Lok Sabha Question No. 3295 (UNSTARRED), answered on 2019-07-12
Subject: Doctor-Patient Ratio
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Kunwar Danish Ali

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

## LOK SABHA UNSTARRED QUESTION NO. 3295 TO BE ANSWERED ON 12 TH JULY, 2019

## DOCTOR - PATIENT RATIO

## 3295. SHRI KUNWAR DANISH ALI:

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

(a) the number of Government hospitals in the country and the number of doctors appointed in each hospital especially in Uttar Pradesh;

(b) whether it is a fact that a number of patient/children had died due to lac k ofdoctors and other facilities in Government hospitals in the country;

(c) if so, the details thereof and the reasons therefor;

(d) the number of patient/children died during the last five years in the country, especially in Uttar Pradesh; and

(e)the corrective steps being taken by the Government in this regard?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

( a) As per National Health Profile 2018, total 23582 Government Hospitals are in the country out of which 4635 hospitals are in Uttar Pradesh. State/UT wise details of Government hosp providing In Patient Care (IPD) services is given at Annexure -I. The data in respect of number of  doctors  appointed  in  each  hospital  is  not  maintaine d  centrally.  However,  as  per  National Health  Profile  2018,  there  are  a  total  10,41,395  allopathic  doctors  registered  with Council of India/State Medical Council up to 2017 out of which 71,480 doctors are regis with  State  Medical  Council  of  Utt ar  Pradesh.  Details  of  State/UT  wise  number  of  doctors  is given at Annexure -II.

(b) to (e) Public health and hospitals being a State subject, the primary responsibility healthcare facilities to its citizens lies with the State Governments. Under the Na ional Health Mission (NHM), financial and technical support is provided to States/UTs to strengthen healthcare systems including support for insourcing or engagement of doctors, specialist and other staff on contractual basis and to improve other facilities in Government hospitals as per Indian Public Health Standards (IPHS),  based on the requirements posed by the States/U their Programme Implementation Plans (PIPs) within their overall resource envelope.

However, Government has taken various remedial steps to increase number of doctor and Specialists in the country. These steps include:

(i)  The  ratio  of  teachers  to  students  has  been  revised  from  1:1  to  1:2  for  all disciplines and 1:1 to 1:3 in subjects of Anaesthesi ology, Forensic Medicine, Radiotherapy,

Medical  Oncology,  Surgical  Oncology  and  Psychiatry  in  all  medical  colleges  across country. Further, teacher: student ratio in public funded Government Medical College Professor in MD/MS courses has been incr eased from 1:2 to 1:3 in all clinical subjects and for Associate Prof. from 1:1 to 1:2 if the Associate Prof. is a unit head.

(ii) Strengthening/upgradation of State Government Medical Colleges for starting new courses/Increase of PG seats.

(iii) Establishment  of  New  Medical  Colleges  by  upgrading  district/referral  hospit preferably in underserved districts of the country.

(iv) Strengthening/ upgradation of existing State Government/Central Government Medic Colleges to increase MBBS seats etc.

(v) Also, in order to encourage doctors to work in remote and difficult areas, the Council of India, with the previous approval of Central Government, has amended the Graduate Medical Education Regulations, 2000 to provide:

- 50% reservation in Post Graduate Diploma Courses for Medical Officers in th Government service, who have served for at least three years in remote and diff areas; and
- Incentive at the rate of 10% the marks obtained for each year in service in r or difficult areas as upto the maximum of 30% of the marks obtained in the entranc for admissions in Post Graduate Medical Courses.

Further, Under NHM, States are also encouraged to adopt flexible norms for engagi specialists for public health fac ilities. These include various mechanisms for 'contracting in' and  'contracting  out'  of  specialist  services,  methods  of  engaging  specialists  outside  the government system for service delivery at public facilities.

States have also been allowed to offer n egotiable salaries to attract Specialists includin flexibility in strategies such as 'You quote, we pay".  Financial support is also pr States for providing performance - based incentives, providing accommodation and transport facilities in rural a nd remote areas, sponsoring training programmes, etc to engaged human resources  to  address  the  issue  of  shortage  of  doctors  and  specialists  in  the  publi facilities. Support is also provided to States/UTs in term of hard area allowance for t doctors who serve in rural and remote areas as well as for residential quarters for the

Also, States are advised to put in place transparent policies of posting and tran ensure rational deployment of doctors. As the posts required for health facilities are filled up by respective State/UT Governments, they are impressed upon from time to time to fill u vacant posts.

The information in respect of number of patients/children died due to lack of docto other health facilities in Government hospitals in the country is not maintained centrally.

State/UT wise Number of Government Hospitals and Beds in Rural & Urban Areas In India (Provisional)

| S No   |                    | Rural Hospitals (Govt.)   | Rural Hospitals (Govt.)   | Urban Hospitals (Govt.)   | Urban Hospitals (Govt.)   | Total Hospitals (Govt.)   | Total Hospitals (Govt.)   | Provisional/ Projected Population as on   | Average Population Served Per   | Average Population Served Per   | Reference Period    |
|--------|--------------------|---------------------------|---------------------------|---------------------------|---------------------------|---------------------------|---------------------------|-------------------------------------------|---------------------------------|---------------------------------|---------------------|
| S No   | State/UT/Division  | No.                       | Beds                      | No.                       | Beds                      | No.                       | Beds                      | reference period in (000#)                | Govt.                           | Govt. Hospital                  |                     |
| S No   |                    |                           |                           |                           |                           |                           |                           |                                           | Hospital                        | Beds                            |                     |
|        | India              | 19810                     | 279588                    | 3772                      | 431173                    | 23582                     | 710761                    | 1310944                                   | 55591                           | 1844                            |                     |
| 1      | Andhra Pradesh     | 193                       | 6480                      | 65                        | 16658                     | 258                       | 23138                     | 88361                                     | 342484                          | 3819                            | 1.1.2017            |
| 2      | Arunachal Pradesh* | 208                       | 2136                      | 10                        | 268                       | 218                       | 2404                      | 1327                                      | 6087                            | 552                             | 31.12.2017          |
| 3      | Assam *            | 1176                      | 10944                     | 50                        | 6198                      | 1226                      | 17142                     | 32810                                     | 26762                           | 1914                            | 31.12.2017          |
| 4      | Bihar              | 930                       | 6083                      | 103                       | 5936                      | 1033                      | 12019                     | 103908                                    | 100589                          | 8645                            | 31.12.2016          |
| 5      | Chhattisgarh       | 169                       | 5070                      | 45                        | 4342                      | 214                       | 9412                      | 24909                                     | 116397                          | 2647                            | 1.1.2016            |
| 6      | Goa*               | 17                        | 1405                      | 25                        | 1608                      | 42                        | 3013                      | 2023                                      | 48167                           | 671                             | 31.12.2017          |
| 7      | Gujarat            | 364                       | 11715                     | 122                       | 20565                     | 486                       | 32280                     | 62825                                     | 129270                          | 1946                            | 31.12.2016          |
| 8      | Haryana*           | 609                       | 6690                      | 59                        | 4550                      | 668                       | 11240                     | 28057                                     | 42001                           | 2496                            | 31.12.2016          |
| 9      | Himachal Pradesh*  | 705                       | 5665                      | 96                        | 6734                      | 801                       | 12399                     | 7151                                      | 8928                            | 577                             | 31.12.2017          |
| 10     | Jammu& Kashmir     | 56                        | 7234                      | 76                        | 4417                      | 132                       | 11651                     | 12419                                     | 94083                           | 1066                            | 30.12.2016          |
| 11     | Jharkhand          | 519                       | 5842                      | 36                        | 4942                      | 555                       | 10784                     | 33203                                     | 59825                           | 3079                            | 31.12.2015          |
| 12     | Karnataka*         | 2471                      | 21072                     | 374                       | 49093                     | 2844                      | 69865                     | 68415                                     | 24056                           | 979                             | 31.12.2017          |
| 13     | Kerala             | 981                       | 16865                     | 299                       | 21139                     | 1280                      | 38004                     | 35677                                     | 27873                           | 939                             | 1.1.2017            |
| 14     | Madhya Pradesh     | 334                       | 10020                     | 117                       | 18819                     | 451                       | 28839                     | 76745                                     | 170166                          | 2661                            | 1.1.2016            |
| 15     | Maharashtra        | 273                       | 12398                     | 438                       | 39048                     | 711                       | 51446                     | 118652                                    | 166880                          | 2306                            | 31.12.2015          |
| 16     | Manipur            | 23                        | 730                       | 7                         | 697                       | 30                        | 1427                      | 2506                                      | 83533                           | 1756                            | 1.1.2014            |
| 17     | Meghalaya*         | 143                       | 1970                      | 14                        | 2487                      | 157                       | 4457                      | 2803                                      | 17854                           | 629                             | 31.12.2017          |
| 18     | Mizoram*           | 56                        | 604                       | 34                        | 1393                      | 90                        | 1997                      | 1074                                      | 11933                           | 538                             | 31.12.2017          |
| 19     | Nagaland           | 21                        | 630                       | 15                        | 1250                      | 36                        | 1880                      | 2354                                      | 65389                           | 1252                            | 31.12.2015          |
| 20     | Odisha*            | 1655                      | 6339                      | 149                       | 12180                     | 1804                      | 18519                     | 42808                                     | 23729                           | 2312                            | 31.12.2017          |
| 21     | Punjab*            | 510                       | 5805                      | 172                       | 12128                     | 682                       | 17933                     | 29372                                     | 43067                           | 1638                            | 31.12.2017          |
| 22     | Rajasthan          | 602                       | 21088                     | 150                       | 10760                     | 752                       | 31848                     | 72948                                     | 97005                           | 2291                            | 31.12.2016          |
| 23     | Sikkim*            | 24                        | 260                       | 9                         | 1300                      | 33                        | 1560                      | 653                                       | 19788                           | 419                             | 31.12.2017          |
| 24     | Tamil Nadu*        | 692                       | 40179                     | 525                       | 37353                     | 1217                      | 77532                     | 69730                                     | 57297                           | 899                             | 31.12.2017          |
| 25     | Telangana*         | 802                       | 7668                      | 61                        | 13315                     | 863                       | 20983                     | 37823                                     | 43827                           | 1803                            | 31.12.2017          |
| 26     | Tripura*           | 99                        | 1140                      | 56                        | 3277                      | 155                       | 4417                      | 3867                                      | 24948                           | 875                             | 31.12.2017          |
| 27     | Uttar Pradesh*     | 4442                      | 39104                     | 193                       | 37156                     | 4635                      | 76260                     | 221469                                    | 47782                           | 2904                            | 31.12.2017          |
| 28     | Uttarakhand        | 410                       | 3284                      | 50                        | 5228                      | 460                       | 8512                      | 10499                                     | 22824                           | 1233                            | 31.12.2015          |
| 29     | West Bengal        | 1272                      | 19684                     | 294                       | 58882                     | 1566                      | 78566                     | 91920                                     | 58697                           | 1170                            | 1.1.2015            |
| 30     | A&N Island         | 27                        | 575                       | 3                         | 500                       | 30                        | 1075                      | 551                                       | 18367                           | 513                             | 31.12.2016          |
| 31 32  | Chandigarh         | 0                         | 0                         | 4                         | 778                       | 4                         | 778                       | 1780                                      | 445000                          | 2288                            | 31.12.2016          |
|        | D&N Haveli*        | 10                        | 273                       | 1                         | 316                       | 11                        | 589                       | 437                                       | 39727                           | 742                             | 31.12.2017          |
| 33     | Daman& Diu         |                           |                           |                           | 0                         |                           |                           |                                           | 63400                           |                                 |                     |
| 34     | Delhi              | 5 0                       | 240 0                     | 0 109                     | 24383                     | 5 109                     | 240 24383                 | 317 20092                                 | 184331                          | 1321 824                        | 31.12.2015 1.1.2015 |
| 35     | Lakshadweep        | 9                         | 300                       | 0                         | 0                         | 9                         | 300                       | 79                                        | 8778                            | 263                             | 1.1.2016            |

Source:

Directorate General of State Health Services

Notes:

Government hospitals includes central government, state government and local govt. bodies

#            Projected population is taken from Report of the Technical Group on Population Projections May 2006,

National Commission on

*            States/Uts provided information for the year 2017 and PHCs are also included in the number of hopsitals.

Population,Registrar General of India

States/UTs  wise  Number  of  Doctors  Possessing  Recognised Medical, Qualifications  (Under  I.M.C Act)  Registered  With  State  Medical  Councils/Medical  Council  of  India  from  the  year  upto  2010 to 2017.

| S. No.   | State/UT          |   Upto 2010 |   2011 |   2012 | 2013   | 2014   | 2015   | 2016   | 2017 (Prov.)   |   Total up to 2017 |
|----------|-------------------|-------------|--------|--------|--------|--------|--------|--------|----------------|--------------------|
| 1        | Andhra Pradesh    |       66109 |   4370 |   4498 | 5737   | 5415   | NR     | NR     | NR             |              86129 |
| 2        | Arunachal Pradesh |         334 |     80 |     12 | 55     | 29     | 108    | 145    | 77             |                840 |
| 3        | Assam             |       19147 |    561 |    487 | 529    | 611    | 564    | 555    | 78             |              22532 |
| 4        | Bihar             |       37368 |    969 |    464 | 429    | 813    | NR     | NR     | NR             |              40043 |
| 5        | Chhattisgarh      |        3224 |    882 |    595 | 556    | 812    | 370    | 145    | 331            |               6915 |
| 6        | Delhi             |        6748 |   1006 |    946 | 1073   | 1713   | 419    | 2549   | 1722           |              16176 |
| 7        | Goa               |        2828 |    119 |    136 | 132    | NR     | 103    | 18     | 31             |               3367 |
| 8        | Gujarat           |       47231 |   1795 |   2197 | 2153   | NR     | 578    | NR     | NR             |              53954 |
| 9        | Haryana           |        5356 |    361 |      0 | NR     | NR     | NR     | NR     | NR             |               5717 |
| 10       | Himachal Pradesh  |         913 |    310 |    459 | 296    | 276    | 363    | 232    | NR             |               2849 |
| 11       | Jammu& Kashmir    |       11360 |    635 |    471 | 473    | 67     | 495    | 437    | 388            |              14326 |
| 12       | Jharkhand         |        3245 |    490 |    355 | 283    | 45     | 285    | 238    | 152            |               5093 |
| 13       | Karnataka         |       87734 |   3727 |   4207 | 4772   | 833    | NR     | NR     | 3521           |             104794 |
| 14       | Madhya Pradesh    |       26669 |    947 |   1338 | 1298   | 1409   | 1417   | 1269   | NR             |              34347 |
| 15       | Maharashtra       |      138303 |   3157 |   3433 | 3682   | 4938   | NR     | NR     | NR             |             153513 |
| 17       | MCI               |       37300 |   3730 |   4864 | 5603   | 1169   | NR     | NR     | NR             |              52666 |
| 16       | Nagaland          |           0 |      0 |      0 | 0      | 0      | 751    | 50     | NR             |                801 |
| 18       | Odisha            |       16786 |    460 |    380 | 719    | 2402   | 934    | NR     | NR             |              21681 |
| 19       | Punjab            |       39291 |   1128 |   1083 | 1234   | 1270   | 676    | NR     | NR             |              44682 |
| 20       | Rajasthan         |       28797 |   1146 |   1442 | 1468   | 1963   | 2040   | 1821   | 1882           |              40559 |
| 21       | Sikkim            |         608 |     69 |     74 | 73     | NR     | 69     | NR     | NR             |                893 |
| 22       | Tamil Nadu        |       86822 |   3476 |   4182 | 9218   | 5064   | 5088   | 7997   | 4552           |             126399 |
| 23       | Kerala            |       40007 |   2008 |   1703 | 1482   | 2500   | 3363   | 3355   | 833            |              55251 |
| 24       | Uttar Pradesh     |       58168 |   2081 |   2247 | 2253   | 594    | 840    | 3025   | 2272           |              71480 |
| 25       | Uttarakhand       |        3394 |    307 |    527 | 169    | 660    | 748    | 600    | 655            |               7060 |
| 26       | West Bengal       |       59264 |   1230 |    917 | 1419   | 953    | 1211   | 492    | 1488           |              66974 |
| 27       | Telengana         |           0 |      0 |      0 | 0      | 0      | 0      | 2354   | 0              |               2354 |
|          | Total             |      827006 |  35044 |  37017 | 45106  | 33536  | 20422  | 25282  | 17982          |            1041395 |

Source: Medical Council of India

Note:    N R: Not reported by the State Medical Council