The Maharashtra Medical Practitioners Act, 1961: A Legal Analysis

The Maharashtra Medical Practitioners Act, 1961: A Legal Analysis of Registration, Scope of Practice, and Regulatory Evolution

Introduction

The Maharashtra Medical Practitioners Act, 1961 (MMPA, 1961)[A] stands as a cornerstone legislation in the State of Maharashtra, primarily aimed at regulating the qualifications, registration, and practice of practitioners of Indian systems of medicine, namely Ayurveda, Siddha, and Unani.[17] This Act has undergone significant evolution since its enactment, shaped by judicial pronouncements, societal needs, and legislative amendments designed to address emerging complexities in the healthcare sector. This article seeks to provide a comprehensive legal analysis of the MMPA, 1961, focusing on its key provisions related to the registration of medical practitioners, the permissible scope of their practice, the prohibition on practice by unregistered individuals, and the critical amendments that have redefined the contours of medical practice for traditional systems in Maharashtra. It will draw heavily upon landmark judicial decisions and statutory developments to elucidate the Act's impact on the medical profession and public health within the state.

Historical Context and Legislative Evolution

The original MMPA, 1961, aimed to consolidate and amend the law relating to Ayurvedic and Unani practitioners in the State of Maharashtra. However, certain provisions of the initial Act faced constitutional challenges. In Kumari Rukmani v. Appellate Authority Under Maharashtra Medical Practitioners Act Xxviii Of 1961, Bombay (1968)[8], the Bombay High Court addressed grievances concerning the inclusion of names in the list of practitioners. The Court found Section 18(2)(b)(ii) of the Act to be violative of Article 14 of the Constitution. Crucially, it held that Section 18(2)(b)(ii) and Section 33 (which prohibited practice by persons not registered under the Act) formed part of a single scheme. Consequently, the invalidity of the former led to the Court declaring both Section 18(2)(b)(ii) and the original Section 33 as ultra vires the Constitution.[8] This judgment necessitated legislative action to rectify the framework.

Subsequently, the Maharashtra State Legislature passed the Maharashtra Medical Practitioners (Amendment) Act, 1978. This amendment significantly altered Section 33 of the MMPA, 1961. The amended Section 33 stipulated that, notwithstanding any other law, no person could practise any system of medicine in the State unless their name was entered in:

  • the register maintained under the MMPA, 1961; or
  • the register or list under the Bombay Homoeopathic and Biochemic Practitioners' Act, 1959; or
  • the register under the Maharashtra Medical Council Act, 1965; or
  • the Indian Medical Register under the Indian Medical Council Act, 1956.[4]
This amended provision was pivotal in clarifying who was legally permitted to practice medicine in Maharashtra and formed the basis for subsequent regulatory actions and judicial interpretations.

Key Provisions of the MMPA, 1961

Definitions and Scope of Application

The MMPA, 1961, specifically governs practitioners of Indian systems of medicine. The Bombay High Court in Archana Sudhir v. Maharashtra Medical Council (2005)[17] clarified that the MMPA, 1961 "applies to Indian Medicine i.e. it applies to Ashtang Ayurvedic or Siddha or Unani or Unani Tibb systems." Practitioners of modern scientific medicine (allopathy) are regulated by the Maharashtra Medical Council Act, 1965.[5], [17] This distinction is fundamental to understanding the jurisdictional scope of the MMPA, 1961, and the respective councils. The Act provides for the establishment of the Maharashtra Council of Indian Medicine, which is responsible for maintaining a register of practitioners qualified in these traditional systems.

Registration of Practitioners

A central tenet of the MMPA, 1961, is the mandatory registration of practitioners of Indian medicine. As per the Act, every registered practitioner is to be given a certificate of registration, which must be displayed conspicuously at their place of practice.[6] The registration remains valid until duly cancelled. The significance of registration under a state act for practicing within that state, even if registered elsewhere, was highlighted in DR.ARUN ABHIMANYU BISWAS v. STATE OF MAHARASHTRA AND ORS. (2006)[11]. In this case, a practitioner with an "Ayurvedratna" from Hindi Sahitya Sammelan, Allahabad, and registration in Bihar, sought entitlement to practice in Maharashtra. The Bombay High Court held that since the petitioner's name was not entered in any of the registers specified in Section 33 of the MMPA, 1961, and not yet in the Central Register of Indian Medicine (under the Indian Medicine Central Council Act, 1970), he was not entitled to practice medicine in Maharashtra.[11]

Prohibition of Practice by Unregistered Persons (Section 33)

Section 33 of the MMPA, 1961, as amended in 1978, is the linchpin of the Act's regulatory mechanism, imposing a strict prohibition on medical practice by individuals not registered under the specified statutes. The Supreme Court in Registered Medical Practitioners Association v. Registrar, Maharashtra Council Of Indian Medicine And Others (2002)[4] dealt with a case where members of an association did not fall within any of the categories of registered practitioners permitted by the amended Section 33 and were thus held not entitled to practise in Maharashtra. This underscores the comprehensive nature of the prohibition.

The penal consequences for violating Section 33 were evident in R.R. Singh (Dr.) v. Pratibha P. Gamre (2012)[14], where an Ayurvedic practitioner who treated a patient using allopathic methods was convicted under Section 33 of the MMPA, 1961, for practicing a system of medicine he was not registered for (at that time, prior to later amendments regarding allopathic practice by Indian system practitioners). The Supreme Court in Ayurvedic Enlisted Doctors' Association v. State Of Maharashtra And Another (2009)[6], while addressing issues of registration and practice rights under the Indian Medicine Central Council Act, 1970, also touched upon prosecutions under Section 33 of the MMPA. The Court directed that prosecutions for past infractions not be continued in the peculiar facts of that case but affirmed the authorities' right to act prospectively under the statute.[6]

It is also noteworthy that Section 33(1) contains a proviso allowing the State Government to relax conditions to enable persons to practice in the State, upon individual representations.[4]

Scope of Practice and the "Cross-pathy" Conundrum

The issue of "cross-pathy," i.e., practitioners of one system of medicine prescribing remedies from another, has been a contentious area. The Supreme Court in Poonam Verma v. Ashwin Patel And Others (1996)[1] laid down a crucial principle regarding medical negligence. In this case, a homoeopathic practitioner administered allopathic medicines, leading to the patient's death. The Court held that a person practicing a system of medicine without the requisite qualifications and registration in that specific system could be liable for negligence per se. The Court observed, "no person can practise medicine in any State unless he possesses the requisite qualification and is enrolled as a medical practitioner on the State Medical Register."[5] While this case did not directly interpret the MMPA, 1961, its principles regarding adherence to one's own system of registration are broadly relevant.

The Supreme Court in Dr Mukhtiar Chand And Others v. State Of Punjab And Others (1998)[3] addressed the rights of Vaids/Hakims to prescribe allopathic medicines. The Court upheld State notifications under Rule 2(ee)(iii) of the Drugs and Cosmetics Rules, 1945, which recognized certain traditional practitioners as eligible to prescribe allopathic medicines, provided such recognition was in harmony with specific State laws. It clarified that if a State law relating to the registration of medical practitioners permits the practice of allopathic medicine on the basis of a degree in integrated medicine, the bar in Section 15(2)(b) of the Indian Medical Council Act, 1956 (which restricts practice of modern medicine to qualified persons) would not apply.[7] This judgment provided a pathway for states to define the scope of practice for traditional practitioners.

In a significant development for Maharashtra, the Maharashtra Medical Practitioners Act, 1961, was amended by Maharashtra Act XXVIII of 2014. This amendment added, inter alia, clause (iv) to Section 25 of the Act. As noted in several consumer dispute redressal commission cases, this amendment conferred a privilege upon registered practitioners of Indian Medicine holding qualifications mentioned in Parts A, A-1, B, or D of the Schedule to the MMPA, 1961. It stated that such practitioners "shall have privilege to practice the modern scientific medicine known as allopathic medicine to the extent of the training they received in that system, along with the system of Indian Medicine for which they are registered."[12], [13], [15]

This amendment was based on government resolutions and circulars (e.g., circular dated 25/11/1992[13], [15]) and was judicially upheld. The District Consumer Disputes Redressal Commission in Pradip Baburao Hivare v. National Insurance Co.Ltd. (2018)[13] and Smt.Ranjana Prakash Ranware v. National Insurance Co. Ltd. (2019)[15] referenced that the Indian Medical Association (IMA) Pune unit had challenged a Maharashtra Government Resolution allowing BAMS graduates to practice allopathy, but their writ petition was dismissed by the Bombay High Court, and a subsequent SLP (SLP/CC/9134/2015) before the Supreme Court was also disposed of, upholding the Government Resolution. This effectively legitimized the practice of allopathic medicine by BAMS/BUMS graduates registered under the MMPA, 1961, but strictly "to the extent of the training they received in that system."

Interplay with Central Legislations

The MMPA, 1961, operates within a broader framework of central legislations governing medical education and practice.

Indian Medical Council Act, 1956 (IMC Act): Section 15(2)(b) of the IMC Act, 1956, generally prohibits individuals not possessing qualifications listed in its Schedules from practicing modern scientific medicine. However, as established in Dr Mukhtiar Chand[3], [7], State laws can create exceptions for practitioners of traditional systems, especially those with integrated training, to practice modern medicine to a defined extent. The 2014 amendment to Section 25 of the MMPA, 1961, is an example of such state-level enablement.

Indian Medicine Central Council Act, 1970 (IMCC Act): This Act aims to standardize education and regulate the practice of Indian systems of medicine (Ayurveda, Siddha, Unani) at a national level. It provides for the maintenance of a Central Register of Indian Medicine. Section 17 of the IMCC Act deals with the rights of persons to be enrolled on State Registers and the Central Register. Section 29 grants registered practitioners the privilege to practice Indian medicine in any part of India.[11] The case of Ayurvedic Enlisted Doctors' Association[6] discussed the rights of practitioners under Section 17(3) of the IMCC Act. The interpretation of "modern advances" within the IMCC Act has also been subject to judicial scrutiny, with some courts holding it refers to advances within the respective traditional systems, not necessarily allopathic medicine, unless specifically permitted by law.[16]

Drugs and Cosmetics Act, 1940, and Rules, 1945: Rule 2(ee) of the Drugs and Cosmetics Rules, 1945, defines "Registered Medical Practitioner." Clause (iii) of this rule allows persons declared by a State Government to be registered medical practitioners for the purposes of the Drugs Act. Dr Mukhtiar Chand[3] extensively analyzed this provision, affirming the States' competence to make such declarations for practitioners of Indian medicine.

Judicial Scrutiny and Interpretation: A Summary

The judiciary has played a vital role in shaping the MMPA, 1961:

  • Kumari Rukmani (1968)[8]: Highlighted early constitutional infirmities in the Act, leading to legislative amendments.
  • Registered Medical Practitioners Association (2002)[4]: Affirmed the validity and enforceability of the amended Section 33, restricting practice to duly registered individuals under specified Acts.
  • DR.ARUN ABHIMANYU BISWAS (2006)[11]: Emphasized the necessity of registration under Section 33 of the MMPA for practicing Indian medicine in Maharashtra, irrespective of registration in other states, if not yet on the Central Register.
  • R.R. Singh (Dr.) v. Pratibha P. Gamre (2012)[14]: Demonstrated the penal consequences under Section 33 for practicing a system of medicine without due registration and authorization (in this instance, an Ayurvedic doctor practicing allopathy before the 2014 amendment).
  • Consumer Cases (e.g., Mahadeo Ganapati Patil[12], Pradip Baburao Hivare[13], Smt.Ranjana Prakash Ranware[15]): Consistently recognized and applied the 2014 amendment to Section 25 of the MMPA, allowing BAMS/BUMS practitioners to practice allopathy to the extent of their training, and acknowledged the Supreme Court's affirmation of the related government policy.
  • Poonam Verma v. Ashwin Patel (1996)[1]: While not directly on MMPA, established broader principles of negligence when practitioners transgress their system of qualification and registration.
  • Dr Mukhtiar Chand (1998)[3], [7]: Provided the foundational legal basis for states to permit integrated practice by traditional medicine practitioners, influencing the legislative approach in Maharashtra.

Contemporary Issues and Challenges

Despite the legislative clarity brought by amendments, particularly the 2014 amendment to Section 25, challenges remain. A key issue is ensuring that practitioners of Indian medicine who practice allopathy adhere strictly to the "extent of the training they received in that system." Defining and monitoring this "extent" can be complex and requires robust oversight from the Maharashtra Council of Indian Medicine.

Continued vigilance against unqualified individuals practicing any system of medicine remains a priority. The effective enforcement of Section 33 is crucial for public safety. Furthermore, coordination between different regulatory bodies, such as the Maharashtra Council of Indian Medicine (under MMPA, 1961) and the Maharashtra Medical Council (under Maharashtra Medical Council Act, 1965), is essential to ensure a well-regulated healthcare environment in the State. The case State Of Maharashtra v. Indian Medical Association And Others (2001)[2], though concerning the establishment of medical colleges under a different Act (Maharashtra University of Health Sciences Act, 1998), illustrates the State's overarching role and interest in medical education and infrastructure, which indirectly impacts the availability and quality of medical practitioners.

Conclusion

The Maharashtra Medical Practitioners Act, 1961, has evolved significantly from its original form into a detailed legislative instrument for regulating the practice of Indian systems of medicine in Maharashtra. Through crucial amendments, particularly to Sections 33 (prohibition of practice) and Section 25 (scope of practice), and guided by judicial interpretations, the Act has sought to balance the promotion of traditional Indian medicine with the imperative of public health and safety. The 2014 amendment, allowing registered practitioners of Indian medicine to practice modern scientific medicine to the extent of their training, represents a major policy shift towards integrated medical practice, addressing healthcare needs, especially in underserved areas. However, this also brings forth the challenge of ensuring adherence to prescribed limits and maintaining quality of care. The MMPA, 1961, thus continues to be a dynamic piece of legislation, reflecting the ongoing dialogue between tradition, modernity, and regulatory prudence in the healthcare landscape of Maharashtra.

References

  1. [A] Maharashtra Medical Practitioners Act, 1961 (Maharashtra Act No. XXVIII of 1961).
  2. [1] Poonam Verma v. Ashwin Patel And Others (1996 SCC 4 332, Supreme Court Of India, 1996).
  3. [2] State Of Maharashtra v. Indian Medical Association And Others (2002 SCC 1 589, Supreme Court Of India, 2001).
  4. [3] Dr Mukhtiar Chand And Others v. State Of Punjab And Others (1998 SCC 7 579, Supreme Court Of India, 1998).
  5. [4] Registered Medical Practitioners Association v. Registrar, Maharashtra Council Of Indian Medicine And Others (Supreme Court Of India, 2002) [Text provided refers to Maharashtra Medical Practitioners (Amendment) Act, 1978 amending Sec 33 of MMPA 1961].
  6. [5] Poonam Verma v. Ashwin Patel And Others (Supreme Court Of India, 1996) [Text provided refers to Maharashtra Medical Council Act, 1965 and definitions therein].
  7. [6] Ayurvedic Enlisted Doctors' Association v. State Of Maharashtra And Another (Supreme Court Of India, 2009).
  8. [7] DR. MUKHTIAR CHAND & ORS. v. THE STATE OF PUNJAB & ORS. (Supreme Court Of India, 1998) [Text provided refers to practice of allopathic medicine based on integrated degrees and Section 15(2)(b) of the 1956 Act].
  9. [8] Kumari Rukmani v. Appellate Authority Under Maharashtra Medical Practitioners Act Xxviii Of 1961, Bombay (Bombay High Court, 1968).
  10. [9] Neelam Narayan Bansode Petitioner. v. State Of Maharashtra And Others (Bombay High Court, 2009) [Primarily about nursing, less direct to MMPA for medical practitioners].
  11. [10] MANMOHAN PASHUPATINATH UPADHYAY AND 9 ORS. v. MAHARASHTRA COUNCIL OF HOMOEOPATHY AND 4 ORS. (Bombay High Court, 2023) [Deals with Maharashtra Homoeopathic Practitioners Act].
  12. [11] DR.ARUN ABHIMANYU BISWAS v. STATE OF MAHARASHTRA AND ORS. (Bombay High Court, 2006).
  13. [12] Mahadeo Ganapati Patil v. The New India Assurance Co. Ltd., Tarfe Divisional Manager (District Consumer Disputes Redressal Commission, 2016).
  14. [13] Pradip Baburao Hivare v. National Insurance Co.Ltd. (District Consumer Disputes Redressal Commission, 2018).
  15. [14] R.R. Singh (Dr.) v. Pratibha P. Gamre (2012 SCC ONLINE NCDRC 246, National Consumer Disputes Redressal Commission, 2012).
  16. [15] Smt.Ranjana Prakash Ranware v. National Insurance Co. Ltd. (District Consumer Disputes Redressal Commission, 2019).
  17. [16] Homeopathic Surgeon Association Of India v. Union Of India (Allahabad High Court, 2017).
  18. [17] Archana Sudhir v. Maharashtra Medical Council (Bombay High Court, 2005).