Lok Sabha Question No. 164 (STARRED), answered on 2019-11-29
Subject: Shortage of Doctors/Nurses
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Bhartruhari Mahtab, Rahul Ramesh Shewale

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

## LOK SABHA STARRED QUESTION NO. 164 TO BE ANSWERED ON THE 29 TH NOVEMBER , 2019 SHORTAGE OF DOCTORS/ NURSES

## *164. SHRI BHARTRUHARI MAHTAB: SHRI RAHUL RAMESH SHEWALE:

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

- (a)  whether  the  shortage  of  doctors/  nurses  and  the  number  of  patients increased in Central Government Hospitals in Delhi, particularly in the Kalawati Saran Children's Hospital during each of the last three years and the current year;
- (b)  if  so,  the  details  thereof,  hospital  and  cadre - wise  along  with  the  reasons therefor;
- (c) whether the Government has conducted any study/enquiry in this reg ard;
- (d) if so, the details and the outcome of such study/enquiry; and
- (e) the steps taken by the Government to bridge the gap between the sanct and  actual  strength  of  doctors  and  nurses  in  the  said  hospitals  along  w progress made in this regard so far?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE (DR. HARSH VARDHAN)

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

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 164* FOR 29 TH NOVEMBER , 2019

(a) &(b) The sanctioned strength, incumbency status as well as the vacancy p of  doctors  &  nurses  in  the  Central  Government  Hospitals  in  Delhi,  na Safdarjung  Hospital  (SJH)  &  Vardhman  Mahavir  Medical  College  (VMMC),  Dr. Ram Manohar Lohia Hospital & A tal Bihari Vajpayee Institute of Medical Scienc (RML  &  ABVIMS)  and  Lady  H ardinge  Medical  College  (LHMC) and  Kalawati Saran  Children  Hospital  (KSCH)  during  last  three  years  and  current  year Annexure - I and II . Further, the number of patients who attended the In Patient Department (IPD) as well as Out Patient Department (OPD) in these hospitals d last three years and current year is at Anneuxre - III .

A total of 2 23 number of posts of Assistant Professor have been created s 2016 in the ab ove referred Hospitals to ensure better care of patients .Further, in KSCH  there  is  no  shortage/vacancy  in  the  sub - cadres  of General  Duty  Medical Officers ( GDMOs ) /Teaching& Non - Teaching Specialist as on date. The details o sanctioned and filled up positio ns in respect of doctors and nurses in KSCH areat Annexure - IV .

(c)  &  (d)  As  per  available  information,  no  such  specific  study  with  re shortage of doctors & nurses in Central Government Hospitals in Delhi has conducted by the Government. Howev er, the positions with respect to the shorta of  doctors/nurses  are  being  reviewed  from  time  to  time  by  the  Government necessary action for creation/recruitment of posts are undertaken as per requ

(e) The Government has taken various steps t o increase availability of doctors & nursing officers in these hospitals, as stated under:

- (i) Every year on the basis of vacancies projected by the Ministry of Heal Family  Welfare,  Union  Public  Service  Commission  conducts  combined Medical Officer s Service Examination for recruitment of Medical Officers GDMO sub- cadre of Central Health Service. The Commission also conduct interviews for recruitment of Specialist doctors in Teaching, Non - Teaching and Public Health sub - cadre of C entral H ealth Ser vice (CHS) .
- (ii)Pending recommendations from Union Public Service Commission ( UPSC ) , concerned units are permitted to make contractual appointment agains vacant posts, as a stop gap arrangement, in public interest.
- (iii) To fill up the vacancies of nurses in three Central Government Hospita SJH, Dr. RML Hospital and LHMC & Associated Hospitals, examinations for appointment of Nurses on regular basis as per recruitment rules ar conducted  from  time  to  time. Examinations  were  conducted  in  February, 2019 and September, 2019 to fill up the vacant posts of Nursing Offic Central Government Hospitals viz. Safdarjung, Dr. RML and Lady Harding Medical  College  &  Associated  Hospitals. Further,  the  hospitals  have  be en permitted to make contractual appointment against the regular vacant po nurses, as a stop gap arrangement, in public interest.
- (iv) Diplomate  of  National  Board  (DNB)  qualification  has been  recognized appointment as faculty to take care of sh ortage.
- (v) Starting of Bachelor of Medicine, Bachelor of Surgery ( MBBS )Course with intake of 100 students in ABV IMS , RML Hospital.
- (vi) Strengthening/up - gradation  of  Central  Government  Medical  Colleges  & Institutes  for  starting  new  P ost G raduate cour ses/Increase  of  P ost G raduate seats.
- (vii) Establishment/Upgradation  of  State  Government  Medical  Colleges  fo starting new PG courses/increase PG seats.
- (vii i ) Strengthening/ up - gradation of existing State Government/Central Government Medical Colleges t o increase MBBS seats.
- (ix) Establishment  of  new  Medical  Colleges  by  upgrading  district/refe hospitals preferably in underserved districts of the country.
- ( x) The ratio of teachers to students has been revised from 1:1 to 1:2 Doctor of Medicine ( MD ) /Master of Science ( MS )disciplines and 1:1 to 1:3  in  subjects  of  Anaesthesiology,  Forensic  Medicine,  Radiother Medical  Oncology,  Surgical  Oncology  and  Psychiatry  in  all  medic colleges across the country. Further, teacher:student ratio in publi c funded Government Medical Colleges for Professor has been increased from 1 to 1:3 in all clinical subjects and for Associate Professor from 1:1 the Associate Professor is a unit head. This would result in incr number of PG seats in the country.
- ( xi) Enhancement of maximum intake capacity at MBBS le vel from 150 to 250.

Further,  a  number  of  measures/steps  have  been  taken,  in  recent  pas Government to retain the doctors in Government by making the service attract the sehealth profession alsas per following details:

- (i) The  superannuation  age  of  CHS  doctors  and  dental  doctors  workin under the Ministry of Health and Family Welfare has been enhanced 65 years.
- (ii) Enhancement  of  age  limit  for  appointment/extension/re - employme nt against posts of teachers/Dean/Principal/Directors in Medical Col upto 70 years.
- (iii)Introduction  of  time - bound  promotion  for  doctors  under  Dynamic Assured  Career  Progression  (DACP)  Scheme,  without  linkage  to vacancies, upto Senior Administrative Gra de (SAG) level,
- (i v) The benefit of Non - Functional Up - gradation (NFU) has been extended to CHS doctors upto Higher Administrative Grade
- (v) The duration of study leave to pursue higher studies/research wor been increased from 24 months to 36 months for CHS doctors
- (vi ) The  Ministry  has  started  Foundation  Training  Programme  (FTP)  fo newly  recruited  General  Duty  Medical  Officers  in  Central  Heal Service,  to  equip  theme  professionally  to  handle  patient  care  s more effectively.
- (vi i ) Doctors are encouraged to attend international seminars, conferences health sector to increase their professional capabilities and fo their career advancement.
- (vi i i) In addition to Annual Allowance, all CHS doctors are entitled to -Practicing Allowance (NPA) @ 20% of their basic pay subject to the condition  that  the  sum  of  basic  pay  and  NPA  does  not  exceed  R 2,37,500 which is the average of the apex level pay and pay of Ca Secretary.

## Annexure -I

## Incumbency Position of Doctors in Central Government Hospitals  in Delhi from 2016 onwa

| Year   | Sub - cadre                  | Safdarjung Vardhman Medical College   | Safdarjung Vardhman Medical College   | Hospital Mahavira   | & Atal Bihari Institute Sciences & Manohar Lohia   | & Atal Bihari Institute Sciences & Manohar Lohia   | Vajpayee of Medical Dr Ram Hospital, Lady College & Smt. Kalawati Children's   | Vajpayee of Medical Dr Ram Hospital, Lady College & Smt. Kalawati Children's   | Hardinge Medical Associated Sucheta Kriplani Saran Hospital   | Hardinge Medical Associated Sucheta Kriplani Saran Hospital   |
|--------|------------------------------|---------------------------------------|---------------------------------------|---------------------|----------------------------------------------------|----------------------------------------------------|--------------------------------------------------------------------------------|--------------------------------------------------------------------------------|---------------------------------------------------------------|---------------------------------------------------------------|
|        |                              | Sanctioned                            | Filled                                | Vacant              | Sanctioned                                         | Filled                                             | Vacant                                                                         | Sanctioned                                                                     | Filled                                                        | Vacant                                                        |
| 2016   | General Duty Medical Officer | 73                                    | 65                                    | 08                  | 67                                                 | 51                                                 | 16                                                                             | 14                                                                             | 14                                                            | 00                                                            |
| 2016   | Teaching                     | 183                                   | 146                                   | 37                  | 150                                                | 105                                                | 45                                                                             | 294                                                                            | 233                                                           | 61                                                            |
| 2016   | Non - Teaching               | 134                                   | 139                                   | +5                  | 82                                                 | 91                                                 | +9                                                                             | 07                                                                             | 07                                                            | 00                                                            |
|        | Total                        | 390                                   | 350                                   | 40                  | 299                                                | 247                                                | 52                                                                             | 315                                                                            | 254                                                           | 61                                                            |
| 2017   | General Duty Medical Officer | 73                                    | 65                                    | 08                  | 67                                                 | 58                                                 | 09                                                                             | 14                                                                             | 14                                                            | 00                                                            |
| 2017   | Teaching                     | 372                                   | 167                                   | 205                 | 157                                                | 116                                                | 41                                                                             | 294                                                                            | 236                                                           | 58                                                            |
| 2017   | Non - Teaching               | 134                                   | 140                                   | +06                 | 71                                                 | 77                                                 | +06                                                                            | 07                                                                             | 08                                                            | +01                                                           |
|        | Total                        | 579                                   | 372                                   | 207                 | 295                                                | 251                                                | 44                                                                             | 315                                                                            | 258                                                           | 57                                                            |
| 2018   | General Duty Medical Officer | 73                                    | 73                                    | 00                  | 67                                                 | 63                                                 | 04                                                                             | 14                                                                             | 14                                                            | 00                                                            |
|        | Teaching                     | 372                                   | 230                                   | 142                 | 161                                                | 136                                                | 25                                                                             | 300                                                                            | 241                                                           | 59                                                            |
|        | Non - Teaching               | 134                                   | 142                                   | +08                 | 71                                                 | 77                                                 | +06                                                                            | 07                                                                             | 08                                                            | +01                                                           |
|        | Total                        | 579                                   | 445                                   | 134                 | 299                                                | 276                                                | 23                                                                             | 321                                                                            | 263                                                           | 58                                                            |

| 2019   | General Duty Medical Officer   |   73 |   72 |   01 |   67 |   67 |   00 |   14 |   12 |   02 |
|--------|--------------------------------|------|------|------|------|------|------|------|------|------|
|        | Teaching                       |  372 |  250 |  122 |  184 |  140 |   44 |  305 |  254 |   51 |
|        | Non - Teaching                 |  134 |  142 |  +08 |   71 |   77 |  +06 |   07 |   08 |  +01 |
|        | Total                          |  579 |  464 |  115 |  322 |  284 |   38 |  326 |  274 |   52 |

Note I: In addition to the above, there are 12 Dental Doctors in position against sanctioned stre of 12 in the above referred hospitals. - gap arrangement, hospitals are allowed to make contractual appointments ag tors in SJH against 115 vacant post, doctors  in  Dr.  RML  Hospital  against  38  vacant  posts  &  13  doctors  in  LHMC  hospital  agai

Note II: As a stop vacant posts till regular incumbent join. At present, 51 doc vacant posts have been appointed on contract basis.

## Annexure - II

## Incumbency Position of Nurses in Central Government Hospitals in Delhi from 2016 onwards

&

| Year   | Safdarjung Hospital Vardhman Mahavira Medical College   | Safdarjung Hospital Vardhman Mahavira Medical College   | Safdarjung Hospital Vardhman Mahavira Medical College   | & Atal Bihari Institute of Sciences & Manohar Hospital, New   | & Atal Bihari Institute of Sciences & Manohar Hospital, New   | Vajpayee Medical Dr Ram Lohia Delhi.   | Lady Hardinge Medical College & Associated and Smt. Sucheta Kriplani Kalawati Saran Children's Hospital   | Lady Hardinge Medical College & Associated and Smt. Sucheta Kriplani Kalawati Saran Children's Hospital   | Lady Hardinge Medical College & Associated and Smt. Sucheta Kriplani Kalawati Saran Children's Hospital   |
|--------|---------------------------------------------------------|---------------------------------------------------------|---------------------------------------------------------|---------------------------------------------------------------|---------------------------------------------------------------|----------------------------------------|-----------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------|
|        | Sanctioned                                              | Filled                                                  | Vacant                                                  | Sanctioned                                                    | Filled                                                        | Vacant                                 | Sanctioned                                                                                                | Filled                                                                                                    | Vacant                                                                                                    |
| 2016   | 1001                                                    | 704                                                     | 297                                                     | 1203                                                          | 944                                                           | 259                                    | 1164                                                                                                      | 1088                                                                                                      | 76                                                                                                        |
| 2017   | 1001                                                    | 698                                                     | 303                                                     | 1203                                                          | 1187                                                          | 16                                     | 1180                                                                                                      | 1073                                                                                                      | 107                                                                                                       |
| 2018   | 1772                                                    | 1057                                                    | 715                                                     | 1506                                                          | 1208                                                          | 298                                    | 1188                                                                                                      | 1081                                                                                                      | 107                                                                                                       |
| 2019   | 1822                                                    | 1361                                                    | 461                                                     | 1522                                                          | 957                                                           | 565 *                                  | 1188                                                                                                      | 944                                                                                                       | 244                                                                                                       |

Note:  As  a  stop - gap  arrangement,  hospitals  are  allowed  to  make  contractu appointments  against  vacant  posts  of  nurses  till  regular  incumbent  joi present, 380 nurses in Safdarjung Hospital out of 461 vacant posts, 190 nu Dr. RML Hospital out of 565 vacant posts and 136 nurses in LHMC Hospital out of 244 vacant posts have been appointed on contract basis.

* In a recently conducted examination to recruit nursing officers on regular 512 candidates have been provisionally selected for appoint ment against existing vacancies .

Annexure - III Number of Patients attended since 2016

&

Smt.

&

| Year   | Safdarjung & Mahavira College   | Hospital Vardhman Medical   | Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New   | Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New   | Lady Hardinge Medical College Associated and Sucheta Kriplani Kalawati Saran Children's Hospital   | Lady Hardinge Medical College Associated and Sucheta Kriplani Kalawati Saran Children's Hospital   |
|--------|---------------------------------|-----------------------------|-------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------|
|        | IPD Patient                     | OPD Patient                 | IPD Patient                                                                               | OPD Patient                                                                               | IPD Patient                                                                                        | OPD Patient                                                                                        |
| 2016   | 168937                          | 3111973                     | 77528                                                                                     | 1834491                                                                                   | 64944                                                                                              | 1087567                                                                                            |
| 2017   | 189970                          | 3109487                     | 82554                                                                                     | 2051506                                                                                   | 68280                                                                                              | 1045390                                                                                            |
| 2018   | 184166                          | 3297638                     | 94599                                                                                     | 2246888                                                                                   | 73140                                                                                              | 1073808                                                                                            |
| 2019   | 2378990 (up to 09/2019)         | 135734 (up to (09/2019)     | ----                                                                                      | ----                                                                                      | 62297 (up to 10/2019)                                                                              | 921761 (up to 10/2019)                                                                             |

## Annexure - IV

## Incumbency Position of Kalawati Saran Children Hospital Vacancy Position of doctors is as under:

|   S.NO . |   Y EARS |   A CTUAL SANCTIONED STRENGTH | V ACANT   |   F ILLED |
|----------|----------|-------------------------------|-----------|-----------|
|        1 |     2016 |                            13 | 01        |        12 |
|        2 |     2017 |                            13 | -         |        13 |
|        3 |     2018 |                            13 | 01        |        12 |
|        4 |     2019 |                            13 | -         |        13 |

## Vacancy Position of Nurses Whole Cadre including Contractual Appointment

|   S.NO . |   Y EARS | A CTUAL SANCTIONED STRENGTH                                           |   V ACANT | F ILLED                            |
|----------|----------|-----------------------------------------------------------------------|-----------|------------------------------------|
|        1 |     2016 | 367                                                                   |        36 | 331 (271 Regular + 60 contractual) |
|        2 |     2017 | 383 (including 16 new posts sanctioned for Paed. Nephrology Division) |        33 | 350 (295 Regular + 55 Contractual) |
|        3 |     2018 | 383                                                                   |        22 | 361 (314 Regular+ 47 Contractual)  |
|        4 |     2019 | 383                                                                   |        13 | 370 (340 Regular + 30 Contractual  |