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Central Information Commission

Mukta Sharma vs Ministry Of Health & Family Welfare on 17 January, 2018

                     CENTRAL INFORMATION COMMISSION
                   Room No.414, Baba Gangnath Marg, Munirka
                               New Delhi-110067

                                   F. No.CIC/SB/A/2016/000299/MH&FW

Date of Hearing                     :   03.01.2018
Date of Decision                    :   03.01.2018
Appellant/Complainant               :   Ms. Mukta Sharma
                                        Through:
                                        Commodore Rajiv Sharma
Respondent                          :   CPIO, MoH &FW
                                        & RTI Cell, Safdarjang Hospital &
                                        VMMC & Ors.
                                        Through:
                                        Dr. A.K. Sen, FAA, with Dr. A.K.
                                        Malhotra for Dr. RML Hospital,
                                        Delhi

                                        Dr. Sandeep Sharma, CPIO with
                                        Shri Mahesh & Shri Nitesh for
                                        Safdarjung Hospital, Delhi

                                        Dr. Anil      Manektala,    DDG(P)
                                        MoH&FW

Information Commissioner            :   Shri Yashovardhan Azad

Relevant facts emerging from appeal:
RTI application filed on            :   17.02.2015
PIO replied on                      :   08.06.2015
First Appeal filed on               :   14.08.2015
First Appellate Order on            :   17.08.2015
2nd Appeal/complaint received on    :   13.01.2016

Information sought

and background of the case:

Vide RTI application dated 17.02.2015, the appellant sought information with regard to DoPT regulations relating to the physical examination of candidates suffering from type 1 Insulin Dependent Diabetes Mellitus (IDDM) appearing for Civil Services Examination conducted by Union Public Service Commission. While referring to various DoPT instructions prescribed for health parameters and lack of precise guidelines qua evaluation of micro & macro vascular complications due to Diabetes Mellitus, the appellant sought the following information:

" ...3. However, your regulations are "silent", with respect to the medical fitness status after undergoing the above mentioned Biochemical and Adiological tests for evaluation of micro and macro vascular complications of Diabetes Mellitus. And hence, it is requested to kindly furnish the following information based on under mentioned queries:

(a) If a candidate is found to be having diabetes mellitus with above normal levels of Fasting Blood Sugar (FBS) and HbA1C, during medical examination, but his Biochemical and Adiological tests for evaluation of micro and macro vascular complications of Diabetes Mellitus are found to be NORMAL, then, is the candidate declared to be medically fit/eligible for all civil services job through UPSC employment?

(b) Kindly also confirm whether a Type-I Insulin Dependent Diabetes Mellitus candidate ) will be given medically FIT or UNFIT status for UPSC civil services employment, if though the HbA1C is between 7.0 and 8.5 but the Biochemical and Adiological tests for evaluation of micro & macro vascular complications of Diabetes Mellitus are all found within normal limits..

(c) Copy of all relevant rules and regulations governing medical examination of candidates for UPSC civil Services Examinations conducted under DoPT which disqualify candidates on grounds of Diabetes Mellitus, if they do.

(d) In case, the test parameters of para 14 of Appendix-III of DOPT rules, if found normal for cases at para 3 (a) & b above, and a diabetes mellitus candidate is declared medically fit by empanelled hospital, and still if UPSC regulations/DOPT do not support this medical fitness for UPSC employment, what is the essence/reason of deciding a candidate is Unfit for UPSC services in the above context quoting and enclosing copy of the UPSC/Govt. Of India employment regulations used for such decision making."

The CPIO, vide letter dated 08.06.2015 furnished the information as under:-

1. The Gazette of India (June 19, 2004 for Civil Services Examination 2014 received from Department of Personnel & Training) states the candidate will be declared fit there are no micro vascular or macro vascular implication.

2. This does not come under the preview of RTI.

3. Copy of relevant rules & regulations to be obtained from DoPT.

4. There has been a recent change only in the guidelines (as given in the gazette) wherein patients with DM in the absence of complications can be considered. However, if there is a discrepancy relevant rules from the concerned department to be obtained.

Dissatisfied with response received from PIO, the appellant filed first appeal. FAA vide letter dated 17.08.2015 directed the PIO to provide a reply to the appellant to the extent possible under RTI Act 2005 within 15 days. The CPIO furnished the following revised reply dated 03.09.2015:

"Reference to your application dated 11.08.2015 received in this office on 22.08.2015 on the subject cited above. The requisite information is asunder:-

As per the Gazette, it is clearly mentioned that patients of diabetes mellitus with microvascular or macrovascular complications are medically unfit.

However, the gazette is silent on the degree of glycemic control. As per this particular case type I diabetes mellitus, all effort could be made to make the patient euglycemic (HBA1c<7%). Once, the patient is euglycemic, the candidate could be considered medically fit provided microvasucular & macrovascular complications are absent.'' Dissatisfied with the information furnished, the appellant approached the Commission.

Relevant facts emerging during hearing:

Both the parties are present and heard. The Appellant is represented through her husband Commodore Rajiv Sharma. The appellant highlights the issue of lack of definite policy by DoPT for conducting medical tests of candidates of Civil Services Examination (CSE) for the persons suffering from Diabetes Mellitus. While referring to the extant medical standards prescribed for medical examination of CSE qualified candidates, the appellant contends that a candidate suffering from Insulin Dependent Diabetes Mellitus (IDDM) would never be able to pass the medical test. He strenuously argues that persons suffering from IDDM constitute a different class and subjecting them to the criterion as applicable to persons without Diabetes would offend their right to Page 3 of 5 equality in public employment. He argues that the query is aimed at knowing if a candidate having type 1 IDDM would ever be declared medically fit for the purpose of CSE conducted by UPSC. Per contra, the respondents jointly submit that the query is hypothetical inasmuch as the norms contained in Gazette notification for CSE-2014 as received from DoPT mandate that a candidate must not exhibit micro vascular or macro vascular implication. Respondents, who are also qualified medical practitioners submit that Insulin Dependent Diabetes Mellitus is a chronic disorder and categorized as macro vascular disorder. The relevant examinations conducted by medical board for CSE are:

a) Blood Sugar Fasting

b) HbA1C

c) Urine Analysis: Sugar They opine that though no specific regulation is prescribed for examining candidates suffering with IDDM, a candidate having results in the standard reference range for the aforesaid tests may be declared fit provided in absence of other complications. To this, the Appellant takes strong exception and contends that a candidate with IDDM may quality test (a) & (c) but shall never be able to qualify 'HbA1C test'. The said medical examination measures the level of glycated haemoglobin in human body. It develops when haemoglobin, a protein within red blood cells that carries oxygen throughout human body joins with glucose in the blood, becoming 'glycated'. With HbA1c results, clinicians are able to get an overall picture of a candidate's average blood sugar levels over a period of few months. However, the respondents would contend that with proper medication and life style adaptations, an IDDM patient can figure within the prescribed levels. To this, the Appellant would reply that the CSE regulations prohibit consumption of medicines before being subjected to a medical examination before the Medical Board.

The appellant made further passionate submissions at length as his son is suffering from IDDM and aspires to take on the CSE. Decision:

After hearing the parties at length and perusal of record, the Commission finds that information sought by the appellant has been furnished. Any further information would fall within the realm of seeking professional medical advice which would be beyond the purview of information as defined under Section 2(f) of the RTI Act, 2005. However, considering the fact that there are more than One Lac reported cases of IDDM in persons below the age of 25 years in India and for ensuring equal opportunity for all in light of Constitutional ethos specifically Article 16 of the Constitution of India; the Commission recommends to DoPT & Union Public Service Commission to examine the case of CSE candidates/ aspirants suffering with IDDM and take Page 4 of 5 a decision whether a clarification is called for, in respect of IDDM affected candidates, while laying out the medical standards/requirements. A copy of the present order may be marked to Secretary, DoPT & Secretary, UPSC for further action.

(Yashovardhan Azad) Information Commissioner Authenticated true copy. Additional copies of orders shall be supplied against application and payment of the charges prescribed under the Act to the CPIO of this Commission.

(R.P.Grover) Designated Officer Page 5 of 5