Lok Sabha Question No. 1728 (UNSTARRED), answered on 2018-07-27
Subject: Shortage of Doctors
Ministry: HEALTH AND FAMILY WELFARE
Asked by: RITI PATHAK, RANGASWAMY DHRUVANARAYANA, RAJU ALIAS DEVAPPA ANNA SHETTI, JANAK RAM, K. MARAGATHAM, CHANDRAKANT BHAURAO KHAIRE

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

## LOK SABHA UNSTARRED QUESTION NO. 1728 TO BE ANSWERED ON 27 th JULY, 2018

## SHORTAGE OF DOCTORS

## 1728. SHRIMATI RITI PATHAK:

SHRI R. DHRUVA NARAYANA:

SHRI RAJU SHETTY:

SHRI JANAK RAM:

SHRIMATI K. MARAGATHAM:

SHRI CHANDRAKANT KHAIRE:

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

- (a) the details of requirement and availability of doctors in the country particularly in rural and remoteareas, State/ UT - wise along with the existing doctor peopleratio;
- (b)  whether  there  is  acute  shortage  of doctors  including  specialist  doctors  in  the cou try particularly in rural and remote areas and if so, the details thereof, State/ UT - wise;
- (c) wheth er the Government has issued any instructions regarding the posting of doctors in rural areas and if so, the details thereof;
- (d) whether it is a fact that rural health statistics 2017 shows that of the 25,650 sanctioned posts of doctors 3,027 are vacantand if so, the reaction of the Government thereto; and
- (e) the corrective measures being taken by the Government to tackle the situation and mprove the doctor - population ratio in the country?

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

- (a) & (b) : As per Rural Health Statistics (RHS) 2017, State/UT - wise status of doctors and specialists  at  various  public  health  facilities  and  shortfall  thereof  is  at  Annexur respectively.

As perMedical Council of India, there are a total 10,62,398 allopathic doctors regi with the State Medical Councils/ Medical Council of India as on 31 st December, 2017. Assuming 80%  availability,  it  is  estimated  that  around  8.50  lakh  doctors  may  be  actuall y  available  for active service. It gives a doctor - population ratio of 1:1565 as per current population estimate 1.33 billion.

- (c) : Public  health  and  hospitals  being  a  state  subject,  the  primary  responsibility  to posting of doctors in public heal th facilities lies with the State Governments. However, under t National Health Mission (NHM), support is provided to States/UTs to strengthen their heal systems including for engaging of doctors on contractual basis based on the requirements by the States/UTs in their Programme Implementation Plans.

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 f res pective  State/UT  Governments,  they  are  impressed  upon  from  time  to  time  to  fill  up vacant posts.

Further, in order to encourage doctors to work in remote and difficult areas, the Me Council of India, with the previous approval of Central Governm ent, has amended the Post Graduate Medical Education Regulations, 2000 to provide:

- 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 diffi areas; and
- II. Incentive at the rate of 10% the marks obtained for each year in service in remo difficult areas as upto the maximum of 30% of the marks obtained in the entrance t for admissions in Post Graduate Medical Courses.

(d) : As per RHS- 2017, there are 33,698 posts of doctors at Primary Health Centres out of which 8,826 are vacant.

However,  as  stated  above,  Public  health  and  hospitals'  is  a  State  subject.  Shortage  of Doctors  in  public  health  sector  varies  from  State  to  State  depending  upon  their  polic s  and context.

(e): The Government has taken various steps to increase the number of doctors in the cou This includes:

- 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 Medicine, Radiotherapy,  Medical  Oncology,  Surgical  Oncology  and  Psychiatry.  Further,  teache student  ratio  in  public  funded  Government  Medical  Colleges  for  Professor  has  be increased from 1:2 to 1:3 in all clinical subjects and for Asso. Prof. from 1:1 to 1:2 if the Asso.  Prof.  is  a  unit  head.  The  same  has  also  been  extended  to  the  private  me colleges with the conditions that it should be a standing of 15 years, running PG since 10 years, should have completed at le ast 1 continuance of recognition assessment satisfactorily and applies u/s 10A of the IMC Act, 1956 for increase of seats.This result in increase in number of PG seats in the country.
- II. DNB  qualification  has  been  recognized  for  appointment  as  faculty to  take  care  of shortage of faculty.
- III. Enhancement of maximum intake capacity at MBBS level from 150 to 250.
- IV. Relaxation in the norms of setting up of Medical College in terms of requirement faculty, staff, bed/bed strength and other infrastructure.
- V. Requirement  of  land  for  establishment  of  medical  college  in  metropolitan  citie notified under Article 243P(c) of the Constitution of India has been dispensed with.
- 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 preferably in underserved districts of the country.

hospit

- VIII. Strengthening/ upgradation of existing State Government/Central Government Medica Colleges t o increase MBBS seats.
- IX. Enhancement of age limit for appointment/ extension/ re - employment  against  posts  of teachers/dean/principal/ director in medical colleges from 65 - 70 years.

|        |                     | DOCTORS + AT PRIMARY HEALTH CENTRES (As on 31st March, 2017)   | DOCTORS + AT PRIMARY HEALTH CENTRES (As on 31st March, 2017)   | DOCTORS + AT PRIMARY HEALTH CENTRES (As on 31st March, 2017)   | DOCTORS + AT PRIMARY HEALTH CENTRES (As on 31st March, 2017)   | DOCTORS + AT PRIMARY HEALTH CENTRES (As on 31st March, 2017)   |
|--------|---------------------|----------------------------------------------------------------|----------------------------------------------------------------|----------------------------------------------------------------|----------------------------------------------------------------|----------------------------------------------------------------|
| S. No. | State/UT            | Required 1                                                     | Sanctioned                                                     | In Position                                                    | Vacant                                                         | Shortfall                                                      |
| 1      | Andhra Pradesh      | [R] 1147                                                       | [S] 1952                                                       | [P] 1644                                                       | [S-P] 308                                                      | [R-P] *                                                        |
| 2      | Arunachal Pradesh   | 143                                                            | NA                                                             | 122                                                            | NA                                                             | 21                                                             |
| 3      | Assam               | 1014                                                           | NA                                                             | 1048                                                           | NA                                                             | *                                                              |
| 4      | Bihar #             | 1899                                                           | 2078                                                           | 1786                                                           | 292                                                            | 113                                                            |
| 5      | Chhattisgarh        | 785                                                            | 798                                                            | 341                                                            | 457                                                            | 444                                                            |
| 6      | Goa                 | 24                                                             | 48                                                             | 56                                                             | *                                                              | *                                                              |
| 7      | Gujarat             | 1392                                                           | 1769                                                           | 1229                                                           | 540                                                            | 163                                                            |
| 8      | Haryana             | 366                                                            | 687                                                            | 429                                                            | 258                                                            | *                                                              |
| 9      | Himachal Pradesh    | 538                                                            | 636                                                            | 492                                                            | 144                                                            | 46                                                             |
| 10     | Jammu & Kashmir     | 637                                                            | 1347                                                           | 704                                                            | 643                                                            | *                                                              |
| 11     | Jharkhand           | 297                                                            | 569                                                            | 331                                                            | 238                                                            | *                                                              |
| 12     | Karnataka           | 2359                                                           | 2359                                                           | 2136                                                           | 223                                                            | 223                                                            |
| 13     | Kerala              | 849                                                            | 1120                                                           | 1169                                                           | *                                                              | *                                                              |
| 14     | Madhya Pradesh      | 1171                                                           | 1771                                                           | 954                                                            | 817                                                            | 217                                                            |
| 15     | Maharashtra         | 1814                                                           | 3009                                                           | 2929                                                           | 80                                                             | *                                                              |
| 16     | Manipur             | 85                                                             | 238                                                            | 194                                                            | 44                                                             | *                                                              |
| 17     | Meghalaya ##        | 109                                                            | 128                                                            | 112                                                            | 16                                                             | *                                                              |
| 18     | Mizoram ###         | 57                                                             | 152                                                            | 56                                                             | 96                                                             | 1                                                              |
| 19     | Nagaland            | 126                                                            | 108                                                            | 122                                                            | *                                                              | 4                                                              |
| 20     | Odisha              | 1280                                                           | 1285                                                           | 940                                                            | 345                                                            | 340                                                            |
| 21     | Punjab              | 432                                                            | 593                                                            | 568                                                            | 25                                                             | *                                                              |
| 22     | Rajasthan           | 2079                                                           | 2664                                                           | 2382                                                           | 282                                                            | *                                                              |
| 23     | Sikkim              | 24                                                             | NA                                                             | 30                                                             | NA                                                             | *                                                              |
| 24     | Tamil Nadu          | 1362                                                           | 2927                                                           | 2759                                                           | 168                                                            | *                                                              |
| 25     | Telangana           | 689                                                            | 1318                                                           | 966                                                            | 352                                                            | *                                                              |
| 26     | Tripura             | 93                                                             | 0                                                              | 156                                                            | *                                                              | *                                                              |
| 27     | Uttarakhand         | 257                                                            | 386                                                            | 215                                                            | 171                                                            | 42                                                             |
| 28     | Uttar Pradesh       | 3621                                                           | 4509                                                           | 2209                                                           | 2300                                                           | 1412                                                           |
| 29     | West Bengal         | 914                                                            | 1390                                                           | 918                                                            | 472                                                            | *                                                              |
| 30     | A& N Islands        | 22                                                             | 42                                                             | 34                                                             | 8                                                              | *                                                              |
| 31     | Chandigarh          | 3                                                              | 0                                                              | 3                                                              | *                                                              | 0                                                              |
| 32     | D & N Haveli        | 9                                                              | 15                                                             | 8                                                              | 7                                                              | 1                                                              |
| 33     | Daman & Diu         | 4                                                              | 3                                                              | 7                                                              | *                                                              | *                                                              |
| 34     | Delhi               | 5                                                              | 21                                                             | 21                                                             | 0                                                              | *                                                              |
| 35     | Lakshadweep         | 4                                                              | 8                                                              | 8                                                              | 0                                                              | *                                                              |
| 36     | Puducherry          | 40                                                             | 38                                                             | 46                                                             | *                                                              | *                                                              |
|        | All India 2 / Total | 25650                                                          | 33968                                                          | 27124                                                          | 8286                                                           | 3027                                                           |

Notes:

# Sanctioned data for year 2011 used

# Sanctioned data for year 2015 used

### Sanctioned data for year 2013 - 14 used

NA: Not Available.

- +: Allopathic Doctors

All India figures for Vacancy and Shortfall are the totals of State - wise Vacancy and Shortfall ignoring surplus in some States / UTs

- *: Surplus.

1 One per Primary Health Centre

- 2 For calculating the overall percentages of vacancy, the States/UTs for which manpower position is not available, are excluded

NA: Not Available.

Four per Community Health Centre

All India figures for Vacancy and Shortfall are the totals of State

Surplus.

## Annexure - II

| TOTAL SPECIALISTS AT CHCs   | TOTAL SPECIALISTS AT CHCs   | TOTAL SPECIALISTS AT CHCs                                                                | TOTAL SPECIALISTS AT CHCs                                                                | TOTAL SPECIALISTS AT CHCs                                                                | TOTAL SPECIALISTS AT CHCs                                                                | TOTAL SPECIALISTS AT CHCs                                                                |
|-----------------------------|-----------------------------|------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------|
| S.                          |                             | Total Specialists [Surgeons, OB&GY, Physicians & Paediatricians] (As on31st March, 2017) | Total Specialists [Surgeons, OB&GY, Physicians & Paediatricians] (As on31st March, 2017) | Total Specialists [Surgeons, OB&GY, Physicians & Paediatricians] (As on31st March, 2017) | Total Specialists [Surgeons, OB&GY, Physicians & Paediatricians] (As on31st March, 2017) | Total Specialists [Surgeons, OB&GY, Physicians & Paediatricians] (As on31st March, 2017) |
| No.                         | State/UT                    | Required 1                                                                               | Sanctioned                                                                               | In Position                                                                              | Vacant                                                                                   | Shortfall                                                                                |
| 1                           | Andhra Pradesh              | [R] 772                                                                                  | [S] 533                                                                                  | [P] 348                                                                                  | [S-P] 185                                                                                | [R-P] 424                                                                                |
| 2                           | Arunachal Pradesh           | 252                                                                                      | NA                                                                                       | 4                                                                                        | NA                                                                                       | 248                                                                                      |
| 3                           | Assam                       | 632                                                                                      | NA                                                                                       | 139                                                                                      | NA                                                                                       | 493                                                                                      |
| 4                           | Bihar                       | 600                                                                                      | NA                                                                                       | 82                                                                                       | NA                                                                                       | 518                                                                                      |
| 5                           | Chhattisgarh                | 676                                                                                      | 620                                                                                      | 59                                                                                       | 561                                                                                      | 617                                                                                      |
| 6                           | Goa                         | 16                                                                                       | 5                                                                                        | 4                                                                                        | 1                                                                                        | 12                                                                                       |
| 7                           | Gujarat                     | 1452                                                                                     | 611                                                                                      | 92                                                                                       | 519                                                                                      | 1360                                                                                     |
| 8                           | Haryana                     | 448                                                                                      | 74                                                                                       | 16                                                                                       | 58                                                                                       | 432                                                                                      |
| 9                           | Himachal Pradesh            | 356                                                                                      | NA                                                                                       | 12                                                                                       | NA                                                                                       | 344                                                                                      |
| 10                          | Jammu & Kashmir             | 336                                                                                      | 344                                                                                      | 191                                                                                      | 153                                                                                      | 145                                                                                      |
| 11                          | Jharkhand                   | 752                                                                                      | 424                                                                                      | 75                                                                                       | 349                                                                                      | 677                                                                                      |
| 12                          | Karnataka                   | 824                                                                                      | 824                                                                                      | 498                                                                                      | 326                                                                                      | 326                                                                                      |
| 13                          | Kerala                      | 928                                                                                      | 30                                                                                       | 40                                                                                       | *                                                                                        | 888                                                                                      |
| 14                          | Madhya Pradesh              | 1236                                                                                     | 1236                                                                                     | 180                                                                                      | 1056                                                                                     | 1056                                                                                     |
| 15                          | Maharashtra                 | 1440                                                                                     | 823                                                                                      | 508                                                                                      | 315                                                                                      | 932                                                                                      |
| 16                          | Manipur                     | 68                                                                                       | 4                                                                                        | 3                                                                                        | 1                                                                                        | 65                                                                                       |
| 17                          | Meghalaya                   | 108                                                                                      | 3                                                                                        | 13                                                                                       | *                                                                                        | 95                                                                                       |
| 18                          | Mizoram                     | 36                                                                                       | 33                                                                                       | 0                                                                                        | 33                                                                                       | 36                                                                                       |
| 19                          | Nagaland                    | 84                                                                                       | NA                                                                                       | 8                                                                                        | NA                                                                                       | 76                                                                                       |
| 20                          | Odisha                      | 1480                                                                                     | 884                                                                                      | 318                                                                                      | 566                                                                                      | 1162                                                                                     |
| 21                          | Punjab                      | 604                                                                                      | 593                                                                                      | 203                                                                                      | 390                                                                                      | 401                                                                                      |
| 22                          | Rajasthan                   | 2316                                                                                     | 1593                                                                                     | 497                                                                                      | 1096                                                                                     | 1819                                                                                     |
| 23                          | Sikkim                      | 8                                                                                        | NA                                                                                       | 1                                                                                        | NA                                                                                       | 7                                                                                        |
| 24                          | Tamil Nadu                  | 1540                                                                                     | NA                                                                                       | 78                                                                                       | NA                                                                                       | 1462                                                                                     |
| 25                          | Telangana                   | 456                                                                                      | 284                                                                                      | 125                                                                                      | 159                                                                                      | 331                                                                                      |
| 26                          | Tripura                     | 84                                                                                       | 0                                                                                        | 0                                                                                        | 0                                                                                        | 84                                                                                       |
| 27                          | Uttarakhand                 | 240                                                                                      | 200                                                                                      | 41                                                                                       | 159                                                                                      | 199                                                                                      |
| 28                          | Uttar Pradesh               | 3288                                                                                     | 2099                                                                                     | 484                                                                                      | 1615                                                                                     | 2804                                                                                     |
| 29                          | West Bengal                 | 1396                                                                                     | 669                                                                                      | 117                                                                                      | 552                                                                                      | 1279                                                                                     |
| 30                          | A& N Islands                | 16                                                                                       | 9                                                                                        | 0                                                                                        | 9                                                                                        | 16                                                                                       |
| 31                          | Chandigarh                  | 8                                                                                        | 9                                                                                        | 15                                                                                       | *                                                                                        | *                                                                                        |
| 32                          | D & N                       | 8                                                                                        |                                                                                          |                                                                                          | 0                                                                                        |                                                                                          |
|                             | Haveli                      |                                                                                          | 0                                                                                        | 0                                                                                        |                                                                                          | 8                                                                                        |
| 34                          | Delhi                       | 0                                                                                        | 0                                                                                        | 0                                                                                        | 0                                                                                        | 0                                                                                        |
| 35                          | Lakshadweep                 | 12                                                                                       | 0                                                                                        | 0                                                                                        | 0                                                                                        | 12                                                                                       |
| 36                          | Puducherry                  | 16                                                                                       | 4                                                                                        | 5                                                                                        | *                                                                                        | 11                                                                                       |
|                             | All India 2 / Total         | 22496                                                                                    | 11910                                                                                    | 4156                                                                                     | 8105                                                                                     | 18347                                                                                    |

Notes:

1

*:

- 2 For calculating the overall percentages of vacancy and shortfall, the States/UTs for which manpower position is not available , are excluded

- wise Vacancy nd Shortfall ignoring surplus in some States / UTs