Lok Sabha Question No. 3829 (UNSTARRED), answered on 2023-08-11
Subject: Contractual Appointment of Doctors under NRHM
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Sumalatha Ambareesh, D.K. Suresh

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTHAND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3829 TO BE ANSWERED ON THE 11 TH AUGUST, 2023

## CONTRACTUALAPPOINTMENT OFDOCTORS UNDER NRHM

## 3829. SHRIMATI SUMALATHAAMBREESH: SHRI D.K. SURESH:

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to state:

- (a) whether the Government is aware that the doctors appointed on the Roster-cum-Merit basis under the National Rural Health Mission (NRHM) enjoy Grade-1 status with adequate salary and whereas the doctors appointed on contract basis by the Health and Family Welfare Department are getting relatively meagre salary in Karnataka;
- (b) if so, the details thereof along with necessary steps taken in this regard;
- (c) whether the government proposes to take steps to address the disparity in salary structure of the doctors appointed on contract basis and to utilise their services in the hospitals to extend better health facilities; and
- (d) if so, the details thereof along with the steps taken in this regard?

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

- (a) and (b): State Government of Karnataka has informed that the doctors are appointed on the rostercum-merit basis under National Health Mission (NHM) in the State and their salary is as per NHM norms.
- (c) and (d): The NHM supplements the regular human resources by filling up the gaps in human resources in secondary and primary care facilities (District Hospital and below) as per Indian Public Health Standards (IPHS). 5% of the total Human Resource (HR) budget is approved as increment to all human resource for health (HRH) engaged under NHM and 3% of the total HR budget is recommended for HR rationalisation within which the State has a discretion to decide the actual increment. HR rationalization exercise and its principles, including increments, are approved by State Health Society

Governing Body (SHS GB). The State have to ensure that increment is approved in such a way that it smoothens the process of HR integration and leads to rationalization of salaries of staff with similar qualification, workload and skills.

Under NHM, following types of incentives and honorarium are also provided for encouraging specialist doctors to practice in rural and remote areas of the country:

 Hard area allowance to specialist doctors for serving in rural and remote areas and for their residential quarters so that they find it attractive to serve in public health facilities in such areas.

 Honorarium to Gynecologists/ Emergency Obstetric Care (EmoC) trained, Pediatricians & Anesthetist/ Life Saving Anaesthesia Skills (LSAS) trained doctors is also provided to increase availability of specialists for conducting Cesarean Sections in rural & remote area.

 Incentives like special incentives for doctors, incentive for ANM for ensuring timely ANC checkup and recording, incentives for conducting Adolescent Reproductive and Sexual Health activities.

 States are also allowed to offer negotiable salary to attract specialist including flexibility in strategies such as 'You Quote We Pay'.

 Non-Monetary incentives such as preferential admission in post graduate courses for staff serving in difficult areas and improving accommodation arrangement in rural areas have also been introduced under NHM.

 Multi-skilling of doctors is supported under NHM to overcome the shortage of specialists. Skill upgradation of existing HR is another major strategy under NRHM for achieving improvement in health outcomes.

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