After rejecting hundreds of complaints from patients for over five years claiming that only doctors can appeal to the National Medical Commission (NMC) against decisions of state medical councils, the ethics and medical registration board (EMRB) of the commission has now lobbed the ball into the health ministry’s court.On May 20, the EMRB issued an office memorandum stating that the NMC Act was enacted by the central govt and “any interpretation relating to the provisions of the said Act may appropriately be undertaken by the ministry”.An RTI activist and ophthalmologist from Kerala, Dr Babu KV, has been repeatedly writing to the health ministry pointing out that section 8.8 of the Medical Council ethics code 2002, which is still in force, allows patients and the public to appeal to the NMC against SMC decisions. He pointed out that the EMRB was rejecting patients’ appeals illegally and sought action against 27 members of the NMC who were party to the decision to reject the appeals under section 1.9 of the ethics code. Section 1.9 of the code, which pertains to evasion of legal restrictions, states: “The physician shall observe the laws of the country in regulating the practice of medicine and shall also not assist others to evade such laws.”EMRB claimed that though the ethics code of 2002 was in force, section 30(3) of the NMC Act, 2019 would prevail over the ethics code. Section 30(3) of the NMC Act states that a medical practitioner or professional who is aggrieved by any action taken by a State Medical Council may prefer an appeal to the EMRB against such action. The NMC meeting held in October 2021 interpreted this section as stating that only medical practitioners should be allowed to file appeal before EMRB and approved it unanimously. Dr Babu pointed out that the word “only” was introduced by NMC and that it did not exist in section 30(3) and that there was nothing in the NMC Act or the specific section that barred patients from filing appeals.Dr Babu’s January 2026 email to the health ministry on the issue and his demand for action against NMC members was forwarded by the medical education policy division of the health ministry to the NMC’s policy and coordination division. This was stated in EMRB’s office memorandum dated May 20 which was obtained using RTI. Interestingly, the NMC’s website shows that the five-member EMRB is still empty barring one-part-time member. So, who took the decision to shift the decision on to the health ministry when the board concerned is empty?