medical practitioner, filed a writ petition in the Delhi High Court challenging the appointment of Ketan Desai as president of the MCI and seeking directions to the Central government to constitute the Council. In an interim order issued on May 28, 2001, a single Judge of the High Court ordered the removal of Ketan Desai as MCI president until fresh elections were conducted. The Union of India and Ketan Desai filed appeals against the order. On June 4, a Division Bench of the High Court stayed the order and permitted the MCI to hold elections to the post of president and vice-president as scheduled. Harish Bhalla approached the Supreme Court. The apex court passed an order on June 18 substantially maintaining the Division Bench ruling. It directed the Delhi High Court to dispose of the appeals expeditiously. The petitioner filed an additional affidavit in the High Court. The final hearing began after all parties concerned filed their affidavits, rejoinders and counter-affidavits.

The High Court had three aspects to deal with: the constitution of the MCI, the eligibility of Ketan Desai to hold the post of president and the alleged misuse of office by Ketan Desai. Under the Medical Council Act, the MCI has to be a representative body with people drawn from various sections of the medical community. It was found that the Council had only 77 members against the stipulated 123. Also, the number of nominated members was much larger than the number of elected members. Under the Act, the number of elected members must be more than twice the number of nominated members. But the Council had an equal number of members from each category. A two-member Bench of the High Court pulled up the Central government on this matter. It observed that the Centre had failed to perform its duty of constituting the Council under Section 3 of the Act and that it was owing to this failure that the Council had lost its representative character. The government, it noted, "had not at all made bona fide efforts and not adopted effective measures to ensure that elected members are in place". The order said that the fact that Ketan Desai had won the election to the post of president with an overwhelming majority proved that he sought to retain control over the Council by such manoeuvres.

Despite the gravity of the charges against Ketan Desai, he was renominated to several committees at the AIIMS in August 2001. Union Health Minister C.P. Thakur is the president of the institute and the chairman of the governing body. The AIIMS Faculty Association's plea against Ketan Desai's continuance in the institute body went unheard.

Apart from levelling corruption charges against Ketan Desai, the petitioner questioned his membership of the Council. Ketan Desai was initially appointed against a vacancy and his term was to end on February 19, 2000. However, the Central government nominated him as a member on February 1, 2000. The date was later changed to February 14, 2000. Ketan Desai had got himself elected to the Council as a representative of the faculty members of the medical colleges in Gujarat on March 29, 1999. The petitioner argued that under Section 5 (2) of the Act, Desai could not be a member of the Council in more than one capacity at the same time.

The petitioner also alleged that the MCI's inspection norms were bypassed in the case of Santosh Medical College, Ghaziabad, and the D.Y. Medical College for Women, Pimpri, Pune. According to the petitioner, the inspection reports about the infrastructure and the bed occupancy rates of hospitals attached to these colleges were fake. He also alleged that the admission quota for non-resident Indians (NRIs) was exceeded. Santosh Medical College allegedly exceeded the quota by 40. Similar was the case with Kasturba Medical College, Manipal, according to the petitioner. A total of 18,000 students are admitted to the MBBS course in the 179 medical colleges in the country every year. Of this, 62 were private medical colleges, which accounted for 8,000 seats. Fifteen per cent of these seats are allotted to NRIs, but many private medical colleges do not stick to this quota as NRI seats fetch huge payments. Significantly, Ketan Desai did not dispute the charges relating to excess admissions and the absence of inspections. He only stated before the court that the "Council was taking the necessary steps".

On February 18 and 20, 2000, the Income Tax Department raided the business and residential premises of Ketan Desai and bank drafts for Rs.65 lakhs were found to have been received by him and his family members. The Joint Director of Income Tax (Investigation), Ahmedabad, concluded that prima facie these drafts appeared to be arranged gifts and that further inquiry was needed in this matter. This conclusion was conveyed to the Income Tax Department in Delhi. Investigations by the Joint Directors of Income Tax in Ahmedabad and Delhi revealed that the gift entries were not in lieu of loans and records as claimed by Ketan Desai. The Joint Director of Income Tax (Investigation), Delhi, stated in a letter to his counterpart in Ahmedabad that "these are accommodation transactions in the form of gifts and the alleged donors merely acted as conduits to channelise the unaccounted money of Dr. Ketan Desai into his and his family members' bank accounts."

The minutes of the executive committee meetings of the MCI over the last three years (1998 to 2000) were replete with resolutions leaving the matters of inspection, recognition and admission in medical colleges to the absolute discretion of the president. The court order said that Ketan Desai had managed to manipulate the affairs of the Council in such a way as to exercise complete control over its affairs. Manipulation, the court said, was evident in the presidential election on June 21, 2001, in which he got 69 out of 73 votes. The executive committee, the Bench held, was being used to legitimise his activities as president. It was also found that there was not one instance where the Central government had differed or disagreed with the recommendations of the MCI.

Ketan Desai stated before the court that only Rs.50,000 had been seized from his house during the Income Tax Department raids and not crores of rupees as mentioned in the petition. He produced an income tax order that showed his 'undisclosed income' as nil. Taking cognisance of the order, the Bench noted that it did not "inspire any credibility or confidence in the nature of allegations" made by Ketan Desai against the petitioner. Ketan Desai did not produce any evidence of income tax returns filed either by him or his wife who was running a nursing home. The Bench noted that it was "strange that parties in Delhi, including two doctors, were sending money by way of demand drafts obtained from the same bank in Delhi totalling around Rs.65 lakhs, the drafts being made out in the name of Ketan Desai and his family members". Ketan Desai neither denied the receipt of these payments nor disclosed their source. On the basis of evidence, mainly that furnished by the Income Tax Department, and Ketan Desai's inability to justify these payments, the Bench ruled that there was a prima facie case for the prosecution of Ketan Desai on charges of corruption under the Prevention of Corruption Act.

Since there is no provision to debar a person from the membership of the Council before the expiry of his or her term, the court ordered that Ketan Desai step down with immediate effect. The Central Bureau of Investigation (CBI) was directed to launch prosecution. Significantly, the court ordered that the CBI would not take any instructions from the Central government or any of its departments and would pursue the prosecution independently. The court also directed the management of B.J. Medical College to initiate disciplinary proceedings against Ketan Desai.

The court directed the government to take steps to constitute the Council as early as possible and appointed S.P. Jhingon, a non-medical person, to officiate as president of the Council until its constitution.

It was not as if the Health Ministry was not aware of the state of affairs in the MCI. During a Rajya Sabha debate on August 6, C.P. Thakur agreed with the criticism by Y. Radhakrishna Murthy of the Communist Party of India (Marxist) of the functioning of the MCI. The member's observations, the Minister said, were "not far from the truth". In this context, it is not clear why the government did not take any action to straighten out matters. In fact, it was only two days after the Rajya Sabha debate that Ketan Desai was renominated to the AIIMS committees.