17 October 2025 Special Leave Petition >> Civil & Consumer Law   |   Medical, Pharma & Healthcare >> Miscellaneous  

The Supreme Court has again been grappling with the sensitive interface between contemporary medicine and ancient systems of healing, as it referred to a larger Bench the issue of whether physicians in allopathic practice and those in indigenous systems of medicine (AYUSH) could be treated on an equal footing for the purposes of service conditions, specifically age of retirement and scales of pay.

The Court's direction emanated in a cluster of Special Leave Petitions where divergent High Court rulings had challenged the legality of having separate service parameters for allopathic and AYUSH practitioners working under State governments and public institutions.

Background of the Controversy:

The controversy arises due to conflicting administrative policies pursued in different States. While allopathic physicians have frequently been permitted a retirement age of 65 years, physicians in indigenous streams like Ayurveda, Unani, Siddha, and Homeopathy still retire at the age of 60 years in many States. The issue, thus, is whether such discrimination violates Articles 14 and 16 of the Constitution, or whether the two streams of practitioners constitute different classes on the basis of qualifications and functions.

This argument has run through various judicial rulings, commonly yielding conflicting results. Some of the earlier decisions seemed to tilt toward equality, acknowledging that the two categories of physicians end up pursuing the same public health mission. Others, nonetheless, emphasized the qualitative and functional distinctions between the two streams, especially in relation to the type of duties, training, and medical intervention involved.

Divergent Judicial Views:

The initial major case on this subject was Dr. Ram Naresh Sharma, where the Court held that both allopathic and AYUSH physicians provide similar services to patients and therefore, differential in retirement age would be discriminatory. The judgment was brought about by a policy decision of the Union Cabinet, extending the higher retirement age to AYUSH doctors as well.

A subsequent ruling in Dr. P.A. Bhatt, however, overruled such reasoning and took a very different stance. It ruled that equal age at retirement does not necessarily mean equality of pay or terms of service because the educational qualifications, degrees of skill, and workloads of the two classes differ considerably. The Court argued that although respect and recognition are due to all systems of medicine, the scale and severity of medical responsibilities MBBS doctors undertake—e.g., emergency care, trauma care, surgery—are not to be compared to what is undertaken in traditional systems.

An identical position was repeated in Dr. Solamon A. v. State of Kerala, where the Court held that qualitative distinctions in academic courses and clinical work constituted a valid reason for the State in differentiating between AYUSH and allopathic doctors for the purposes of compensation and retirement.

Current Reference: The Need for Authoritative Clarity

Admitting the inconsistency in judicial thoughts, the current Bench noted that although Dr. Ram Naresh Sharma was differentiated in Dr. P.A. Bhatt, uncertainty still remains in deciding whether functional similarity alone can be the basis to justify parity of service conditions.

The Court stressed that such equality should best be tested on the yardstick of equal duties, similar work, and same responsibilities—not just the common aim of delivering healthcare. It also pointed out that allopathic practitioners provide serious and emergency care, including operations and invasive procedures, which indigenous practitioners are neither trained nor qualified to undertake.

Significantly, the Court also believed the States' argument that the increased retirement age for allopathic physicians had been enacted mainly to respond to the paucity of veteran MBBS practitioners in government hospitals—a policy rationale based on public interest and medical necessity. There was no such shortage in the AYUSH system, nor did their work justify the same increase.

Interim Directions Pending the Reference:

Subject to the decision of the larger Bench, the Supreme Court made interim orders for administrative consistency and equity:

1. State governments can retain AYUSH doctors beyond their retirement age limit—up to that applicable to allopathic physicians—but without pay and allowances.

2. If the larger Bench later decides in their favor, such physicians will be entitled to arrears of pay and allowances for the additional period.

3. On the other hand, if they refuse to resume on these interim conditions, their retirement shall be deemed as final.

4. The Court also ordered that those kept on in service shall get half pay and allowances, releasable against future entitlements subject to the decision of the reference.

These proportional directions strike a balance between fair treatment and administrative expediency, so neither group of practitioners is prejudiced pending the final resolution of the constitutional issue.

The Broader Implications:

The Court's call for a larger Bench indicates the seriousness with which the Court is determined to address the doctrinal ambiguity respecting "equal pay for equal work" and "reasonable classification" in the medical profession. The judgment will have nationwide repercussions, impacting not only pay scales and retirement policies, but also relative status granted to traditional modes of medicine within the public healthcare system.

At its essence, the case compels a subtle question:

• Whether equality should be measured by the nature of healing or the complexity of practice?
• Are medical practitioners of different medical philosophies equal just because both are working in the cause of public health?
• Until the larger Bench responds to these questions, the question of parity between AYUSH and allopathy is medically common but legally divided.