State must protect the clinical status of Rural Health Practitioners following a transfer between legislative frameworks.

The 609 petitioners completed a "Diploma in Medicine and Rural Health Care" (DMRHC) under the Assam Rural Health Regulatory Authority Act, 2004 (2004 Act), which authorized them as "Rural Health Practitioners" (RHPs) to practice allopathic medicine with limited scope in rural areas.

In 2014, the Gauhati High Court struck down the 2004 Act as unconstitutional, reasoning it conflicted with Section 10A of the Indian Medical Council (IMC) Act, 1956.

To preserve the health workforce, the State enacted the Assam Community Health Professionals (Registration & Competency) Act, 2015 (2015 Act), re-designating RHPs as "Community Health Officers" (CHOs) and labeling them as paramedical personnel.

Petitioners challenged this transition, arguing it downgraded their status from medical practitioners to paramedics and stripped them of accrued rights to practice allopathy as originally permitted under the 2004 Act.

The court relied on the Supreme Court's decision in Bikram Pathak v. Indian Medical Association (2023), which clarified that while the 2004 Act was void for lack of legislative competence under Entry 66 List I, the 2015 Act was valid because the IMC Act, 1956 does not occupy the field regarding "Community Health Professionals".

The "Doctrine of Prospective Overruling" and the principle from State of Manipur v. Surajkumar Okram, which holds that a statute declared unconstitutional is obliterated, but relief can be moulded to save past transactions.

The court also invoked the "Doctrine of Legitimate Expectation" and Article 21's right to life and health as established in Devika Biswas v. Union of India.

The Court noted that the Supreme Court in 2023 specifically held that the 2015 Act was valid because it dealt with a distinct category of professionals not covered by Central medical laws; specifically, that these professionals were "permitted to practise... in the manner as they were permitted to practise under the Assam Act [2004]".

The High Court reasoned that the 2015 Act was intended to restore the position of diploma holders and remove the basis of the 2014 invalidation, and consequently, the State cannot unilaterally downgrade their clinical competencies to mere paramedical assistance.

Despite internal government committee meetings acknowledging these rights, the State had failed to finalize the rules or cadre structure; protecting the petitioners’ status is necessary to prevent wastage of public resources and to satisfy the rural population's right to health.

The Court directed the State to expedite the Committee process to lay down criteria/modalities ensuring petitioners can perform duties as originally envisaged under the 2004 Act, formulate a separate cadre with clear particulars on pay, grade, and promotional avenues, and required the Committee to submit recommendations within 90 days.

The re-designation as CHOs stands, but their clinical "allopathic" functions must be retained within the rural scope.