Lok Sabha Question No. 888 (UNSTARRED), answered on 2021-07-23
Subject: Shortage of Doctors and Paramedics
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Vishnu Dayal Ram, Prasun Banerjee, Pratima Mondal, Rajiv Pratap Rudy, Dr. T. Sumathy (a) Thamizhachi Thangapandian

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

LOK SABHA U NSTARRED QUESTION NO. 888 TO BE ANSWERED ON 23 RD JULY, 2021

## SHORTAGE OF DOCTORS AND PARAMEDICS

## 888. SHRI VISHNU DAYAL RA M:

SHRI PRASUN BANERJEE:

SHRIMATI PRATIMA MON DAL:

SHRI RAJIV PRATAP RU DY:

DR. T. SUMATHY (A) T HAMIZHACHI THANGAPANDIAN:

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

- (a)  the  details  of  allopathic  doctors  and  nurses registered  across  the  country  and their  actual requirement State/ UT wise;
- (b)  the  details  of  present  norms  regarding  doctorpatients ratio  and  Nurse - patient  ratio  being followed by the Government along with the effective step taken to bridge he gap in the said ratios in the country;
- (c)the number of diploma/degree schools and colleges with seats imparting nursing education in thecountry, State/UT - wise along with the steps taken/ proposed to be taken by the Government to open new nursing educational institutions in the country, location, State/UT - wise;
- (d) whether the Government proposes to increase umber of medical colleges and seats in allied institutions to bridge the gap and meet the shortage of doctors and paramedics and if so, the details thereof along with necessary steps taken in this regard;
- (e) whether the Government proposes to bring in a natio al policy by making it mandatory for all PG/MBBS doctors to work in rural areas for three years and if so, the details thereof and if not the reasons therefor; and
- (f) the other steps taken by the Government to ensure availability of doctors in rural and remote areas of the country?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR . BHARATI PRAVIN PAW AR )

(a) to (d): There are 12.68 lakh allopath ic doctors registered with the State Medical Councils and the National Medical Commission (NMC). The doctor - population ratio is 1:854 in the country assuming  80%  availability  of  registered  allopathic  doctors  and  5.65  lakh  AYUSH  docto Further, as per inf ormation available with Indian Nursing Council, there are around 32.63 la registered nursing personnel (22.72 lakh registered nurses (RN&RM) and 9.91 lakh registere nurse  associates  (RANM))  in  the  country. considering around  70%  availability  of  registered nursing personnel, the nurse -population ratio in the country is 1:559. The State - wise details of registered allopathic doctors and Nurses are at Annexure I and Annexure II respectively. The details of State - wise Nu rsing Institutions with seats are at Annexure III .

The Government has taken various steps to further increase the availability of do nurses and paramedics in the country which include: -

- i) Centrally  Sponsored  Scheme  for  establishment  of  new  medical college  by  upgrading district hospital in   underserved districts of the country.
2. ii) Centrally Sponsored Scheme for Strengthening/ upgradation of existing Government/Central Government Medical Colleges to increase MBBS and PG seats.

Sta

- iii)  Viability Gap  Funding  Scheme  for  establishment  of  medical  colleges  in  Public - Private Partnership mode.
- iv) A Consortium (a group of 2 or upto 4 private organizations) has been allowed to esta medical college.
- v) Relaxation in the norms for setting up of Medi cal College in terms of requirement for faculty, staff, bed strength and other infrastructure.
- vi) Enhancement of maximum intake capacity at MBBS level from 150 to 250.
- vii) DNB  qualification  has  been  recognized  for  appointment  as  faculty  to  take  care shortage of faculty.
- viii) Enhancement of age limit for appointment/ extension/ re - employment  against  posts  of teachers/dean/principal/ director in medical colleges upto 70 years.
- ix) The  ratio  of  teachers  to  students  has  been  rationalized  to  increase the  number  of postgraduate medical seats in the country.
- x) By amending the regulations, it has been made mandatory for all medical colleges to PG courses within 3 years from the date of their MBBS recognition /continuation of recogni
- xi) Provis ion has been made in the Regulations to offer less number of seats to the app medical college, in case, it falls short of minimum prescribed requirements of applied i avoid wastage of human resources.
- xii) U nder the Central Sector Scheme -D evelopment of Nursing Services, financial assistance to the tune of Rs. 7 crore for each institution is provided to schools of nursing to be u college of nursing.
- xiii) The requirement of land to construct building for School/College of Nursing a nd Hostel has been relaxed.
- xiv) The requirement of a 100 beded parent hospital has been relaxed for hilly and trib for School/College of Nursing and Hostel.
- xv) The student teacher ratio for M.Sc(N) programme has been relaxed from 1:5 to 1:10.
- xvi ) Student patient ratio for Nursing Institutions has been relaxed from 1:5 to 1:3.
- xvii)  Distance  from  Nursing  School  to  hospital  has  been  relaxed  from  15  km  to  30  k However, for hilly and tribal areas the maximum distance is 50 km. Super speciality hos pital can start M.Sc.(N) without having under graduate programme.
- xviii) The  National  Commission  for  Allied  and  Healthcare  Professions  Act,  2021  has  bee enacted to formulate and regulate standards of education, training and practice for more allie d and healthcare professions.

(e): The policy for mandatory rural service for MBBS / PG doctors is decided by the conc State  Government  as  per  the  healthcare  requirement  and  availability  of  human  resource public health facilities of the State.

(f): The following steps have been taken to increase the availability of doctors in rura and difficult areas:

(i) 50% of the seats in Post Graduate Diploma Courses are reserved for Medical Officers the  Government  service,  who  have  served  for at  least  three  years  in  remote  and/or  difficult and/or rural areas. After acquiring the PG Diploma, the Medical Officers shall serve f more years in remote and/or difficult and/or rural areas.

(ii) Incentive at the rate of 10% of the marks obtained for each year in service in remote and/or difficult or rural areas as upto the maximum of 30% of the marks obtained in the en test for admissions in Post Graduate Medical Courses.

(iii) The National Board of Examinations (NBE)  have started 2 years p ost MBBS Diploma courses in eight disciplines -Anaesthesia, OBGY, Paediatrics, Family Medicine, Ophthalmology,  ENT,  Radio  Diagnosis  and  Tuberculosis  &  Chest  Disease.  These  Diploma courses shall mostly be run in the District hospitals and thereby improve a vailability of trained healthcare manpower at district level.

(iv) District Residency Scheme for compulsory three months training of PG medical students at District Hospitals as an essential component of postgraduate medical training curriculu been notified. Under the Scheme, the second/third year PG students of medical colleges w be posted in the district hospital s for a period of three months. This will ensure round the yea availability of residents at the district level.

(v) 50%seats of DNB courses  have also been reserved for in - service doctors of the State.

## NUMBER OF DOCTORS POSSESSING RECOGNISVD MEDICAL QUALIFICATIONS  AND REGISTERED WITH STATE MEDICAL COUNCILS / THE ERSTWHILE MEDICAL COUNCIL OF  INDIA

| Name ofStateMedical Council           |   Totalnumber of allopathic d octors |
|---------------------------------------|--------------------------------------|
| Andhra PradeshMedicalCouncil          |                               104886 |
| ArunachalPradeshMedicalCouncil        |                                 1246 |
| Assam Medical Council                 |                                24083 |
| BiharMedicalCouncil                   |                                45795 |
| Chattisgarh Medical Council           |                                10020 |
| DelhiMedical Council                  |                                26685 |
| Goa Medical Council                   |                                 4035 |
| Gujarat MedicalCouncil                |                                71348 |
| HaryanaDental& MedicalCouncils        |                                15679 |
| HimachalPradeshMedicalCouncil         |                                 3406 |
| Jammu & Kashmir                       |                                16648 |
| JharkhandMedicalCouncil               |                                 6926 |
| Karnataka Medical Council             |                               131903 |
| Madhya PradeshMedicalCouncil          |                                42600 |
| Maharashtra MedicalCouncil            |                               188540 |
| MedicalCouncilofIndia                 |                                52667 |
| Mizoram MedicalCouncil                |                                  118 |
| NagalandMedicalCouncil                |                                  141 |
| Orissa Council of MedicalRegistration |                                24780 |
| PunjabMedicalCouncil                  |                                51685 |
| Rajasthan MedicalCouncil              |                                48230 |
| SikkimMedicalCouncil                  |                                 1414 |
| TamilNadu MedicalCouncil              |                               148216 |
| TravancoreMedicalCouncil, Cochin      |                                65672 |
| Uttar Pradesh Medical Council         |                                84560 |
| Uttaranchal MedicalCouncil            |                                 9348 |
| West BengalMedical Council            |                                77664 |
| Tripura MedicalCouncil                |                                 1945 |
| TelenganaMedicalCouncil               |                                 7932 |
| Grand Total                           |                              1268172 |

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

## Details of State-wise Nursing Institutions

|                     | B.Sc (N)    | B.Sc (N)   | M.Sc (N)    | M.Sc (N)   | P B B.Sc    | P B B.Sc   |
|---------------------|-------------|------------|-------------|------------|-------------|------------|
| State Name          | Institution | Seats      | Institution | Seats      | Institution | Seats      |
| Andaman & Nicobar   | 0           | 0          | 0           | 0          | 0           | 0          |
| Andhra Pradesh      | 150         | 7925       | 36          | 726        | 32          | 920        |
| Arunachal Pradesh   | 2           | 90         | 0           | 0          | 0           | 0          |
| Assam               | 18          | 800        | 7           | 121        | 4           | 115        |
| Bihar               | 10          | 490        | 2           | 55         | 4           | 160        |
| Chandigarh          | 2           | 120        | 1           | 20         | 1           | 40         |
| Chattisgarh         | 100         | 4550       | 21          | 424        | 19          | 565        |
| Chhattisgarh        | 1           | 50         | 0           | 0          | 0           | 0          |
| Dadra &Nagar Haveli | 1           | 60         | 1           | 20         | 1           | 20         |
| Daman &Diu          | 1           | 50         | 0           | 0          | 0           | 0          |
| Delhi               | 14          | 665        | 7           | 123        | 4           | 100        |
| Goa                 | 3           | 180        | 1           | 25         | 1           | 10         |
| Gujarat             | 108         | 4919       | 21          | 394        | 23          | 600        |
| Haryana             | 41          | 1935       | 11          | 242        | 30          | 875        |
| Himachal Pradesh    | 35          | 1370       | 8           | 181        | 14          | 355        |
| Jammu &Kashmir      | 18          | 880        | 5           | 88         | 4           | 170        |
| Jharkhand           | 14          | 640        | 2           | 37         | 5           | 140        |
| Karnataka           | 338         | 18600      | 160         | 3305       | 178         | 6490       |
| Kerala              | 132         | 7320       | 58          | 1091       | 41          | 1290       |
| Madhya Pradesh      | 198         | 8745       | 68          | 1174       | 74          | 2130       |
| Maharashtra         | 105         | 4905       | 44          | 775        | 53          | 1495       |
| Manipur             | 8           | 300        | 2           | 18         | 2           | 40         |
| Meghalaya           | 2           | 90         | 1           | 10         | 1           | 30         |
| Mizoram             | 3           | 95         | 0           | 0          | 0           | 0          |
| Nagaland            | 1           | 40         | 0           | 0          | 1           | 20         |
| Orissa              | 40          | 1765       | 14          | 337        | 10          | 360        |
| Pondicherry         | 15          | 1045       | 9           | 193        | 7           | 220        |
| Punjab              | 111         | 5520       | 37          | 742        | 93          | 3025       |
| Rajasthan           | 171         | 8095       | 29          | 525        | 49          | 1325       |
| Sikkim              | 3           | 170        | 1           | 25         | 0           | 0          |
| Tamilnadu           | 192         | 11620      | 82          | 1809       | 66          | 2255       |
| Telangana           | 87          | 4980       | 24          | 493        | 18          | 530        |
| Tripura             | 4           | 190        | 2           | 20         | 1           | 20         |
| Uttar Pradesh       | 132         | 5820       | 23          | 544        | 45          | 1300       |
| Uttarakhand         | 25          | 1215       | 8           | 149        | 7           | 210        |
| Uttaranchal         | 1           | 30         | 0           | 0          | 0           | 0          |
| West Bengal         | 41          | 2545       | 16          | 305        | 14          | 675        |
| Grand Total         | 2127        | 107814     | 701         | 13971      | 802         | 25485      |