Gauhati HC Directs Assam to Restore Practice Rights of 609 Rural Health Practitioners Trained Under Struck-Down 2004 Act

The Gauhati High Court held that diplomas earned under the unconstitutional ARHRA Act 2004 cannot be nullified, directing the State to frame a separate cadre and restore practice rights within 90 days.

Six hundred and nine persons who completed a Diploma in Medicine and Rural Health Care under the Assam Rural Health Regulatory Authority Act, 2004 — a law subsequently declared unconstitutional — approached the Gauhati High Court seeking restoration of their right to practise medicine in rural areas. The court, in a judgment pronounced on 29 May 2026, allowed the writ petition in part. It held that the diplomas and training acquired under the 2004 Act could not be stripped away retrospectively, applied the doctrine of prospective overruling to the Supreme Court's judgment of 24 January 2023, and directed the State of Assam to expedite a committee's recommendations for a separate cadre — covering pay, grade, service benefits and promotion — within 90 days of receipt of the certified copy of the order.

The Dispute Before the Court

The petitioners, spread across districts from Baksa to Tinsukia, had enrolled in different batches of the Diploma in Medicine and Rural Health Care (DMRHC) course at the Medical Institute, Jorhat, which was affiliated to Srimanta Sankaradeva University of Health Sciences. The course ran for three and a half years, including six months of internship, and covered subjects ranging from Anatomy and Physiology to Surgery, Obstetrics and Gynaecology, and Paediatrics. Admission was restricted to toppers in the Science stream of the Higher Secondary (10+2) examination from each district of Assam.

On completing the course, the petitioners were enrolled in the State Register of Rural Health Practitioners and were appointed under the National Rural Health Mission (now the National Health Mission) as Rural Health Practitioners. Under Section 24 of the ARHRA Act, 2004, they were permitted to treat common diseases, prescribe listed drugs, perform minor surgery, and issue illness and death certificates — but only in rural areas and without using the prefix “Doctor” or “Dr.”

In 2005, the Assam Branch of the Indian Medical Association filed WP(C) No.5789 of 2005 before the Gauhati High Court challenging the constitutional validity of the ARHRA Act, 2004. The petitioners were never arrayed as parties in those proceedings, and no interim order staying the courses or the Act was issued. A Division Bench of the Gauhati High Court, by judgment dated 30 October 2014, struck down the Act as unconstitutional, holding it to be in conflict with Section 10A of the Indian Medical Council Act, 1956.

The State of Assam then enacted the Assam Community Health Professionals (Registration and Competency) Act, 2015, which came into force on 29 May 2015. Under Section 3(2) of the 2015 Act, those who had completed or were undergoing the DMRHC course were deemed to have completed the paramedical course of B.Sc. (Community Health) and were registered as “Community Health Professionals.” By a notification dated 24 June 2015, the Principal Secretary, Health and Family Welfare, re-designated them as “Community Health Officers” (CHO).

The petitioners' grievance was that this re-designation downgraded them from practitioners who could prescribe medicines to paramedical staff. They alleged that in practice they were being used for data entry and administrative support rather than clinical work. No separate cadre with defined pay, grade or service benefits had been created for them.

Two writ petitions challenging the 2015 Act were transferred to the Supreme Court and connected with SLP No.32592–32593 of 2015. By judgment dated 24 January 2023, the Supreme Court dismissed the SLP and the transferred cases. It upheld the conclusion that the ARHRA Act, 2004 was null and void — though for a different reason than the Gauhati High Court had given — and separately upheld the constitutional validity of the 2015 Act.

The Legal Questions

Before the Gauhati High Court in the present petition, the petitioners sought four broad directions: that the State notify them as allopathic practitioners in the manner permitted under the 2004 Act; that rules and regulations be framed accordingly; that a regulatory authority be established; and that a condensed MBBS-equivalent course be formulated as a one-time measure. They also sought creation of permanent posts with a separate cadre.

The core legal tension was whether rights accrued under a statute that was later declared unconstitutional could survive that declaration, and whether the Supreme Court's 2023 judgment — particularly paragraph 25(iv) — impliedly applied the doctrine of prospective overruling so as to protect the petitioners' acquired qualifications.

Senior Counsel for the petitioners, Mr. Harin P. Raval, assisted by Mr. Adeel Ahmed and Mr. A.M.S. Mazumder, argued that the ARHRA Act, 2004 was a valid piece of legislation at the time the petitioners enrolled and completed their courses. No interim stay operated during the pendency of the IMA's challenge. The petitioners were not parties to those proceedings. The striking down of the Act on 30 October 2014 could not, therefore, operate retrospectively to nullify qualifications already earned. Counsel also pressed Article 21 of the Constitution, arguing that depriving the petitioners of their right to practise — earned under a then-valid statute — violated their right to live a dignified life. Promissory estoppel and legitimate expectation were also urged, pointing to an affidavit dated 12 January 2021 filed by the Joint Secretary, General Administrative Department, Government of Assam before the Supreme Court, which averred that the petitioners possessed the requisite skill and training for a limited licence to practise under Section 32 of the National Medical Commission Act, 2019.

The Standing Counsel for the Health Department, Mr. D.P. Borah, countered that the petitioners were already registered as Community Health Professionals under the valid 2015 Act and continued to be engaged under the NHM. He submitted that their interests were being taken care of under the 2015 Act and that the apprehensions expressed were unfounded.

How the Court Reasoned

The court first traced the constitutional basis on which the Supreme Court had struck down the ARHRA Act, 2004. The Supreme Court had held that Entry 25 of List III of the Seventh Schedule, which covers education, is expressly made subject to Entry 66 of List I, which covers coordination and determination of standards in institutions for higher education. The Indian Medical Council Act, 1956 was enacted by Parliament under Entry 66 of List I to set standards for modern scientific medicine, which includes allopathic medicine. A State legislature therefore had no competence to enact a law permitting persons to practise allopathic medicine without possessing qualifications listed in the Schedules to the IMC Act. The ARHRA Act, 2004 fell foul of this restriction and was declared null and void.

The Supreme Court had, however, simultaneously upheld the 2015 Act on the ground that the IMC Act, 1956 did not deal with Community Health Professionals practising as allopathic practitioners in the limited manner permitted under the Assam Act in rural areas. The 2015 Act was therefore not hit by Entry 66 of List I and was within the State legislature's competence.

The Gauhati High Court read paragraph 25(iv) of the Supreme Court's 2023 judgment as an implied application of the doctrine of prospective overruling. The court reasoned that by upholding the 2015 Act — which gave the same status to DMRHC diploma holders as B.Sc. (Community Health) graduates and registered them as Community Health Professionals — the Supreme Court had effectively protected the benefit accrued to the petitioners from their diplomas and training under the 2004 Act. The change was one of nomenclature, not of substance.

The court held that the diplomas and training earned by the Rural Health Practitioners under the erstwhile 2004 Act could not be taken away. The State was bound to retain their status as Rural Health Practitioners, notwithstanding the change in nomenclature to Community Health Professionals under the 2015 Act. The State could not restrict the petitioners from rendering services in the manner they had earlier served as Rural Health Practitioners merely because the label had changed.

The court declined to separately examine the doctrines of promissory estoppel and legitimate expectation. It reasoned that since the 2015 Act had been upheld by the Supreme Court and was specifically enacted to address the consequences of the 2004 Act being struck down, those doctrines did not require independent examination in these proceedings.

The court also observed, drawing on the demographic reality that roughly 62.5 to 63 per cent of India's population of 1.47 billion resides in rural areas, that it is in national interest to ensure qualified health professionals are available in rural communities. Involving members of the local rural community who have undergone prescribed training serves the interest of better health care in areas that lack access to specialised facilities. The State Health Department, in conjunction with the Central Health Department, was better placed to lay down the criteria and modalities for this purpose.

Directions Issued

The court directed the State to expedite the process of obtaining recommendations from a committee that had already been constituted and had held several meetings. If any committee members needed to be re-notified, the State Health Department was to take those steps without further delay.

Once the recommendations were finalised, they were to be submitted through the appropriate department to the concerned authority in the State. The recommendations were required to work out a separate cadre for Rural Health Practitioners/Community Health Professionals, covering pay, grade, health benefits, all service benefits, and avenues for promotion.

The committee was directed to submit its recommendations within 90 days of receipt of the certified copy of the order. The State was thereafter to consider the recommendations and pass appropriate orders for implementation, so as to give effect to paragraph 25(iv) of the Supreme Court's judgment dated 24 January 2023 in SLP(C) No.32592–32593 of 2015.

Outcome

The writ petition was allowed to the extent indicated above and disposed of. The judgment was reserved on 6 November 2025 and pronounced on 29 May 2026. The full judgment was pronounced; the pronouncement was not limited to the operative part.