A system meant to protect, yet difficult to access
Across the country, patients approach medical regulators with the expectation that errors will be fairly examined and misconduct will be corrected with firmness. The National Medical Commission (NMC), which replaced the Medical Council of India, was created with the promise of improving accountability and public confidence. Yet the structure of its appellate mechanism continues to puzzle ordinary citizens who seek redress. The statutory design seems to reflect a form of fraternal preference in which the rights of medical professionals receive greater protection than the rights of the patients who approach these bodies in distress.
A sense of unease arises because the governing statute appears to favour medical practitioners even where their conduct may be prodigal or negligent. Section 30 (3) of the National Medical Commission Act, 2019 allows only a registered medical practitioner to file an appeal against the disciplinary decisions of a State Medical Council. The complainant who has suffered the consequences of the alleged malpractice is excluded. This selective conferral of appellate rights gives the impression that the regulatory mechanism remains inward looking, functioning as an exclusive channel of professional oversight rather than a forum equally accessible to those affected by medical error.
Why this issue matters in Goa
The importance of this interpretation becomes clear when real situations are examined. The present reflection draws its impetus from the order dated 19.07.2024 passed by the Goa Medical Council through its Ethics and Disciplinary Committee. The facts recorded in the order demonstrate that the respondent surgeon who performed a laparoscopic appendectomy on 01.08.2023 did not hold lawful registration with the Goa Medical Council at the time of surgery. He therefore lacked the legal entitlement to practice medicine in the State. The statutory duty of the Council included ensuring that such unauthorised practice attracted the consequences envisaged under the Goa Medical Council Act, 1991 and the National Medical Commission Act, 2019. Yet the findings reveal that only a nominal penalty was imposed. The absence of action under provisions dealing with unregistered practice raises immediate concerns about the robustness of the disciplinary process.
Regulation and the public mind
For the ordinary citizen, such situations create the sense that regulatory systems are not fully aligned with public welfare. When a complaint of unregistered medical practice results in minimal scrutiny and limited penalty, confidence in the regulatory framework diminishes. The role of such bodies is not merely to protect the medical profession but to assure the public that standards will be uniformly and fairly enforced.
It is within this context that the appeal structure of the NMC becomes relevant. A complainant who disagrees with the findings of a State Medical Council does not have an appellate forum within the statutory scheme. The practitioner who has been penalised may appeal. The person who has suffered the alleged negligence may not. This creates a notable asymmetry, particularly where the findings appear inconsistent with statutory mandates.
Regulatory ambiguity and its consequences
The difficulty deepens because the NMC itself, through a Gazette Notification dated 23 August 2023, has reissued the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002. These Regulations contain Clause 8.8, which explicitly permits any person aggrieved to file an ethics appeal. The simultaneous existence of a statute that confines appeal to practitioners and a regulation that expands it to all aggrieved persons creates an immediate conflict in interpretation. Citizens deserve clarity in procedures that affect their rights, and such inconsistency places both complainants and regulators in uncertain territory.
A transparent regulatory scheme should not require legal training to comprehend. If the public is expected to trust the process, the process must be accessible, predictable and responsive to citizens.
Judicial circumspection and the patient’s burden
Judicial oversight remains the constitutional safeguard for correcting administrative lapses. Yet judicial intervention in medical regulatory matters has often been marked by circumspection, particularly where constitutional questions are raised. In the present instance, the High Court in the State appeared to be influenced by broader constitutional considerations while examining the grievance arising from the surgery performed at a private hospital in Malbhat, South Goa, near the Margao railway line. The citizen who approached the Court continues to bear the physical and emotional consequences of the surgery performed by a consultant surgeon from Andhra Pradesh who, at the relevant time, lacked the legal right to practice in Goa. The remedial framework, however, has offered only partial assistance, revealing a disconcerting gap between abstract constitutional theory and the urgent remedial needs of the individual patient.
Natural justice and fair play
Administrative law has repeatedly affirmed that when the outcome of a proceeding affects a person’s rights, that person must have a meaningful opportunity of redress. Decisions such as State of Orissa v. Binapani Dei, K. I. Shephard v. Union of India and Whirlpool Corporation v. Registrar of Trade Marks have emphasised that public authorities must act fairly, must consider relevant factors and must provide avenues of effective correction. The absence of a statutory appeal for complainants in medical disciplinary matters appears inconsistent with these principles. The question therefore arises whether judicial review should intervene to fill the gap created by legislative design.
A call for transparent reform
Professional regulation should not be perceived as a closed fraternity. It must function as a public institution committed to protecting both practitioners and patients. The National Medical Commission, as the apex regulator, carries the responsibility of ensuring that its processes are intelligible, inclusive and fair. A system that limits the right of appeal to only one side of a dispute risks undermining public confidence and weakening the integrity of disciplinary oversight.
