Lok Sabha Question No. 281 (STARRED), answered on 2017-08-04
Subject: Treatment in Government Hospitals
Ministry: HEALTH AND FAMILY WELFARE
Asked by: RAVINDRA KUMAR RAY, SANKAR PRASAD DATTA

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA STARRED QUESTION NO. 281 TO BE ANSWERED ON THE 4 TH AUGUST , 2017 TREATMENT IN GOVERNM ENT HOSPITALS

## †*281. DR. RAVINDRA KUMAR RAY: SHRI SANKAR PRASAD DATTA:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a)  whether  a  large  number  of  patients  fail  to  get  treatment  in  Gover hospitals of Delhi in the absence of infrastructural and other facilitie s;
- (b) if so, the details thereof and the steps taken/proposed to be taken for the facilities in Government hospitals of Delhi;
- (c) the number of patients registered for treatment in various Government ho of Delhi including AIIMS alon g with the number of patients who got treatment during the last one year, hospital - wise;
- (d)  whether  the  Government  has  received  proposals  from  various  States financial assistance  for improving  the infrastructural  and other  facilitie respec tive Government hospitals and if so, the details thereof including the allocated during the last three years, State/ UT - wise including Tripura; and
- (e) whether the Government proposes to allocate more funds to the States fo purpose, if so, the details thereof and if not, the reasons therefor?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE ( SHRI JAGAT PRAKASH NADDA )

- (a)to ( e) : A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 281* FOR 4 TH AUGUST , 2017

(a)to ( c) The  number  of  patients  visiting  Central  Government  Hospitals  an Institutions in Delhi including All India Institute Medical Sciences (AIIMS), New Delhi,  Safdarjung  Hospital,  Dr.  Ram  Manohar  Lohia  (RML)  Hospital , Lady Hardinge Medical College (LHMC) and associated Hospitals , National Institute of Tuberculosis  and  Respiratory  Diseases  (NITRD)  and  Vallabhbhai  Patel  Ches Institute  (VPCI), for  treatment  is  much  larger  as  compared  to  their  handli capacity  in  terms  o f  number  of  beds,  manpower  and  other  resources.  Despite availability of huge infrastructure and other services in these Hospitals, waiting  period  for  certain  procedures  due  to  the  ever  increasing  pressu infrastructure  and  available  manpower in  these  hospitals,  which  varies  from Department to Department in these Hospitals. As such, various Clini Departments make their own waiting lists of patients in need of admission t into consideration the condition of patients, urgency of treatmen t required and bed availability on a particular day. However, all the patients registered in OPD are attended to by the doctors on that particular day.

2. The  details  of  number  of  patients  registered  for  treatment  in  the  C Government Hospitals/Insti tutes during 2016 are given below:
3. Expansion of existing/creation of new facilities in a Hospital are an o - going process and are undertaken as per the requirement and availability of resour that pursuit, the Government has undertaken ex ensive development plan in respect of Central Government Hospitals/Institutes.
4. V arious infrastructure related projects have been undertaken in connection with  expansion  of  AIIMS,  New  Delhi  as  well  as  other  Central  Government Hospitals in Delhi, the details of which are as under:

|   S. No. | Name of the Hospital                     | Number of patients registered for treatment during 2016   |
|----------|------------------------------------------|-----------------------------------------------------------|
|        1 | AIIMS, New Delhi *                       | 37,83,438                                                 |
|        2 | Safdarjung Hospital, New Delhi           | 31,07,991                                                 |
|        3 | Dr. RML Hospital, New Delhi              | 21,73,718                                                 |
|        4 | LHMC and Associated Hospitals, New Delhi | 10,87,567                                                 |
|        5 | NITRD, New Delhi*                        | 2,20,740                                                  |
|        6 | VPCI , New Delhi *                       | 1,11,022                                                  |

## (i) AIIMS, New De lhi

## Ongoing/approved projects

( Rs.  in c rore )

| S. No.   | Name of Department/Centre          |   No. of Beds Proposed |    Cost |
|----------|------------------------------------|------------------------|---------|
| 1        | Surgical Block                     |                    200 |  188.34 |
| 2        | Mother & Child Block               |                    450 |  548.14 |
| 3        | Burn & Plastic Surgery             |                    100 |  247.85 |
| 4        | National Cancer Institute, Jhajjar |                    700 | 2035    |
| 5        | New Private Ward                   |                    113 |  100    |
|          | Total                              |                   1563 | 3119.33 |

In addition, 200 bedded National Centre for Ageing in AIIMS, New Delhi with estimated cost of Rs. 167.70 crore has been approved.

## (ii) Dr. RML Hospital

## A pproved and completed project

A  289  bedded  New  Emergency  Care  Building  at  Dr.  RML  Hospital  with estimated cost of Rs. 26.10 crore has become operational in 2015.

## (iii)Safdarjung Hospital

## Approved and ongoing project

Under  Redevelopment  Plan  of Safdarjung  Hospital,  construction  of  500 bedded  Emergency  Building  and  807  bedded  Super  Specialty  Block  has been approved with an estimated cost of Rs. 1333 crore.

## (iv) LHMC and associated Hospitals

## Approved project

Government  has  approved  comprehensive redevelopment  Plan  of  Lady Hardinge Medical College and Associated Hospitals with an estimated co of Rs. 586 crore for additional 570 beds.

5. In  addition to  the  above ,  the  Government has  taken  several  measures to provide tertiary care to the public in t he respective States/region as stated under:

- (a) The Government has approved setting up 6 new AIIMS -viz. (i) AIIMS, Bhopal,  (ii)  AIIMS,  Jodhpur,  (iii)  AIIMS,  Patna,  (iv)  AIIMS,  Raipur, AIIMS,  Rishikesh  and  (vi)  AIIMS,  Bhubaneshwar  under  Pradhan  Mantt ri Swasthya Suraksha Yojana (PMSSY) .
- (b) The Government alsoproposes to  establish  an  additional  14  New  AIIMS under various phases of PMSSY in different parts of the country.
- (c) Further, the proposals were approved and funds released for upgradatio 13 existing Government Medical Colleges/Institutions at a cost of Rs. crore each (Central share Rs. 100 crore and State share Rs. 20 crore) Phase I of PMSSY. Besides, upgradation of 6 existing Government Medical Colleges/Institutes  was  approved  a t  a  cost  of  Rs.  150  crore  each  (Central share-Rs. 125 crore and State share -Rs. 25 crore) under PMSSY Phase II.
- (d) The Government has also approved upgradation of 39 existing Government M edical C ollege s/Institutions  at  an  approved  outlay  of  Rs.  150  c rore  per Institution  (Central  share - Rs.  120  crore  and  State  share -Rs.  30  crore) under  Phase  III  of  PMSSY.  The  upgradation  includes improving  health infrastructure  through  construction  of  Super  Speciality Blocks/Trauma centres , etc. and procurement of medical equipment for existing as well new facilities.
- (e) Under  theNational  Programme  for  Prevention  and  Control  of  Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) ,it is envisaged to support the establishment of 20 State Cancer Institutes (SCIs) (Upto Rs. 120 crore per Institute) and 50 Tertiary Care Cancer Centres (TCCCs) (Upto Rs. 45  crore  per  Institute) in  different  parts  of  the  country f r  strengthening tertiary care  facilities  in  these  areas .    The  Government  has  released  Rs. 858.56 crore to various TCCCs and SCIs in the State s since 2014 - 15.
- (f) Government hasapprovedan amount of Rs. 376.30 crore during 2016 - 17 for strengthening District Hospitals including new constructions/ renovation/setting up of new facilities of various States/UTs during 20 - 17.

6. These initiatives will progressively bring down the patient load on existing Hospitals in the coming years leading to reduction of waiting period substantia y.

(d)to(e): Public  Health  and  hospitals  being  a  State  subject,  the  prim responsibility to provide health care services to the citizens lies with the State/UT Governments. It is the responsibility of the State government to availabi lity of the adequate number of health facilities as per requirement State. However, Under National Health Mission (NHM), support is extended States/UTs  to  strengthen  their  healthcare  system  for  provision  of  acces affordable and quality heal th care to all the citizens based on proposals submit by  the  States  /  UTs  in  their  Programme  Implementation  Plans under  which assistance is  provided  for  infrastructure  strengthening,  capacity  building resource, medical equipments, etc . Approvals are given in accordance with the Gap Analysis, population norms and case load in the facilities of the State as d the National  Programme  Coordination  Committee  ( NPCC  meetings,  within  the resource  envelope  available  for  particular  State/UT.  The PIPs  submitted  by States/UTs and approvals issued in the form of Records of Proceedings (RoPs the States/ UTs including to the State of Tripura are available in public http:// nhm.gov.in/nrhm - in - state/state - programimplementation - plans - pip.html. The amount approved for the hospital strengthening and new constructions/ renova invarious States/UTs is given in Annexure - I & II .

---------------------------------

## Annexure - I

## Statement Showing the State/Uts -wise SPIP Approval under Hospital Stre ngthening (B.4) from the F.Y. 2014-15 to 2016 -17

Rs. In Lakhs

| S.No.                    | State                     | 2014-15   | 2015-16   | 2016-17   |
|--------------------------|---------------------------|-----------|-----------|-----------|
| A. High Focus States     |                           |           |           |           |
| 1                        | Bihar                     | 2821.67   | 4762.53   | 3487.30   |
| 2                        | Chattisgarh               | 4254.90   | 2948.40   | 3524.81   |
| 3                        | Himachal Pradesh          | *0.00     | 1993.04   | 2600.00   |
| 4                        | Jammu & Kashmir           | 11077.03  | 4930.77   | 2705.67   |
| 5                        | Jharkhand                 | 158.00    | *0.00     | 15.00     |
| 6                        | Madhya Pradesh            | 2904.67   | 6310.00   | 12507.19  |
| 7                        | Orissa                    | 12807.70  | 14105.97  | 24964.48  |
| 8                        | Rajasthan                 | 25347.72  | 23471.05  | 14074.91  |
| 9                        | Uttar Pradesh             | 4883.02   | 49049.33  | 10751.39  |
| 10                       | Uttarakhand               | 363.27    | 117.47    | 581.25    |
|                          | Sub Total                 | 64617.98  | 107688.56 | 75212.00  |
| B. NE States             |                           |           |           |           |
| 11                       | Arunachal Pradesh         | 1391.53   | 822.51    | 658.91    |
| 12                       | Assam                     | 7362.07   | 9269.12   | 7944.79   |
| 13                       | Manipur                   | 42.00     | 431.87    | 525.96    |
| 14                       | Meghalaya                 | 1081.24   | 1629.00   | 650.55    |
| 15                       | Mizoram                   | 89.50     | 212.00    | *0.00     |
| 16                       | Nagaland                  | 678.66    | 740.45    | 41.00     |
| 17                       | Sikkim                    | 335.08    | 255.61    | 154.64    |
| 18                       | Tripura                   | 31.00     | 225.00    | 250.00    |
|                          | Sub Total                 | 11011.08  | 13585.56  | 10225.85  |
| C. Non-High Focus States |                           |           |           |           |
| 19                       | Andhra Pradesh            | 7985.75   | *0.00     | 1243.09   |
| 20                       | Goa                       | 54.13     | 15.30     | 4.80      |
| 21                       | Gujarat                   | 1864.80   | *0.00     | *0.00     |
| 22                       | Haryana                   | 567.06    | 577.92    | 46.71     |
| 23                       | Karnataka                 | 9822.61   | 6600.43   | 4658.27   |
| 24                       | Kerala                    | 5073.03   | 4473.00   | 3282.00   |
| 25                       | Maharashtra               | 4752.38   | 4657.73   | 2078.57   |
| 26                       | Punjab                    | 660.00    | 3669.04   | 3000.00   |
| 27                       | Tamil Nadu                | 19865.56  | 11577.35  | 7485.45   |
| 28                       | Telangana                 | 8751.06   | *0.00     | 900.78    |
| 29                       | West Bengal               | 5823.33   | 4112.93   | 767.90    |
|                          | Sub Total                 | 65219.71  | 35683.70  | 23467.57  |
| D. Small States/UTs      |                           |           |           |           |
| 30                       | Andaman & Nicobar Islands | 15.00     | *0.00     | 142.00    |
| 31                       | Chandigarh                | *0.00     | *0.00     | *0.00     |
| 32                       | Dadra & Nagar Haveli      | *0.00     | 10.00     | *0.00     |
| 33                       | Daman & Diu               | 3.24      | 4.56      | 4.56      |
| 34                       | Delhi                     | 6000.00   | 180.00    | 3500.00   |
| 35                       | Lakshadweep               | *0.00     | *0.00     | 3.84      |
| 36                       | Puducherry                | *0.00     | *0.00     | *0.00     |
|                          | Sub Total                 | 6018.24   | 194.56    | 3650.40   |
|                          | Grand Total               | 146867.01 | 157152.38 | 112555.81 |

Note:

1. SPIP -State Programme Implementation Plan.

2. The above data comprises of Hospital Strengtheining -Up -Gradation of CHCs, PHCs, Dist. Hospitals, Strengthening of Districts, Sub Divisional Hospitals, CHCs,  PHCs and Sub Centre Rent and Contingencies.

3. * (0.00) denotes either the proposal not received from State Govt. or if proposed not considered for appr

## Annexure - II

## Statement Showing the State/Uts - wise SPIP Approval under New Constructions/ Renovation and Setting up (B.5) for the F.Y.2014- 15 to 2016 - 17

Rs. In Lakhs

| S.No.                     | State                     | 2014- 15   | 2015- 16   | 2016- 17   |
|---------------------------|---------------------------|------------|------------|------------|
| A. High Focus States      |                           |            |            |            |
| 1                         | Bihar                     | 5251.79    | 569.00     | 8917.99    |
| 2                         | Chattisgarh               | 624.26     | *0.00      | 446.39     |
| 3                         | Himachal Pradesh          | 655.00     | 1728.93    | 1249.11    |
| 4                         | Jammu & Kashmir           | 800.05     | 66.00      | *0.00      |
| 5                         | Jharkhand                 | 3500.00    | 2421.00    | 4847.49    |
| 6                         | Madhya Pradesh            | 2978.30    | 5263.61    | 8004.75    |
| 7                         | Orissa                    | 2280.19    | 2188.93    | 4034.61    |
| 8                         | Rajasthan                 | 4483.59    | 7742.74    | 15639.70   |
| 9                         | Uttar Pradesh             | 133.80     | 5126.99    | 19803.28   |
| 10                        | Uttarakhand               | 1093.77    | 176.95     | 1073.99    |
|                           | Sub Total                 | 21800.75   | 25284.15   | 64017.31   |
| B. NE States              |                           |            |            |            |
| 11                        | Arunachal Pradesh         | 632.00     | 1719.55    | 1132.00    |
| 12                        | Assam                     | 8536.78    | 7702.24    | 5624.81    |
| 13                        | Manipur                   | 908.11     | 332.57     | 1182.60    |
| 14                        | Meghalaya                 | 460.61     | 1055.52    | *0.00      |
| 15                        | Mizoram                   | 54.30      | *0.00      | 2.75       |
| 16                        | Nagaland                  | 3.00       | 25.00      | 77.09      |
| 17                        | Sikkim                    | 10.00      | 221.03     | 6.00       |
| 18                        | Tripura                   | 2130.50    | 233.75     | 760.00     |
|                           | Sub Total                 | 12735.30   | 11289.66   | 8785.25    |
| C. Non- High Focus States |                           |            |            |            |
| 19                        | Andhra Pradesh            | 2646.00    | 10439.50   | *0.00      |
| 20                        | Goa                       | 111.50     | 3.25       | 1.85       |
| 21                        | Gujarat                   | 8512.84    | 7622.84    | 5.14       |
| 22                        | Haryana                   | 338.31     | 303.24     | 190.52     |
| 23                        | Karnataka                 | 710.52     | 1809.00    | 6956.10    |
| 24                        | Kerala                    | 83.17      | 158.50     | 240.64     |
| 25                        | Maharashtra               | 9178.02    | 12782.16   | 7233.08    |
| 26                        | Punjab                    | 183.25     | 150.00     | *0.00      |
| 27                        | Tamil Nadu                | 1816.87    | 3347.99    | 6288.00    |
| 28                        | Telangana                 | 346.00     | 2250.00    | *0.00      |
| 29                        | West Bengal               | 2350.08    | 541.64     | 710.07     |
|                           | Sub Total                 | 26276.56   | 39408.12   | 21625.40   |
| D. Small States/UTs       |                           |            |            |            |
| 30                        | Andaman & Nicobar Islands | 10.00      | 45.00      | 41.60      |
| 31                        | Chandigarh                | *0.00      | *0.00      | *0.00      |
| 32                        | Dadra & Nagar Haveli      | *0.00      | 3.00       | *0.00      |

| 33   | Daman & Diu   | *0.00    | *0.00    | *0.00    |
|------|---------------|----------|----------|----------|
| 34   | Delhi         | 76.50    | 120.00   | *0.00    |
| 35   | Lakshadweep   | *0.00    | *0.00    | *0.00    |
| 36   | Puducherry    | 9.35     | 5.00     | *0.00    |
|      | Sub Total     | 95.85    | 173.00   | 41.60    |
|      | Grand Total   | 60908.46 | 76154.93 | 94469.56 |

Note:

1. SPIP -State Programme Implementation Plan.
2. The above data comprises of New Constructions/ Renovation and Setting up -CHCs, PHCs, SHCs/Sub Centres, Setting up Infrastructure wing for Civil works, Govt. Dispensaries/ others renovations and Construction of BHO, Facility improvement, ci vil work, BemOC and CemOC centres, Major civil works for operationalization of FRUS, Major civil works for operationalization of 24 hour services at PHCs, Civil Works for Operationalising Infection Management & Environment Plan at health facilities, Infrastructure of Training Institutions, SDH, DH and Civil work of DEIC (RBSK).
3. * (0.00) denotes either the proposal not received from State Govt. or if proposed not considered for approval.