Madhya Pradesh HC Dismisses Radiographers' Challenge to Handheld X-Ray TB Screening Guidelines

The Indore Bench declined to interfere with Central TB Division guidelines and NHM-MP orders deploying handheld X-ray devices for community TB screening, rejecting radiation safety and pay grievances raised by a registered association of government radiographers.

The High Court of Madhya Pradesh, Indore Bench, on 3 June 2026 dismissed a writ petition filed by Pragatisheel Radiographers Sangh Madhya Pradesh, a registered association of government radiographers and X-ray technicians, which had challenged guidelines issued by the Central TB Division for deploying ultraportable handheld X-ray (HHXray) devices in community tuberculosis screening camps. Justice Jai Kumar Pillai, sitting singly, held that the court's jurisdiction under Article 226 does not extend to stalling or modifying a national public health welfare policy and its administrative implementation, and found the petition devoid of substance and merit.

The Dispute Before the Court

The petition, registered as Writ Petition No. 17859 of 2026, targeted three layers of official action. At the apex was the August 2023 guideline document titled “Installation and Operational Guidance on Ultraportable Handheld X-Ray Device (HHXray) for Tuberculosis Screening in the Community,” issued by the Central TB Division, Ministry of Health and Family Welfare.

Flowing from that document was Order/Circular No. H/Vst. S.A./CH-279/25/3345 dated 10 November 2025, issued by the Mission Director, NHM-MP, directing Chief Medical and Health Officers (CMHOs) across Madhya Pradesh to immediately press HHXray machines into service for TB screening. District-level circulars from the CMHOs of Neemuch, Jhabua, and Barwani then prescribed daily operational targets of 100 to 150 chest X-rays per radiographer.

The petitioner association, whose members are permanent, regular, or contractual employees in government health facilities across the State, sought writs of mandamus to quash these guidelines and circulars. It also sought a direction to revise the radiation allowance payable to radiographers and to ensure compliance with Atomic Energy Regulatory Board (AERB) safety norms.

Conditions on the Ground

The factual picture presented by the petitioner was specific. Members are required to transport HHXray devices — specifically the Model Mine 2.1 — to remote villages and conduct screening camps in non-designated, non-shielded structures such as Panchayat Bhawans, school rooms, and Anganwadis. These locations lack lead-lined walls or protective enclosures.

The petitioner stated that radiographers operate the devices wearing only partial lead aprons, without mandatory real-time radiologist oversight, and without being provided Thermoluminescent Dosimeter (TLD) badges. The association conducted an informal experiment which, it claimed, showed that X-rays penetrated the provided lead aprons.

On pay, the petitioner pointed out that radiographers in Madhya Pradesh receive only Rs. 50 per month as a radiation allowance — a figure that has remained unchanged for approximately 35 years — while counterparts in other States receive between Rs. 1,500 and Rs. 2,500 per month.

The Legal Arguments

Counsel for the petitioner, Shri Prathviraj Singh Parmar, attacked the Central TB Division guidelines on the ground that they rely solely on the manufacturer's claims without independent scientific validation. Section 4.1.1 of the guidelines states that “the radiation hazard is almost zero/negligible as per the claim of the company,” language the petitioner argued was scientifically unfounded.

The petitioner contended that compelling radiographers to conduct 100 to 150 daily X-ray exposures in unshielded field conditions, without TLD badges and full-body shielding, directly violates Rules 6, 7, and 15 of the Atomic Energy (Radiation Protection) Rules, 2004, as well as AERB Safety Code AERB/SC/MED-2. This, it was argued, exposes government servants to foreseeable occupational health hazards and violates the fundamental right to a safe working environment under Article 21 of the Constitution.

The disparity in radiation allowance was framed as a violation of Article 14. The petitioner argued that multiplying daily radiation exposure without revising the allowance or providing health monitoring is arbitrary and discriminatory when compared to the treatment of radiographers in other States.

The petitioner also invoked WHO guidelines to argue against indiscriminate screening of asymptomatic populations, citing medical literature cautioning that routine chest X-rays in the absence of symptoms may provide a false sense of security and are not usually recommended.

The respondents — represented by Shri Romesh Dave for the Union of India and Shri Kushagra Singh as Deputy Government Advocate for the State — defended the policy as a welfare measure for TB eradication in the larger public interest. They submitted that the 10 November 2025 order was a competent administrative order implementing a vital national programme, that no manifest evidence on record demonstrated adverse legal effect on the petitioners, and that no service rule restricted the State from assigning field duties or numerical targets to radiographers.

How the Bench Reasoned

Justice Pillai framed the foundational question as whether the petitioner's grievance, rooted in a National Health Mission policy for TB eradication, warranted judicial intervention. He answered in the negative, holding that courts must exercise profound restraint when invited to review state policies pertaining to public health initiatives.

The court held that the domain of framing and executing health screening targets rests exclusively with the administrative authorities, and that the prescription of operational targets such as 100 to 150 X-rays per day in community camps are essential administrative tools to achieve the objectives of the TB Mukt Bharat Abhiyan. The court declined to categorise these targets as arbitrary merely because they impose demanding work schedules.

On the radiation safety arguments, the court observed that there was no manifest material on the record that definitively established how the deployment would affect the petitioners. It held that subjective apprehensions or informal experiments conducted by an association cannot substitute for formal administrative findings, and that no actionable prejudice was manifest on the record.

The court's treatment of the service conditions argument was equally brief. It found no condition in the service rules restricting the State from deploying radiographers to field camps or assigning specific daily targets, and held that in the absence of any statutory or service rule violation, a writ of mandamus cannot be issued to interdict the administrative orders.

The court did not engage with the specific provisions of the Atomic Energy (Radiation Protection) Rules, 2004 or the AERB Safety Code cited by the petitioner, nor did it address the Article 14 argument on the radiation allowance disparity in any detail. The reasoning rested on the circumscribed scope of judicial review in executive policy matters and the absence of formal evidence of prejudice on the record.

Outcome

The writ petition was dismissed as devoid of substance and merit. Pending applications, if any, were disposed of accordingly. No order as to costs was made. The judgment was reserved on 14 May 2026 and pronounced on 3 June 2026.