During all four inspections conducted by MCI of the Index Medical College (Indore) on May 8, May 9, May 27 and August 19, the infrastructure of the college was found inadequate. The executive committee of MCI recommended to the Centre that the permission for the admission of 150 students for 2008-09 should not be renewed. The plea of the college to enroll 150 students for academic year 2008-09 was declined by SC.

The court also sought the response of the Centre which had also inspected the college after the MCI's adverse report. Gopal Subramaniam, additional solicitor general said that the central team too had found the infrastructure "woefully inadequate". He added that the Bench rules that no permission could be granted. 

Court order clearly said, "ASG Gopal Subramaniam, appearing for Union of India, stated that inspection was also conducted but the percentage of the teaching staff in various departments and other facilities were inadequate and the petitioner institution cannot be given permission". 

It added, "The writ petitions are accordingly disposed of without prejudice to their rights and to continue to get permission in the next calendar year." 

Anbumani Ramadoss’s Health Ministry openly disobeyed the order of SC. The same day the health ministry wrote to the chairman of Mayank's Welfare Society, saying the college could admit 150 students this year by September 30, the apex court mandated last date for admission. 

The September 26 letter from the ministry, signed by under-secretary N Barik, said, "After careful consideration of MCI inspection reports and central team inspection report, the approval of the central government is granted for renewal of permission for admission of second batch of 150 MBBS students for the academic year 2008-09 at Index Medical College." It seems that health ministry is acting as law in itself, because it granted permission to a college found insufficient by the centre and medical authorities.