Supreme Court Refers AYUSH-Allopathy Parity Dispute to Larger Bench, Citing Conflicting Precedents

NEW DELHI – The Supreme Court of India has referred a pivotal and contentious question to a larger bench for an authoritative pronouncement: whether doctors practicing indigenous systems of medicine (AYUSH) can be treated on par with their allopathic counterparts concerning service conditions, including pay scales and retirement age. The decision, arising from a batch of appeals in State of Rajasthan and Ors. v. Anisur Rahman , addresses a deep-seated ambiguity in service jurisprudence, underscored by conflicting judgments from coordinate benches of the Apex Court itself.

A bench comprising Chief Justice of India B.R. Gavai and Justice K. Vinod Chandran acknowledged the "divergence of opinion" and the need for clarity on a matter with significant implications for thousands of government-employed medical professionals across the country. The core of the dispute lies in the application of Article 14 of the Constitution and the principle of "equal pay for equal work" to medical practitioners from vastly different disciplines.

In its order, the Court framed the central issue, stating, "There is divergence of opinion insofar as whether the MBBS doctors and doctors practicing indigenous systems of medicine can be treated equally, for the purpose of service conditions, which on principle, it is trite cannot result in treatment of unequals as equals. We are of the opinion that there should be an authoritative pronouncement on the issue and we hence refer the matter to a larger Bench."

The Genesis of a Judicial Conundrum

The referral stems from a direct conflict between two distinct lines of judicial reasoning. On one hand, the 2021 judgment in New Delhi Municipal Corporation v. Dr. Ram Naresh Sharma & Ors. held that AYUSH doctors could not be denied the benefit of a higher retirement age granted to allopathic doctors when their work is comparable. The two-judge bench in that case observed that a classification based merely on the system of medicine practiced, without a rational link to job functions or public interest, could amount to unreasonable discrimination.

However, this precedent was challenged by a subsequent coordinate bench in the 2023 case of State of Gujarat & Ors. v. Dr. P. A. Bhatt & Ors. This judgment carved out a clear distinction, holding that classification based on educational qualifications and medical specialization was permissible. The Court in P.A. Bhatt reasoned that the functions of allopathic and AYUSH doctors were fundamentally different, thereby justifying disparate pay scales. It highlighted that critical care, emergency interventions, complex surgeries, and post-mortems are exclusively within the domain of allopathic practitioners. This view found resonance in Dr. Solamon A. v. State of Kerala and Ors. , which also held that AYUSH doctors could not claim parity with medical doctors.

The Touchstone for Parity: Identity of Functions

In the present order, the bench led by CJI Gavai acknowledged the distinction made in P.A. Bhatt but emphasized the persistent "area of ambiguity." The Court proposed a refined test for evaluating such claims, stating that any assessment of parity "should be ideally considered, according to us, on the touchstone of, identity of functions, similarity in work carried out and comparable duties assigned."

The bench elaborated on the significant functional disparities that, in its view, place allopathic doctors in a "different class altogether." It observed: "it is the MBBS doctors, the allopathy practitioners, who are dealing with critical care, immediate life saving measures, invasive procedures including surgeries and even postmortem; none of which can be carried out by any of the practitioners of indigenous systems of medicine."

This functional analysis was coupled with a recognition of the State's public interest argument. The Court noted the States' contention that the higher retirement age for allopathic doctors is a policy decision driven by a "dearth of sufficient allopathy doctors." This shortage, particularly for experienced practitioners capable of handling critical care, creates a reasonable nexus between the classification and the objective of ensuring public health, an issue not as pronounced in the AYUSH sector.

Interim Measures Pending Final Adjudication

Recognizing the prolonged uncertainty this referral would cause, the Supreme Court has instituted a unique interim arrangement to balance the interests of the AYUSH doctors and the State governments. The key directives are:

1. Conditional Continuation of Service: States may permit AYUSH doctors to continue in service beyond their specified superannuation age, up to the retirement age applicable to allopathic doctors.
2. Interim Financial Arrangement: During this extended period, these doctors will not receive their full regular pay and allowances. Instead, they "shall be paid half of the pay and allowances."
3. Final Adjustment: The final financial settlement is contingent on the larger bench's verdict. If the ruling favors the AYUSH doctors, their service during the extension will be regularized, and the remaining salary will be paid. Conversely, if the ruling is against them, the half-pay already disbursed may be adjusted against their pension or other entitlements.
4. Voluntary Retirement: AYUSH doctors who decline this interim arrangement will be treated as retired, and the outcome of the reference will not be applicable to them.

This pragmatic approach prevents immediate prejudice to either party while awaiting a definitive legal resolution.

Broader Implications for Service Law and Public Policy

The impending decision by the larger bench will be a landmark in Indian service law. It will not only determine the service conditions of a large cadre of medical professionals but also refine the constitutional tests for equality under Articles 14 and 16. The final judgment will have to carefully navigate the delicate balance between recognizing the contributions of different professional streams and acknowledging substantive differences in their qualifications, training, and responsibilities.

For legal practitioners, this case serves as a crucial study in the evolution of the "equal pay for equal work" doctrine. The larger bench will likely provide a comprehensive framework for how courts should assess claims of parity between seemingly similar, yet functionally distinct, cadres in public employment. The outcome will undoubtedly influence future litigation involving differential service conditions across various government sectors and professions.