Lok Sabha Question No. 2789 (UNSTARRED), answered on 2021-03-12
Subject: Shortage of Doctors and Paramedics
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Balashowry Vallabbhaneni, Bhartruhari Mahtab, M.K. Vishnu Prasad, D.K. Suresh, Badruddin Ajmal, Sanjay Bhatia

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

## LOK SABHA UNSTARRED QUESTION NO. 2789 TO BE ANSWERED ON 12 TH March , 2021

## SHORTAGE OF DOCTORS AND PARAMEDICS

## 2789. SHRI BALASHOWRY VALLABHANENI:

SHRI BHARTRUHARI MAHTAB:

DR. VISHNU PRASAD M.K.:

SHRI D.K.SURESH:

SHRI M. BADRUDDIN AJMAL:

SHRI SANJAY BHATIA:

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

- (a) whether as per the recent studies the country as a ve poor doctor to pati ent ratio and if so, the details thereof along with number of allopathic doctors and nurses registered across the country, State/ UT wise;
- (b)  whether  the  Government  has  assessed  the adverse  impact  of  shortage  of  Doctors  on implementation of various flagship schemes in health sector, if so, the details thereof and the steps taken by the Government to increase number of doctors and para medics in the country;
- (c) whether the Government proposes to increase number of medical colleges and seats in allie d institutions to bridge the gap and meet the shortage of doctors and paramedics in the country and if so, the details thereof along with necessary steps taken in this regard;
- (d) whether the Government proposes to bring in a national policy by making it mandatory for all PG doctors to work in rural areas for three years and if so, the details thereof and if not the reasons therefor; and
- (e) the other steps taken by the Government to ensure availability of doctors in rural parts of the country?

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

(SHRI ASHWINI KUMAR CHOUBEY)

- (a): As per information provided by the National Medical Commission (NMC), 12.89 lakh allopathic doctors are registered in the country as on 31 st December, 2020. Assuming 80% availability, it is estimated that around 10.31 lakh doctors may be actually available service.The  details  of  number  of  doctors  registered  with  the  concerned  State  Med Council,  State/UT - wise,is  at Annexure - I .  Be sides,  there  are  5.65  lakh  AYUSH  doctors available  in  the  country.  Considering  the  above,  the  doctor -population  ratio  in  the country is 1:845.

Further,  as  per  records  of  the  Indian  Nursing  Council  (INC),  there  are  ar 22,72,208 Registered Nurse s and Registered Midwives (RN&RM),9,34,583 Auxiliary Nurse Midwives (ANM) and 56,842 Lady Health Visitors (LHV) in the Country. The detail of tot number of nurses registered across the country, State/UT wise is at Annexure -II.

(b)& (c) : Public health and hospitals being a State subject, the primary responsibility ensure availability of doctors in public health facilities lies with the Governments.However, under the National Health Mission (NHM), financial and technical support is provided to States/UTs to strengthen their healthcare systems including support engagement  of  doctors,  based  on  the  requirements  made  by  the  States/UTs  in  the Programme Implementation Plans (PIPs).

The  Government  runs  a  Centrally  Sponsored  Scheme  for  establishment  of  new medical colleges attached with district/referral hospitals, under which establishment medical colleges has been approved in three phases, of which 47 have become functio The Government also runs two Centrally Sponsored Schemes for strengthening/ upgradatio of existing State Government/Central Government Medical Colleges to increase MBBS and PG seats.

Further, the Government has taken various steps to increase the availabi lity of doctors in the country which include: -

- I. Relaxation in the norms for setting up of Medical College in terms of requiremen faculty, staff, bed strength and other infrastructure.
- II. Enhancement of maximum intake capacity at MBBS level from 150 to 2 50.
- III. DNB  qualification  has  been  recognized  for  appointment  as  faculty  to  take  care shortage of faculty.
- IV. Enhancement of age limit for appointment/ extension/ re - employment against posts of teachers/dean/principal/ director in medical colleges upto 70 yea rs.
- V. Provision  has  been  made  in  the  Regulations  to  offer  less  number  of  seats  to applicant medical college, in case, it falls short of minimum prescribed requir of applied intake to avoid wastage of human resources.
- VI. A  Consortium  (a  group  of  2  or upto  4  private  organizations)  has  been  allowed  to establish a medical college.
- VII. Viability Gap Funding Scheme for establishment of new medical colleges in Publi -Private Partnership mode.

As  far  as  allied  and  healthcare  professionals  are  concerned,  there is  no  Cent al Regulatory  body  at  present  for  allied  and  healthcare  professionals.  The  Government introduced the National Commission for Allied and Healthcare Professions Bill, 2020 i Rajya Sabhato regulate and standardise the education and practi ce of allied and healthcare professionals .

(d): The  policy  of  compulsory  rural  services  of  MBBS/PG  doctors  is  decided  by  th concerned State Government. Each State has its own bond policy for the medical gradua passing out from the medical colleges, ke eping in view of the healthcare needs of the State.

- (e) To increase availability of doctors in the rural areas, the following steps have be
- I. Two years post MBBS Diploma courses in eight disciplines have been started by t National Board of Examinations to be run mostly in the District hospitals, th improving availability of trained healthcare manpower at district level.
- II. Postgraduate  Medi cal  Education  Regulations,  2000  have  been  amended  to  include District  Residency  Scheme  for  compulsory  three  months  training  of  PG  medical students at District Hospitals.  Under the Scheme, the second/third year PG stu of  medical  colleges  would  be  post ed  in  the  district  hospitals  for  a  period  of  thre months.

Further,  to  encourage  doctors  working  in  remote  and  difficult  areas,  under Regulations it has been provided that: -

- I. 50% of the seats in Post Graduate Diploma Courses shall be reserved for Me dical Officers in the Government service, who have served for at least three years in and/or  difficult  and/or  rural  areas.  After  acquiring  the  PG  Diploma,  the  Me Officers shall serve for two more years in remote and/or difficult and/or rural a eas.
- II. Incentive at the rate of 10% of the marks obtained for each year in service in and/or difficult or rural areas as upto the maximum of 30% of the marks obtaine the entrance test for admissions in Post Graduate Medical Courses.
- III. 50% seats in D iplomate National Board (DNB) courses have also been reserved for in - service doctors of the State.

## Annexure -I

## Number Of Doctors Registered with State Medical Councils / Erstwhile Medical Council of India as on 31.12.2020

| NameofStateMedicalCouncil            |   Number of Registered Doctors |
|--------------------------------------|--------------------------------|
| AndhraPradeshMedicalCouncil          |                         105795 |
| ArunachalPradeshMedical Council      |                           1246 |
| AssamMedicalCouncil                  |                          24960 |
| BiharMedicalCouncil                  |                          47486 |
| ChhattisgarhMedical Council          |                          10020 |
| DelhiMedicalCouncil                  |                          26686 |
| GoaMedicalCouncil                    |                           4035 |
| Gujarat Med icalCouncil              |                          71348 |
| HaryanaDental&MedicalCouncils        |                          15679 |
| HimachalPradeshMedicalCouncil        |                           3942 |
| Jammu&Kashmir                        |                          16648 |
| JharkhandMedicalCouncil              |                           6926 |
| Karnataka MedicalCouncil             |                         131903 |
| MadhyaPradeshMedicalCouncil          |                          42596 |
| MaharashtraMedicalCouncil            |                         188540 |
| MedicalCouncilofIndia                |                          52666 |
| MizoramMedicalCouncil                |                            118 |
| NagalandMedicalCouncil               |                            141 |
| Orissa Council ofMedicalRegistration |                          26924 |
| PunjabMedical Council                |                          51685 |
| RajasthanMedicalCouncil              |                          48229 |
| SikkimMedicalCouncil                 |                           1501 |
| TamilNaduMedicalCouncil              |                         148216 |
| TravancoreMedicalCouncil,Cochin      |                          70619 |
| UttarPradesh MedicalCouncil          |                          89286 |
| UttaranchalMedicalCouncil            |                          10241 |
| WestBengalMedicalCouncil             |                          77664 |
| TripuraMedicalCouncil                |                           2681 |
| Telengana MedicalCouncil             |                          11556 |
| GrandTotal                           |                        1289337 |

Annexure - II

| STATE WISE NUMBER OF REGISTERED NURSES IN INDIA   | STATE WISE NUMBER OF REGISTERED NURSES IN INDIA   | STATE WISE NUMBER OF REGISTERED NURSES IN INDIA                            | STATE WISE NUMBER OF REGISTERED NURSES IN INDIA                            | STATE WISE NUMBER OF REGISTERED NURSES IN INDIA                            |
|---------------------------------------------------|---------------------------------------------------|----------------------------------------------------------------------------|----------------------------------------------------------------------------|----------------------------------------------------------------------------|
| S. No.                                            | STATE                                             | Total No. of Registered Nurses &Auxiliary Nurses in India as on 31.12.2019 | Total No. of Registered Nurses &Auxiliary Nurses in India as on 31.12.2019 | Total No. of Registered Nurses &Auxiliary Nurses in India as on 31.12.2019 |
| S. No.                                            | STATE                                             | ANM                                                                        | RN&RM                                                                      |                                                                            |
| 1                                                 | Andhra Pradesh                                    | 139128                                                                     | 242853                                                                     | 2480                                                                       |
| 2                                                 | Arunachal Pradesh                                 | 4163                                                                       | 4090                                                                       | 159                                                                        |
| 3                                                 | Assam                                             | 28814                                                                      | 23993                                                                      | 386                                                                        |
| 4                                                 | Bihar                                             | 11847                                                                      | 11075                                                                      | 511                                                                        |
| 5                                                 | Chattisgarh                                       | 14782                                                                      | 21984                                                                      | 1352                                                                       |
| 6                                                 | Delhi                                             | 4835                                                                       | 73513                                                                      | 0                                                                          |
| 7                                                 | Goa                                               | 156                                                                        | 477                                                                        | 0                                                                          |
| 8                                                 | Gujarat                                           | 51130                                                                      | 131091                                                                     | 0                                                                          |
| 9                                                 | Haryana                                           | 29771                                                                      | 35304                                                                      | 694                                                                        |
| 10                                                | Himachal Pradesh                                  | 12007                                                                      | 26611                                                                      | 500                                                                        |
| 11                                                | Jharkhand                                         | 7896                                                                       | 4977                                                                       | 142                                                                        |
| 12                                                | Karnataka*                                        | 54039                                                                      | 231643                                                                     | 6840                                                                       |
| 13                                                | Kerala                                            | 31019                                                                      | 288971                                                                     | 8507                                                                       |
| 14                                                | Madhya Pradesh*                                   | 39563                                                                      | 118793                                                                     | 1731                                                                       |
| 15                                                | Maharashtra                                       | 78304                                                                      | 147494                                                                     | 685                                                                        |
| 16                                                | Meghalaya                                         | 2016                                                                       | 7742                                                                       | 237                                                                        |
| 17                                                | Manipur                                           | 4184                                                                       | 10431                                                                      | 0                                                                          |
| 18                                                | Mizoram                                           | 2370                                                                       | 4335                                                                       | 0                                                                          |
| 19                                                | Orissa                                            | 67654                                                                      | 82189                                                                      | 238                                                                        |
| 20                                                | Punjab*                                           | 23029                                                                      | 76680                                                                      | 2584                                                                       |
| 21                                                | Rajasthan*                                        | 108688                                                                     | 200171                                                                     | 2732                                                                       |
| 22                                                | Tamil Nadu                                        | 59167                                                                      | 308812                                                                     | 11262                                                                      |
| 23                                                | Tripura                                           | 2350                                                                       | 5358                                                                       | 148                                                                        |
| 24                                                | Uttar Pradesh                                     | 75671                                                                      | 111860                                                                     | 2763                                                                       |
| 25                                                | Uttarakhand                                       | 9410                                                                       | 15519                                                                      | 37                                                                         |
| 26                                                | West Bengal                                       | 68982                                                                      | 70442                                                                      | 12854                                                                      |
| 27                                                | Telangana                                         | 3372                                                                       | 14495                                                                      | 0                                                                          |
| 28                                                | Sikkim                                            | 236                                                                        | 1305                                                                       | 0                                                                          |
|                                                   | Total                                             | 934583                                                                     | 2272208                                                                    | 56842                                                                      |

Source :

Respective State Nurses Registration Council

ANM:

Auxiliary Nurse Midwives, RN & RM:

Registered Nurses & Registered Midwives,

LHV:

Lady Health Visitors, NA: Not Available

Note - * Last Year Data upto 31.12.2018