How the Centre’s ill-defined reservation criteria led to a massive doctors’ strike

For nearly two weeks now, hospital services in Delhi have been crippled by a strike by resident doctors over the deadlock in admissions to postgraduate medical courses. On Monday, the police allegedly thrashed and detained protesting doctors, registering a case against them, which prompted their association to announce a complete shutdown of services on Wednesday.

Postgraduate medical students work as resident doctors in hospitals while pursuing their studies. They handle a major part of the workload in public hospitals. They are protesting because admissions to postgraduate medical courses have been delayed by several months. With a fresh batch of students yet to join, resident doctors say they are struggling to cope with work pressures as yet another pandemic year looms ahead.

The delay in admissions has been caused by the government’s inability to satisfactorily furnish information that the Supreme Court asked for while hearing legal challenges to the newly introduced reservations for students belonging to economically weaker sections, or EWS.

What are EWS reservations?

Reservations for economically weaker sections were introduced by the government through a constitutional amendment in 2019. It is meant for those outside the ambit of reservations for Scheduled Castes, Scheduled Tribes and Other Backward Classes and who fall below a certain income criteria.

The constitutional amendment gave the government the power to provide reservations for economically weaker sections. It also gave the government the power to notify the economically weaker sections from time to time based on family income and other indicators of economic disadvantages.

On July 29, 2021, the government introduced a 27% quota for OBCs and a 10% quota for EWS students seeking admission to undergraduate and postgraduate courses in medical colleges. Admissions to medical colleges take place through the National Eligibility cum Entrance Test, or NEET.

Currently, to be eligible for reservation under the EWS category, a student’s family income should be less than Rs 8 lakh per annum and the family must not own agricultural land or a residential plot of more than a specified threshold.

On what grounds have EWS reservations been challenged in the Supreme Court?

Soon after the government introduced reservations in NEET, multiple pleas were filed in the Supreme Court challenging it. One petition questioned the income criteria for being considered under the EWS category and argued that the amendment led to more than 50% seats being reserved and is therefore, unconstitutional. Another petition specifically argued against reservations in NEET-PG saying such quota cannot be there in higher degree courses.

The court issued a notice in these cases in the first week of September.

During the hearings, the Supreme Court pointed out that it was not going into questions of policy but was just checking if the constitutional requirements for the implementation of the EWS quota have been met. According to the court, since the constitutional amendment which brought EWS reservations said that the Indian state can notify economically weaker sections from time to time, it wanted to satisfy itself that the government has undertaken a proper exercise in determining the criteria.

The court asked if the Centre had relied on the report submitted by Major General Sinho in 2010. This report was cited by the government to bring the EWS constitutional amendment in 2019. The Supreme Court also demanded that the government furnish a copy of the report if it had relied on it.

The Supreme Court also asked the government several questions about how the maximum income criteria to avail EWS reservation is Rs 8 lakh. The court sought to know if the government had mechanically lifted the criteria which is used for “creamy layer” exclusion in reservation for OBCs.

Presently, an annual income of Rs 8 lakh is also the amount that determines the “creamy layer” for OBC reservation. Candidates from the OBC category belonging to the creamy layer are excluded from reservation since they have “economically progressed” and are less backward. The court said that an OBC applicant with an annual income of less than Rs 8 lakh would be socially and educationally backward compared to a person from the EWS category in the same income bracket. Yet, both would get reservations despite one being more disadvantaged than the other. Therefore, it asked the Centre to clarify if this income metric was not arbitrary.

The court also questioned how the government had kept a uniform income and asset criteria for the entire nation since the value of a person’s income and assets would also be determined by the area they are located in.

Why is the government responsible for the delay?

The counselling for the NEET postgraduate exam has been getting delayed since the Centre had put off filing an affidavit on how it arrived at the criteria to determine the EWS category and later said that it has formed a committee to reconsider the EWS criteria.

Initially, on October 7, the Centre asked for time to file the affidavit. However, by the next hearing on October 21, the Centre did not file the affidavit. It then asked for two more days. The Supreme Court granted five days’ time to file an affidavit after which the Centre submitted it.

On November 25, the Centre told the Supreme Court that it will revisit the criteria to determine the economically weaker sections for reservation as per the constitutional amendment. It asked for four weeks for this exercise.

The Supreme Court, during the hearing, also gave the option to Solicitor General Tushar Mehta to proceed with the admissions without the EWS quota this year. However, Mehta responded that they would not want to delay the implementation of this quota. Mehta, instead, insisted that this year’s EWS reservation can be implemented using the current income criteria. But the court rejected that.

The next hearing is now set for January 6, 2022. However, the doctors have asked for the hearing date to be pushed forward.

How does this affect the doctors?

Since the counselling is not progressing, 50,000 students who have cleared the NEET-PG exam cannot proceed with their admissions. Counselling is the next step after clearing the exam and before getting admission to a college. Students fill their college preferences and the courses they wish to study. After this, they are allotted colleges based on the number of seats and applicable reservation quotas.

The exams are usually held in January and counselling begins in March. But, because of the pandemic, the exams were held in September and counselling was supposed to begin by October. Now, this stands to be further delayed because of the stalemate in the Supreme Court.

Since the admission process is stuck, hospitals are not getting a new batch of postgraduate students who would work as resident doctors. Therefore, current resident doctors complain that they are working with two-thirds of the strength and are exhausted. Given the fears over a possible third wave of Covid-19 as well, the doctors have asked for the admission and and counselling process to be expedited.

On Monday, after the police allegedly thrashed and detained doctors and registered a first information report, or FIR, against them for protesting, the protests intensified. Doctors across the country have expressed support for the protests in Delhi and some have also stopped work in their respective hospitals.

The doctors met Union Health Minister Mansukh Mandaviya on Tuesday who urged the protesters to resume work and expressed regret at any “misbehaviour” on the part of the police. However, the doctors decided to continue the protest and have also demanded that the police issue an apology and withdraw the FIRs.

Corrections and clarifications: An earlier version of this piece incorrectly stated that the government had not filed an affidavit in the Supreme Court.