Lok Sabha Question No. 627 (UNSTARRED), answered on 2018-07-20
Subject: Healthcare Facilities
Ministry: HEALTH AND FAMILY WELFARE
Asked by: CHANDRA PRAKASH JOSHI, RAMCHARAN BOHARA, KANWAR SINGH TANWAR, RAMDAS CHANDRABHANJI TADAS, NARANBHAI KACHHADIA, ARVIND GANPAT SAWANT, BHARAT SINGH, ANIRUDHAN SAMPATH

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 627 TO BE ANSWERED ON 20 th JULY, 2018

## HEALTHCARE FACILITIE S

## 627. SHRI CHANDRA PRAKASH JOSHI:

SHRI RAM CHARAN BOHRA:

SHRI KANWAR SINGH TANWAR:

SHRI RAMDAS C. TADAS:

SHRI NARANBHAI KACHHADIYA:

SHRI ARVIND SAWANT:

SHRI BHARAT SINGH:

DR. A. SAMPATH:

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

- (a) whether people in the rural areas have minimal access to healthcare facilities and if so, the details thereof along with the present status of same in the country, State/ UT - wise;
- (b) whether various Government hospitals in rural areas are facing problem of infrastructure and shortage of doctors and o ther professionals and if so, the details thereof and the reasons therefor;
- (c)  whether  the  Government  is considering  any  mechanism/scheme/plan  to train  more  health professionals and depute them in rural areas and if so, the details ther of; and
- (d) the steps taken/proposed to be tak n by the Government to improve/ provide better health care services in rural areas of the country?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

(SHRI ASHWINI KUMAR CHOUBEY)

- (a): The National Rural Health Mission (NRHM) was launched in 2005 to provide universal access to equitable, affordable and quality health care which is accountable, and at the responsive to the needs of the people, especially those who live in the ru ral areas of the country. As  per  Rural  Health  Statistics  (RHS)  2017,  the  health  care  infrastructure  has  increas launch of NRHM in April 2005. The number of public health facilities in rural areas  Sta -wise during 2005 and 2017 is at Annexure.
- (b): Public health and hospitals being a State subject. Shortage of doctors and Infrastru public  health  sector  varies  from  State  to  State  depending  upon  their  policies  and However, under the National Health Mission (NHM), financial and te chnical support is provided to  States/UTs  to  strengthen  their  healthcare  systems  including  support  for  new  constr renovation/upgradation  of  existing  facilities  and  also  for  engagement  of  doctors  and professionals on contractual basis, based on the requirements posed by them in their Programme Implementation Plans (PIPs) within their overall resource envelope.

(c) : The Government has taken various steps to train more health professionals and depu them in rural areas, these efforts includ e:

- I. 50%  reservation  in  Post  Graduate  Diploma  Courses  for  Medical  Officers  in  the Government service who have served for at least three years in remote and diffic areas.
- II. Incentive at the rate of 10% of the marks obtained for each year in service in remo e or difficult areas up to the maximum of 30% of the marks obtained in the entrance test admissions in Post Graduate Medical Courses.
- III. Support  is  provided  to  States/UTs  for  hard  area  allowance  to  specialist  doctors serving in rural and remote area s and for their residential quarters so that they find attractive to serve in public health facilities in such areas.
- IV. The  States  are  encouraged  to  adopt  flexible  norms  for  engaging  specialists  at  p health facilities. These include various mechanis ms for 'contacting in' and 'contracting out'  of  specialist  services,  methods  of  engaging  specialists  outside  the  government system for service delivery at public facilities and the mechanism to include requ these  in  the  state  Program  Implementation Plans  (PIP)  under  the  National  Health Mission.

(d): As  stated  above,  public  health  and  hospitals  being  a  State  subject,  the  pr responsibility to improve better health care services in rural areas lies with the resp Governments.    However, under  the  National  Health  Mission  (NHM),  technical  and  financial support is provided to States/UTs to strengthen and improve their healthcare system based on the proposals made by the States/UTs in their Programme Implementation Plans (PIPs) within t overall resource envelope.

The  Government  has  taken  various  steps  to  to  improve/  provide  better  health  c services in rural areas. These efforts include -

- I. The  ratio  of  teachers  to  students  has  been  revised  from  1:1  to  1:2  for  all  M disciplines and 1:1 to 1:3 in subjects of Anaesthesiology, Forensic Medic Radiotherapy,  Medical  Oncology,  Surgical  Oncology  and  Psychiatry  in  all  medica colleges across t he country. Further, teacher: student ratio in public funded Governme Medical Colleges for Professor has been increased from 1:2 to 1:3 in all clinical and for Associate Professor from 1:1 to 1:2 if the Associate Professor is a unit he w ould result in increase in number of specialists in the country.
- II. Diplomate of National Board (DNB) qualification has been recognized for appointmen as faculty to take care of shortage of faculty.
- III. Enhancement of maximum intake capacity at MBBS level from 1 50 to 250.
- IV. Enhancement of age limit for appointment/ extension/ re - employment  against  posts  of teachers/dean/principal/ director in medical colleges from 65 - 70 years.
- V. relaxation in the norms of setting up of Medical College in terms of requirement fo , faculty, staff, bed/bed strength and other infrastructure.
- VI. Strengthening/upgradation of State Government Medical Colleges for starting new P courses/Increase of PG seats.
- VII. Establishment of New Medical Colleges by upgrading district/referral pre ferably in underserved districts of the country.

hospit

- VIII. Strengthening/ upgradation of existing State Government/Central Government Medica Colleges to increase MBBS seats.

## NUMBER OF SUB -CENTRES, PHCs & CHCs FUNCTIONING

|            |                      | 2005       | 2005   | 2005   | 2017       | 2017   | 2017   |
|------------|----------------------|------------|--------|--------|------------|--------|--------|
| S. No.     | State/UT             | Sub Centre | PHCs   | CHCs   | Sub Centre | PHCs   | CHCs   |
| 1          | Andhra Pradesh       | 12522      | 1570   | 164    | 7458       | 1147   | 193    |
| 2          | Arunachal Pradesh    | 379        | 85     | 31     | 312        | 143    | 63     |
| 3          | Assam                | 5109       | 610    | 100    | 4621       | 1014   | 158    |
| 4          | Bihar                | 10337      | 1648   | 101    | 9949       | 1899   | 150    |
| 5          | Chhattisgarh         | 3818       | 517    | 116    | 5186       | 785    | 169    |
| 6          | Goa                  | 172        | 19     | 5      | 214        | 24     | 4      |
| 7          | Gujarat              | 7274       | 1070   | 272    | 9082       | 1392   | 363    |
| 8          | Haryana              | 2433       | 408    | 72     | 2589       | 366    | 112    |
| 9          | Himachal Pradesh     | 2068       | 439    | 66     | 2083       | 538    | 89     |
| 10         | Jammu & Kashmir      | 1879       | 334    | 70     | 2967       | 637    | 84     |
| 11         | Jharkhand            | 4462       | 561    | 47     | 3848       | 297    | 188    |
| 12         | Karnataka            | 8143       | 1681   | 254    | 9381       | 2359   | 206    |
| 13         | Kerala               | 5094       | 911    | 106    | 5380       | 849    | 232    |
| 14         | Madhya Pradesh       | 8874       | 1192   | 229    | 9192       | 1171   | 309    |
| 15         | Maharashtra          | 10453      | 1780   | 382    | 10580      | 1814   | 360    |
| 16         | Manipur              | 420        | 72     | 16     | 421        | 85     | 17     |
| 17         | Meghalaya            | 401        | 101    | 24     | 436        | 109    | 27     |
| 18         | Mizoram              | 366        | 57     | 9      | 370        | 57     | 9      |
| 19         | Nagaland             | 394        | 87     | 21     | 396        | 126    | 21     |
| 20         | Odisha               | 5927       | 1282   | 231    | 6688       | 1280   | 370    |
| 21         | Punjab               | 2858       | 484    | 116    | 2950       | 432    | 151    |
| 22         | Rajasthan            | 10512      | 1713   | 326    | 14406      | 2079   | 579    |
| 23         | Sikkim               | 147        | 24     | 4      | 147        | 24     | 2      |
| 24         | Tamil Nadu           | 8682       | 1380   | 35     | 8712       | 1362   | 385    |
| 25         | Telangana            | -          | -      | -      | 4797       | 689    | 114    |
| 26         | Tripura              | 539        | 73     | 10     | 987        | 93     | 21     |
| 27         | Uttarakhand          | 1576       | 225    | 44     | 1847       | 257    | 60     |
| 28         | Uttar Pradesh        | 20521      | 3660   | 386    | 20521      | 3621   | 822    |
| 29         | West Bengal          | 10356      | 1173   | 95     | 10369      | 914    | 349    |
| 30         | A& N Islands         | 107        | 20     | 4      | 123        | 22     | 4      |
| 31         | Chandigarh           | 13         | 0      | 1      | 17         | 3      | 2      |
| 32         | Dadra & Nagar Haveli | 38         | 6      | 1      | 71         | 9      | 2      |
| 33         | Daman & Diu          | 21         | 3      | 1      | 26         | 4      | 2      |
| 34         | Delhi                | 41         | 8      | 0      | 10         | 5      | 0      |
| 35         | Lakshadweep          | 14         | 4      | 3      | 14         | 4      | 3      |
| 36         | Puducherry           | 76         | 39     | 4      | 81         | 40     | 4      |
| All India/ | Total                | 146026     | 23236  | 3346   | 156231     | 25650  | 5624   |

Note: Telangaana came to existence in 2014 after bifurcation of Andhra Pradesh