V. N. Public Health and Educational Trust v State of Kerala and Others (WA No. 828 of 2022)

IN THE HIGH COURT OF KERALA AT ERNAKULAM PRESENT THE HONOURABLE THE CHIEF JUSTICE MR.S.MANIKUMAR & THE HONOURABLE MR. JUSTICE SHAJI P.CHALY MONDAY, THE 22ND DAY OF AUGUST 2022 / 31ST SRAVANA, 1944 ## WA NO. 828 OF 2022 [AGAINST THE JUDGMENT IN W.P.(C) NO.21894/2021 DATED 31.05.2022 ON THE FILE OF HIGH COURT OF KERALA] ## **APPELLANT/PETITIONER:** V. N. PUBLIC HEALTH AND EDUCATIONAL TRUST, A2, JAWAHAR NAGAR COLONY, SALES TAX OFFICE ROAD, KOZHIKODE, REPRESENTED BY ITS MANAGING TRUSTEE - V. ANIL KUMAR. BY ADVS. SRI. AMIT KUMAR (SENIOR) SRI. S. VINOD BHAT SMT. ANAGHA LAKSHMY RAMAN ## **RESPONDENTS/RESPONDENTS:** - 1 STATE OF KERALA, REPRESENTED BY THE SECRETARY TO GOVERNMENT, DEPARTMENT OF HEALTH AND FAMILY WELFARE, SECRETARIAT, THIRUVANANTHAPURAM-695 001. - 2 DIRECTORATE OF MEDICAL EDUCATION, MEDICAL COLLEGE P.O., THIRUVANANTHAPURAM-695011. - 3 NATIONAL MEDICAL COMMISSION, DWARAKA, NEW DELHI-110 077 , REPRESENTED BY ITS CHAIRMAN. - 4 UNION OF INDIA, REPRESENTED BY ITS SECRETARY TO GOVERNMENT, MINISTRY OF HEALTH AND FAMILY WELFARE, NIRMAN BHAVAN, NEAR UDYOG BHAVAN METRO STATION, MOULANA AZAD ROAD, NEW DELHI-110 011. - 5 KERALA UNIVERSITY OF HEALTH SCIENCES, MEDICAL COLLEGE P.O. THRISSUR-680 596. REPRESENTED BY ITS REGISTRAR. WA.828/2022 -:2:- 6 MEDICAL ASSESSMENT & RATING BOARD, (MARB), NATIONAL MEDICAL COMMISSION, (NMC), POCKET-14, SECTOR -8, DWARKA , PHASE-1, NEW DELHI-110 077. R3, R4 & R6 BY ADVS. SRI. MANU S., ASG OF INDIA R1 & R2 BY ADV. SRI. V. MANU, SENIOR GOVERNMENT PLEADER R5 BY ADV. SRI.P.SREEKUMAR, SC, KERALA UNIVERSITY OF HEALTH SCIENCES THIS WRIT APPEAL HAVING COME UP FOR ADMISSION ON 22.08.2022, THE COURT ON THE SAME DAY DELIVERED THE FOLLOWING: WA.828/2022 -:3:- ## **JUDGMENT** ## _**Shaji P. Chaly, J**_ Instant writ appeal is filed by the petitioner in W.P(C) No.21894/2021 against the judgment dated 31.05.2022, by which a learned single Judge of this Court, after considering Exhibit-P21 inter party judgment of the Hon’ble Division Bench in WA No.1194/2021 dated 17.09.2021; Exhibit-P33 report of the DME dated 22.09.2021, and consequential Exhibit P23 order of the State Government, disposed of the writ petition with the following directions: “21. In view of the facts and circumstances discussed above, the writ petition is disposed of with the following directions:- (i) It is declared that the 1[st] respondent cannot have any policy decision not to grant EC to new Medical Colleges in the private sector. (ii) The rejection of EC by Ext. P23 by the State Government based on Ext. P33 report of the DME is sustained. Consequently, the challenge against Ext. P31 also fails. (iii) It is left open to the petitioner to make appropriate application for grant of EC and CoA before the concerned authorities in accordance with the time schedule after the petitioner satisfies the criteria fixed by the National Medical Commission. There will be no order as to costs.” WA.828/2022 -:4:- 2. Brief material facts for disposal of the writ appeal are that: appellant/writ petitioner is a registered charitable trust constituted with the object of promoting education in the field of Health and Medicine. According to the appellant, with a view to start a medical college, the trust has set up 300 bedded hospital in Walayar, a rural backward area in Palakkad District, in 2006; that the requisite infrastructure was put in place and it has been trying to establish a medical college, since 2006 onwards. But, due to the arbitrary and discriminatory action on the part of the State Government and Kerala University of Health Sciences (KUHS), by denying Essentiality Certificate (EC) and Consent of Affiliation (CoA) respectively, appellant could not establish the college. 3. In fact, the case has a checkered history starting from the year 2003-2004. For setting up the proposed medical college, an Essentiality Certificate was secured by the appellant on 24.01.2004 (Exhibit-P1) from the State Government. However, the college could not be established. But fact remains, subsequently for the years 2008-2013, 2014-2018, Essentiality Certificates were issued by the State Government. 4. Appellant has further stated that, Exhibit-P2 renewed Essentiality Certificate dated 11.12.2015 was issued by the State Government for the WA.828/2022 -:5:- years 2016-2018. In each of the Essentiality Certificates issued to the appellant, including Exhibit-P2, it is _inter alia_ certified by the 1[st] respondent that appellant owns and manages 300 bedded hospital; that it is desirable to establish a medical college in the public interest on the proposed location; that the establishment of medical college by the writ petitioner is feasible; and that all clinical materials as per the norms of the erstwhile Medical Council of India, now National Medical Commission, are available in the hospital of the appellant. However, Exhibit-P2 was valid upto the A.Y 2017-2018. According to the appellant, for the reasons solely attributable to the respondents, that is, the State Government; Directorate of Medical Education; National Medical Commission, New Delhi; Union of India, represented by its Secretary to Government; Ministry of Health and Family Welfare, New Delhi; Registrar, Kerala University of Health Sciences and Medical Assessment & Rating Board (MARB), National Medical Commission, New Delhi, writ petitioner was unable to establish the medical college pursuant to Exhibits-P1 and P2. 5. To cut a long story short, the appellant had earlier approached the writ court by filing W.P.(C) No.12550/2021, which was dismissed by judgment dated 27.08.2021. Though a review petition, R.P. No.576/2021, WA.828/2022 -:6:- was filed seeking to review the judgment dated 27.08.2021, that review petition was also dismissed as per order dated 8.9.2021. The judgment and order in the writ petition and review petition were challenged by the appellant by filing W.A. No.1194/2021, which was considered by this bench taking into account the entire gamut of the issues raised by the appellant right from the year 2003-2004 ; and modified the judgment of the learned single Judge, and issued the following directions: “32. Taking into account the above said aspects, and the facts and circumstances dealt with by us, we direct the State Government to consider the applications submitted by the appellant [Exhibit-P8 dated 11.06.2021, Exhibit-P40 dated 12.09.2021 & Exhibit-P41 dated 19.07.2021], in accordance with the law, i.e., the relevant statutes/ regulations in force, the proposition of law laid down by the Hon’ble Apex Court in general, and also taking into account the observations made in Exhibit-P1 judgment of the Hon'ble Apex Court dated 24.02.2021, and pass an order, at the earliest and at any rate on or before 23.09.2021.” 6. It was pursuant to the directions contained in the said judgment, State Government has issued Exhibit-P23 impugned order dated 23.09.2021, on the basis of Exhibit-P33 report of the Directorate of Medical Education, Represented by its Director, Thiruvananthapuram. It is thus challenging Exhibit-P23 order dated 23.09.2021, writ petition was filed for the following reliefs: WA.828/2022 -:7:- A. To declare that the 1[st] respondent cannot have any policy decision not to grant EC to self-financing colleges in the State; B. To declare that provision 2(iii) of Chapter XXI of the Kerala University of Health Sciences First Statute mandating EC for submission of application and grant of CoA is illegal and ultra vires the Constitution; C. To call for the records leading to Exhibit-P23 and after perusing the same, issue a writ of certiorari or such other writ quashing Exhibit-P23 order of the 1[st] respondent; D. To call for the records leading to Exhibit-P31 and after perusing the same, issue a writ of certiorari or such other writ quashing Ext.P31 order of the 5[th] respondent; E. To issue a writ of mandamus or such other writ directing the 1[st] respondent to grant EC at the earliest, within a time frame set by this Court; F. To issue a writ of mandamus or such other writ directing the 5[th] respondent to act upon Exhibit-P12 inspection report dated 22.04.2021 of the 2[nd] respondent for issuance of CoA; G. To direct the 3[rd] respondent to process petitioner’s application for establishment of medical college upon receipt of EC and CoA from the 1[st] and 5[th] respondents and in accordance with further orders/directions of this Court in the writ petition. 7. Refuting the averments contained in the writ petition, the State Government has filed a detailed statement in the writ petition and also an additional statement, wherein it was contended that the stand adopted by the Government in Exhibit-P23 impugned order with respect to the policy and other aspects is in accordance with law. WA.828/2022 -:8:- 8. It is also contended that the State Government can issue EC as and when the college management satisfied the criteria fixed by the 3[rd] respondent and that there was no policy not to grant EC for setting up self financing medical colleges in the State. 9. It was further contended that in Exhibit-P9, it has been undoubtedly stated that the State has taken a stand not to encourage new colleges in the self financing sector, and that the establishment of the proposed medical colleges in the Government sector would certainly solve the deficiency of doctors in the State. 10. Kerala University of Health Sciences has also filed a statement before the writ court, wherein it was contended that the Hon’ble Apex Court in Exhibit-P8 judgment dated 24.02.2021, specifically entered into a finding that the petitioner has been trying long to escape its responsibility and to fill up the lacuna through judicial process by getting orders from the High Court for Consent of Affiliation and consideration of its belated halfbaked applications before the MCI. The Hon’ble Apex Court in Exhibit-P8 judgment also held that there was no ground to call foul upon rejection of EC or CoA or its application before MCI. 11. It was further contended that the whole process of granting letter WA.828/2022 -:9:- of permission for starting a new medical college is to be carried out in terms of the time schedule fixed for the same and that in Exhibit-P8 judgment, the Hon’ble Apex Court has underlined the need to follow the time schedule and the same cannot be violated. So far as the permission for starting a medical course, in the year 2022-23, is concerned, the last date for receiving the application by the 6[th] respondent along with all the requisite documents was on 27.09.2021. Hence, no direction could be issued to any of the authorities to process the application. According to the 5[th] respondent, any such direction would be directly against the series of judgments rendered on the subject and that even the Hon’ble Apex Court has taken note of the attempts made by the petitioner to make the delayed half baked applications processed by the authorities. 12. That apart, it is contended that in the light of the directions contained in Exhibit-P8 judgment, the appellant ought to have submitted an application for EC, without rectifying the defects notified in the previous inspections. The minimum standards for admission to MBBS course are prescribed by the 3[rd] respondent and in terms of the said norms, an applicant should have a full fledged hospital with basic facilities, including blood bank, running for the past two years. Therefore, according to the 5[th] WA.828/2022 -:10:- respondent, Exhibit-P33 report of the DME would show that the appellant has not satisfied the basic requirements for grant of CoA. 13. It was further contended that the appellant can apply only for affiliation along with EC as and when the University invites application for the same and the appellant should have the eligibility to apply at the relevant point of time. The University, after physical verification, grants the CoA, which is a necessary document to apply before the MCI. 14. It was also contended that the 3[rd] respondent prescribes the minimum standards, and it is open for the University to verify whether the applicant adheres to the norms fixed by the 3[rd] respondent as well as the University before permitting the applicant to submit an application before the 3[rd] respondent. Therefore, according to the 5[th] respondent, appellant has not satisfied the prescribed requirements for grant of EC or CoA, which are nothing but, non satisfaction of the requirements of the National Medical Commission for issuing the Letter of Permission. 15. After assimilating the factual and legal circumstances and the principles of law laid down in various decisions of the Hon’ble Supreme Court, as well as this Court, the learned single Judge has arrived at the conclusion that the findings rendered in the impugned Exhibit-P23 order WA.828/2022 -:11:- that EC is declined to the appellant on the basis of policy decision not to grant EC to new medical colleges in private sector, cannot be sustained under law. However, it was held that rejection of the application for EC by the State Government based on Exhibit-P33 report of the DME is sustained and consequently, it was held that the challenge made against Exhibit-P31 order of the Kerala University of Health Sciences dated 11.08.2021 declining Consent of Affiliation (CoA) also cannot be sustained. But, the liberty of the appellant to submit application for grant of EC and CoA before the concerned authorities, in accordance with the prescribed time schedule after the appellant satisfies the criteria fixed by the National Medical Commission is left open by the writ court. 16. It is thus challenging the legality and correctness of the judgment of the learned single Judge, instant appeal is filed, basically contending that Exhibit-P33 report of the DME (Directorate of Medical Education) can only be seen for the purpose of considering the feasibility, desirability and adequacy of clinical materials, which are the only ingredients for issuance of EC and since the said aspects were found to be in favour of the appellant, the appellant should have been issued with Essentiality Certificate. 17. It was further contended that the rules and regulations that are WA.828/2022 -:12:- binding on the respondents would establish that only a limited role is available for the State Government while considering the application for grant of EC. However, the State Government under the garb of considering the application for EC cannot step into the authority or jurisdiction of the National Medical Commission, Kerala University of Health Sciences and Medical Assessment & Rating Board, represented by its Director, New Delhi, respondents 3, 5 and 6. 18. It is further contended by the appellant that the grant of Essentiality Certificate is the first step for a person proposing to establish a medical college and thus, the State Government which has a minimal role to the extent of grant of EC cannot ask such an applicant for compliance of norms relevant at the penultimate or final stage, which are within the domain of National Medical Commission and Medical Assessment and Rating Board, New Delhi. 19. Yet another contention raised by the appellant is that the State Government is acting with ulterior motive and with mala fides, in purposefully rejecting the application of the appellant for grant of EC. That apart, it is contended that the undertaking given by the State Government while issuing EC is not a burden placed on the State Government, whereas, WA.828/2022 -:13:- it is only a discharge of Constitutional function or obligation imposed on the State Government. 20. So also, it is pointed out that when the State Government promotes establishment of medical colleges, it only increases the number of medical professionals which would only go to the benefit of the State Government’s duty to provide better health facilities/health sector/ public health etc. According to the appellant, no prejudice will be caused to the State Government by the undertaking given during grant of EC, in as much as by legislative wisdom, statutory / regulatory mechanism is put in place and that the monetary aspects are met by the bank guarantee, mandatorily submitted by the applicant. 21. It is also contended that grant of CoA is independent from grant of EC and hence, the 5[th] respondent University ought to have issued the Consent of Affiliation. 22. Heard Mr. Amit Kumar, learned Senior Counsel, assisted by Mr. Vinod Bhat, learned counsel for the appellant, Mr. V. Manu, learned Senior Government Pleader, Mr. P. Sreekumar, learned standing counsel for the Kerala University of Health Sciences (KUHS), respondent No.5, and perused the pleadings and material available on record. WA.828/2022 -:14:- 23. In fact, the learned single Judge has made a threadbare survey of the issues raised by the petitioner in the writ petition, principles of law evolved in the matter of grant of EC, CoA, and Letter of Permission by the Hon’ble Supreme Court, and taking into account Exhibit-P8 inter party judgment rendered by the Hon’ble Apex Court in Civil Appeal Nos.703-704 of 2021 dated 24.02.2021, and has arrived at the conclusions, which we have extracted above. 24. We have gone through the judgment of the learned single Judge and contentions putforth by the rival parties. We are of the view that the subject issue revolves around Exhibit-P23 order passed by the State Government. After assimilating the factual and legal situations and the deliberation made by the learned single Judge, we fully agree with the findings rendered in the impugned judgment that declining of EC in the guise of the policy decision of the Government cannot be sustained under law. It is for the basic reason that there cannot be a general policy decision by the State Government that no EC should be issued to start a new medical college in the private sector. However, when an application is filed for grant of EC, it is for the Government to strictly analyze the requirements contained under the regulations and guidelines issued by the National WA.828/2022 -:15:- Medical Commission for the purpose and evaluate the situation taking into account the facts, figures and records available, so as to enable the NMC to arrive at a clear finding and conclusions in the matter of a Letter of Permission to be issued by it . 25. In fact, in Exhibit-P21 judgment dated 17.09.2021 in W.A. No.1194/2021, we have taken note of the findings rendered by the Hon'ble Apex Court in the inter party judgment by and between the appellant and respondents, wherein it was clearly held that Essentiality Certificate in the prescribed form is crucial for avoiding cases where the college, despite grant of initial permission, could not provide the infrastructure, teaching and other facilities, and as a result, the students, who had already been admitted, suffered irreparable hardship and injuries. It was also observed therein that MCI Regulations presently National Commission of India as well as Kerala University of Health Statutes very emphatically mandate that Consent of Application can only be given after the institution fulfills the essential requirements. 26. The basic contention raised by the appellant in this appeal is that the absence of Essentially Certificate is not one of the factors for consideration, and is extraneous to the decision-making process that was WA.828/2022 -:16:- considered by the Hon'ble Apex Court and the argument was negated. It was also found that while granting EC, the State Government shall undertake to take over the obligations of the private educational institution in the event of the institution becoming incapable of setting up the institution or imparting education therein. Such an undertaking on the part of the State Government is unequivocal and unambiguous. 27. It was further found in Exhibit-P21 judgment that an Essentiality Certificate by the State Government legitimizes a medical college declaring it fit to impart medical education and gives accouchement to the expectation amongst the stakeholders that the appellant College shall fulfill the basic norms specified by MCI to start and operate a medical college. It was also observed in the said judgment that the issuance/re-issuances of an Essentiality Certificate is in any way a ministerial job and while dealing with a case of maintaining standards in a professional college, strict approach must be adopted as these colleges are responsible for ensuring that medical graduate has the required skill set to work as a doctor in the country. 28. It is further observed in Exhibit-P21 that poor assessment system; exploding number of medical colleges; shortage of patients/clinical WA.828/2022 -:17:- materials; devaluation of merit in admission, particularly in private institutions; increasing capitation fees; debilitated assessment and accreditation system, are problems plaguing our medical education system. Therefore, allowing such deficient colleges to function jeopardizes the future of the student community and will lead to incompetent doctors to be graduated from such colleges. Ultimately, it will pose a bigger risk to the society at large defeating the very purpose of the Essentiality Certificate issued by the State. 29. Hence, it was observed that the State Government would be deterring from its duty that the requite standards as set by the MCI are met before issuing/renewing the Essentiality Certificate. That apart, other findings are also rendered after conducting a threadbare review of the decisions rendered by the Hon'ble Apex Court in **Chintpurni Medical College & Hospital & Anr. v. State of Punjab & Ors.** [(2018) 15 SCC 1], and **Sukh Sagar Medical College and Hospital v. State of Madhya Pradesh and Ors.** , [(2020) SCC Online SC 851]. 30. Ultimately, after taking into consideration the deficiencies noted by the State Government, to decline Essentiality Certificate, it was held that the Essentiality Certificate was first issued in the year 2004 and over 17 WA.828/2022 -:18:- years later, the appellant College is not in a position to secure requisite permissions from the MCI. It is quite apparent that the appellant has been long trying to escape its responsibility and fill up the lacuna through judicial process by getting orders from the High Court for Consent of Affiliation and consideration of its belated half-baked applications before the MCI. 31. It was also observed that in both the inspections, conducted in 2015 and 2020, it was found that the appellant college lacks proper facilities and that even though the appellant claims to be running a hospital since 2006, neither adequate amenities nor infrastructure on inspection was found to be in existence. It was taking into account the entire facts and circumstances starting from the year 2004 and up to the inspection conducted by the State Government in the year 2020, that Exhibit-P21 judgment in W.A. No.1194/2021 dated 17.09.2021 was passed by issuing the direction to the State to consider the application of the appellant. 32. Based on the abovesaid directions, State has verified the credentials and infrastructure facilities, available for setting up the hospital by the appellant. Even though the appellant has a case that like in earlier cases the report of DME (Exhibit-P33) is in their favour, we are unable to WA.828/2022 -:19:- agree with the same for the reason that when the inspection was conducted on 20.09.2021, the bed occupancy was 48% whereas, the mandatory requirement is 300 bedded fully functional hospital as per the norms of the National Medical Commission . 33. We have gone through the report of the Director of Medical Education, wherein it is stated that the campus is situated on about 40 acres of land along the National Highway, Palakkad - Coimbatore at Walayar. It is further stated in the said report that the 300 bedded hospital building is satisfactory and is functioning; the blood bank license is under processing, which has to be obtained. However it is submitted during the course of arguments that the blood bank license is secured recently . 34. Though it is stated in Exhibit-P33 report that building of academic block is completed; that furnishing as well as setting up of practical laboratories are nearing completion; and that furnished lecture halls, short group discussion halls, library and examination hall are available, it was found that there is deficiency in clinical materials and that the bed occupancy is below 50%. However, it seems that, the authorities concerned have explained the deficiencies as due to COVID-19 pandemic situation and related travel restriction from the border State of Tamil Nadu. WA.828/2022 -:20:- That apart, report of the DME clearly specifies that as per the NMC Guidelines for LOP, for 100 MBBS admissions, there is deficiency of faculty and residents as follows: “There is 41% deficiency of faculty (36/61) & 71% deficiency of residents (7/24).” 35. The details with respect to the deficiencies noted are also provided in a tabular format by the Directorate of Medical Education. Therefore, the findings rendered by the Director of Medical Education, which is not at all challenged in the writ petition, make it clear that there are several deficiencies which dis-entitle the appellant from securing the Essentiality Certificate. The DME has also stated in the report that the hospital building, academic block, hostels and quarters, are satisfactory and recommended that consideration may be given for the deficiencies of clinical materials, and faculty, in the light of present COVID-19 situation and travel restrictions. 36. Therefore, what we intend to say is that, though a contention is raised that Exhibit-P33 report of the DME is in favour of the appellant, it is not true and correct since the report clearly states that the deficiencies with respect to the clinical materials and the faculty have to be rectified. WA.828/2022 -:21:- Taking into account the said report of the DME that Exhibit-P23 impugned order was passed by the State Government. It is also stated in Exhibit-P23 order that the State Government has declined to grant EC, due to the policy decision taken by the Government not to issue any EC for any new medical college in private sectors. But the fact remains that after taking note of the report of DME, it is clearly found that the appellant was unable to comply with the norms issued by MCI or NMC and start the college, even after all these years and that latest inspection also shows that there are deficiencies when comparing with NMC norms. 37. Even though learned Senior Counsel appearing for the appellant has advanced argument that at the time of consideration of the application for grant of Essentiality Certificate, State Government need not look into the requirements of National Medical Commission, for issuance of EC , we are unable to agree with the said contention for the reason that the said contention was considered by the Hon'ble Apex Court in Exhibit-P8 inter party judgment in Civil Appeal Nos.703-704 of 2021 arising out of S.L.P(C) Nos.14219-14220 of 2020 dated 24.02.2021, and held that at the stage of issuance of Essentiality Certificate, the State Government has to take into account the norms of National Medical Commission and conduct inspection, WA.828/2022 -:22:- so as to limit the possibility of the students suffer, due to any deficiencies, and to ensure that half backed applications are not processed by the State Government. 38. That apart, the norms for issuance of EC undoubtedly and admittedly, are issued by the NMC and the role of the State Government is that of a facilitator only. The State Government cannot overlook the imperatives and procedural requirements that are sought for by the NMC, in accordance with the guidelines and statutes framed by it. 39. To put it otherwise, the State Government is obligated under law to look into each and every aspect of the norms prescribed by the National Medical Commission and only if the State Government is satisfied that the applicant has complied with all the requirements, then only the State Government is bound to issue Essentiality Certificate. 40. There is no case for the appellant that the bed occupancy and faculty deficiencies contained in Exhibit-P33 report of the Directorate of Medical Education dated 22-09-2021 are incorrect. The Directorate of Medical Education, in Exhibit-P33 report, has arrived at the findings, after conducting physical inspection, and verification of the records available with the hospital in question. WA.828/2022 -:23:- 41. Even though the learned Senior Counsel appearing for the appellant has raised a contention that the deficiency in faculty is not a matter to be taken note of at the stage of issuance of EC, and only after LOP is issued by the NMC, the qualified doctors are to be appointed in the college; it cannot be sustained for the basic and foundational reason that appointment of faculty is a pre-condition for issuance of Essentiality Certificate. If the EC has to be secured, sufficiently qualified hands for teaching are to be appointed in the hospital, so as to satisfy the requirements of National Medical Commission. Therefore, there is no point in raising the contention that at the stage of consideration of the application for grant of EC, faculty need not be taken note of, in accordance with the norms and standards fixed by the NMC. 42. So also is the contention advanced by the learned Senior Counsel for the appellant that at the time of issuance of Letter of Permission by the National Medical Commission, the NMC is vested with powers to grant certain relaxations for starting the medical college, that will not in any way help the appellant since at the time of consideration of the application for grant of Essentiality Certificate, there is no power vested with the State Government for relaxation of the credentials of the appellant College, as per WA.828/2022 -:24:- the NMC norms and regulations . Even though various decisions are relied on by the learned Senior counsel for the petitioner and the learned Senior Government Pleader, we are of the considered opinion that, in view of the settled legal position in Exhibit-P8 inter - party judgment of the Hon'ble Apex Court in Civil Appeal Nos.703-704 of 2021 dated 24.02.2021, that the Government is duty bound to take into consideration all the requirements set up by the National Medical Commission, the principles of law evolved in the judgment referred to by the rival parties may not of much relevance. Above all, as usual the report of the Directorate of Medical Education, Exhibit P33, is not challenged, as if to appear that it is in favour of the appellant, whereas actually it is not. 43. However we bear in mind the principles of law evolved in the judgments relied on by the respective parties while considering this appeal, viz., **Thirumuruga Kirupananda Variyar Thavathiru Sundara Sawmigal Medical Educational & Charitable Trust v. State of Tamil Nadu & Ors.** [(1996) 3 SCC 15]; **Government of A.P. and another v. Medwin Educational Society and others** [(2004) 1 SCC 86]; **Priya Darshni Dental College and Hospital v. Union of India (UOI) and Ors.** [(2011) 4 SCC 623]; **Asha v. Pt. B.D. Sharma University of Health Sciences and Ors.** WA.828/2022 -:25:- [(2012 ) 7 SCC 389]; Royal Medical Trust v. Union of India (UOI) and Ors. [(2014) 14 SCC 675]; **DM Wayanad Institute of Medical Sciences v. Union of India and Another** [(2016) 2 SCC 315]; **Rajiv Memorial Academic Welfare Society and Ors. v. Union of India (UOI) and Ors.** [(2016) 11 SCC 522]; **Chintpurni Medical College & Hospital & Anr. v. State of Punjab & Ors.** [(2018) 15 SCC 1]; **The Jawaharlal Nehru Technological University Registrar v. Sangam Laxmi Bai Vidyapeet and Ors.** [(2019) 17 SCC 729]; and **Sukh Sagar Medical College and Hospital v. State of Madhya Pradesh and Ors.** [(2020) SCC Online SC 851]. Whatever that be, considering the whole bundle of facts and law, we do not find any reason to depart from the findings rendered by the writ court in the impugned judgment. 44. Taking into account the above aspects, we have no hesitation to hold that the learned single Judge was right in not interfering with ExhibitP23 impugned order passed by the State Government declining Essentiality Certificate to the appellant College for want of clinical facilities. We are also of the considered view that the appellant has not made out any case of jurisdictional error or other legal infirmities susceptible to be interfered in the impugned judgment of the learned Single Judge in exercise of the WA.828/2022 -:26:- powers conferred under Section 5 of the Kerala High Court Act. In the result, writ appeal fails and accordingly, it is dismissed. Sd/- **S. MANIKUMAR CHIEF JUSTICE** Sd/- **SHAJI P. CHALY JUDGE** Krj //TRUE COPY// P.A. TO C.J.