TNCE Act Authority Can't Enforce NMC Regulations or Suspend License Without Breaching Act's Provisions: Madras High Court - 2025-07-05

Madras High Court Quashes Hospital's License Suspension, Cites Grave Violations of Natural Justice and Jurisdictional Overreach

Madurai: In a significant ruling on the scope of power under the Tamil Nadu Clinical Establishments (Regulation) Act, 1997 (TNCE Act), the Madras High Court has quashed an order suspending the license of a hospital in Kanyakumari. Justice V. Lakshminarayanan held that authorities under the TNCE Act cannot enforce regulations of the National Medical Commission ( NMC ) and that a license can only be suspended for a clear breach of the TNCE Act or its rules, not on the basis of an expert's opinion that contradicts the statutory rules.

The court also found grave procedural illegalities, including a "huge and dark cloud" surrounding an unrecorded "oral complaint" from the District Collector that triggered the action, and a serious violation of the principles of natural justice.

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Case Background

The writ petition was filed by Dr. M.G. Ethayarajan , an MBBS doctor with multiple diplomas and special training, who runs "Irudhayams Hospital" in Nagercoil. The Joint Director of Medical and Rural Health Services, Kanyakumari, suspended the hospital's license following an inspection. The key allegations against the petitioner were:

Practicing as a cardiology specialist with only an MBBS degree by using Enhanced External Counter Pulsation (EECP) and Cartography equipment without a cardiologist's opinion.

Charging exorbitant fees from patients.

Advertising with unrecognized additional degrees.

The suspension order was based on recommendations from the TNCEA District Advisory Committee, which concluded that the petitioner had violated professional conduct regulations.

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Arguments from Both Sides

Petitioner's Stance: Represented by Senior Counsel Mr. Sricharan Rangarajan, the petitioner argued that the entire proceeding was vitiated by a patent violation of natural justice, as crucial documents like the inspection and committee reports were never provided to him, despite a request. He contended that the authorities had exceeded their jurisdiction by: - Suspending the license for alleged violations of NMC regulations, which is the sole purview of the Medical Council. - Acting on grounds (like using EECP/ Cartography without a cardiologist) not prohibited by the TNCE Act or its rules, which do not specify such a requirement. - Mistaking the use of his qualifications on a private prescription pad for public "advertisement."

Respondents' Defense: The Special Government Pleader, Mr. S. Shaji Bino, defended the suspension, arguing that an alternate appellate remedy existed. He claimed the initial reports were mere "fact-finding" exercises and did not need to be shared. He asserted that the petitioner was misleadingly projecting himself as a cardiologist using unrecognized foreign degrees, in violation of NMC ethics, which the authority under the TNCE Act was entitled to enforce.

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Court's Detailed Analysis and Findings

Justice V. Lakshminarayanan systematically dismantled the respondents' case, highlighting several critical legal failures.

1. Violation of Principles of Natural Justice: The court firmly rejected the argument that the writ petition was not maintainable due to an alternate remedy, citing the clear violation of natural justice as a valid exception. The judge noted:

"One of the fundamental principles of natural justice is that the authority has to share the documents... with the person who has to answer the accusation... Since this fundamental principle of natural justice has been violated in this case, I am constrained to reject the argument that I have to non-suit the writ petitioner."

The court found that the authorities had relied on these undisclosed reports to pass the suspension order, making their non-disclosure prejudicial to the petitioner.

2. Bias and Procedural Impropriety: The judgment heavily criticized the reliance on the opinion of Dr. Muralidharan , an expert who was also a member of the committee investigating the petitioner. Citing the Supreme Court's decision in State of Uttar Pradesh Vs. Mohammad Nooh , the court ruled that a person cannot be both a witness and a judge in the same proceeding.

"A person cannot be a member of the Committee and at the same time, be a witness before the same... The act of relying upon the report of Dr. Muralidharan violates atleast three well known maxims which deal with bias or interest... (i) No man shall be a judge in his own cause; (ii) Judges like Caesar's wife should be above suspicion; and, (iii) Justice should not only be done but should manifestly and undoubtedly be seen to be done."

3. Jurisdictional Overreach: The court held that the authorities had acted in excess of their jurisdiction. The TNCE Act and its rules do not prescribe that a cardiologist must operate EECP or Cartography equipment. An authority cannot suspend a license based on a non-existent rule or an expert opinion that goes beyond the statutory framework.

Furthermore, the court clarified the distinct roles of different regulatory bodies:

"The jurisdiction and role of the authorities under Tamil Nadu Act 4 of 1997 cannot be expanded to include enforcement of two different legislations [ NMC Act and Tamil Nadu Medical Registration Act]... He is not entitled to exercise the power, either under the Tamil Nadu Medical Council or that of the National Medical Commission."

4. The "Oral Complaint" and Lack of Evidence: The court expressed deep suspicion about the "oral complaint" from the District Collector that initiated the proceedings, noting the lack of any written record, which is contrary to good governance principles laid down by the Supreme Court. On the other allegations, the court found no evidence of exorbitant fees or "advertisement," as a private prescription slip cannot be considered commercial solicitation.

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Final Decision

Concluding that the impugned order suffered from a violation of natural justice and a lack of jurisdiction, the High Court quashed the suspension order. Since the issue was of jurisdiction, the court decided against remanding the matter back to the authority. The writ petition was allowed with costs payable to the petitioner.