Lok Sabha Question No. 2068 (UNSTARRED), answered on 2024-08-02
Subject: Basic infrastructure of Private and Government Hospitals
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Tatkare Sunil Dattatrey

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTHAND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2068 TO BE ANSWERED ON 2 ND AUGUST, 2024

## 'BASIC INFRASTRUCTURE OFPRIVATE AND GOVERNMENT HOSPITALS'

## 2068. SHRI TATKARE SUNILDATTATREY :

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to state:

(a) The norms set for provision of the basic infrastructure by the private and Government hospitals in the country specially in Maharashtra State-wise;

(b) whether the Government has assessed the major deficiencies/challenges confronting the Public Healthcare Centres and Government hospitals in the country and if so, the details thereof;

(c) whether the Government proposes to improve the infrastructure in Hospitals/Public Healthcare Centres and root out deficiencies in order to provide quality healthcare services and if so, the details thereof indicating the number of hospitals upgraded/modernised during the last four years alongwith the amount of funds provided and utilized therefor, State/district and hospital-wise; and

(d) The steps taken/proposed to be taken by the Government for ensuring adequate supply of medicines in public hospitals/healthcare facilities?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SMT. ANUPRIYAPATEL)

(a) to (d) Public Health & Hospital is a State subject and its implementation primarily lies with the State Government to improve and provide basic infrastructure. However, support under the National Health Mission (NHM) through Program Implementation Plans (PIPs) is also extended to states/UTs to meet compliance standards. MoHFW supports & provides continuous handholding to States/UTs for IPHS-based assessment.

The norms set for the basic infrastructure of Government hospitals in the country including in Maharashtra is as per Government of India IPHS 2022 Guidelines. The details of the norms set for the basic infrastructure are available at the link https://nhsrcindia.org/IPHS2022.

To improve infrastructure in Hospitals/Public Healthcare Centres for providing quality healthcare services, Government of India has laid down Indian Public Health Standards.

These standards include norms for services, infrastructure, human resources, diagnostics, equipment, medicines, etc. The overall objective of IPHS is to provide quality-oriented healthcare that is sensitive to the community's needs.

To facilitate the assessment of public health facilities, MoHFW has developed an Open Data Kit (ODK), an Android-based application. This application allows States and UTs to conduct a baseline assessment of their healthcare facilities, identify gaps, and implement timely corrective measures by achieving compliance to provide all essential services and work towards desirable standards.

In addition, the PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) was launched on 25th October, 2021 with an outlay of Rs.64,180 Cr to be implemented over five years from 2021-22 to 2025-26, with the aim to strengthen the public health infrastructure to fill critical gaps in health infrastructure, surveillance and health research - spanning both the urban and rural areas. Centrally Sponsored Components under PM-ABHIM are sanctioned in the State of Maharashtra with the budget outlay of Rs. 1055.28 Crores.

To ensure the availability of essential drugs and reduce the out-of-pocket expenditure (OOPE) of the patients visiting public health facilities, the Government rolled out the Free Drugs Service Initiative (FDSI) under the National Health Mission (NHM) in 2015. The initiative supplements the state's efforts to ensure the availability of free medicines to healthcare seekers at District Hospital and below-level facilities.

The government of India, under the IPHS, also recommends following facility-wise Essential Medicines Lists (EMLs) to the States/UTs:

- AAM- SHC- 106
- AAM- PHC- 172
- Community Health Centre (CHC)- 300
- Sub District Hospital (SDH) - 318
- District Hospital (DH)- 381

The details of State/UT-wise SPIP and Expenditure on Infrastructure Strengthening under National Health Mission (NHM) from FY 2021-22 to FY 2023-24 and Central releases under PM-ABHIM for the FY 2021-22 to FY 2023-24 are at Annexure-I and Annexure-II respectively.

Annexure-I

## State/UT-wise SPIP and Expenditure on Infrastructure Strengthening under National Health Mission (NHM) from FY 2021-22 to FY 2023-24

(Rs. in Lakhs)

| Sl. N o.   | States                              | 2021-22        | 2021-22     | 2022-23            | 2022-23           | 2023-24        | 2023-24     |
|------------|-------------------------------------|----------------|-------------|--------------------|-------------------|----------------|-------------|
| Sl. N o.   | States                              | SPIP Approvals | Expenditure | SPIP Approvals     | Expenditure       | SPIP Approvals | Expenditure |
| 1          | Andaman and Nicobar Islands         | 159.00         | 2.52        | 2.00               | 3.70              | 5.00           | -           |
| 2          | Andhra Pradesh                      | 2,583.25       | 2,682.25    | 633.06             | 315.88            | 875.72         | 52.56       |
| 3          | Arunachal Pradesh                   | 5,674.45       | 4,386.79    | 4,737.52           | 6,568.85          | 2,069.80       | 5,382.51    |
| 4          | Assam                               | 23,425.82      | 15,546.48   | 35,925.05          | 9,521.74          | 10,500.34      | 9,024.95    |
| 5          | Bihar                               | 37,842.57      | 13,032.84   | 99,387.56          | 36,055.09         | 52,900.70      | 45,692.16   |
| 6          | Chandigarh                          | -              | -           | -                  | -                 | -              | -           |
| 7          | Chhattisgarh                        | 15,047.86      | 4,106.67    | 7,789.77           | 6,970.37          | 7,789.77       | 6,682.68    |
| 8          | Dadra & Nagar Haveli and Daman& Diu | 2.88           | -           | 2.88               | -                 | 2.88           | -           |
| 9          | Delhi                               | 681.80         | 172.50      | 1,399.96           | 2,285.11          | 1,399.96       | 2,255.23    |
| 10         | Goa                                 | 125.95         | 54.58       | 260.26             | 134.17            | 225.34         | 197.82      |
| 11         | Gujarat                             | 878.22         | 564.05      | 5,028.85           | 253.57            | 353.08         | 642.44      |
| 12         | Haryana                             | 12,804.52      | 755.18      | 8,555.93           | 8,937.08          | 335.90         | 303.64      |
| 13         | Himachal Pradesh                    | 3,547.39       | 3,149.75    | -                  | -                 | 600.00         | -           |
| 14         | Jammu and Kashmir                   | 3,433.33       | 579.19      | 1,599.96           | 498.41            | 3,375.46       | 2,905.67    |
| 15         | Jharkhand                           | 2,494.78       | 2,389.54    | 9,373.36           | 3,713.19          | 8,850.36       | 6,599.20    |
| 16         | Karnataka                           | 15,324.05      | 15,833.87   | 7,613.96           | 5,158.75          | 4,789.20       | 6,307.16    |
| 17         | Kerala                              | 5,897.00       | 4,539.01    | 12,709.03          | 5,319.77          | 18,104.34      | 3,856.56    |
| 18         | Lakshadweep                         | -              | -           | -                  | -                 | -              | -           |
| 19         | Madhya Pradesh                      | 25,482.92      | 14,190.80   | 19,866.87          | 22,572.53         | 42,679.70      | 25,574.97   |
| 20         | Maharashtra                         | 55,881.84      | 21,942.42   | 61,535.48          | 24,932.60         | 60,134.13      | 33,948.75   |
| 21         | Manipur                             | 2,999.42       | 683.74      | 1,796.82           | 44.62             | 16.41          | 14.77       |
| 22         | Meghalaya                           | 1,656.32       | 262.55      | 1,096.27           | 864.35            | 69.49          | 886.06      |
| 23         | Mizoram                             | 35.40          | 44.42       | 36.75              | 14.37             | 33.79          | 25.42       |
| 24         | Nagaland                            | 1,074.84       | 1,370.75    | 3,073.78           | 1,138.36          | 2,132.23       | 1,375.81    |
| 25         | Odisha                              | 32,846.14      | 35,621.88   | 62,574.68          | 84,110.12         | 48,034.45      | 58,810.00   |
| 26         | Puducherry                          | 26.16          | 1.17        | 6.36               | 8.54              | 6.48           | 2.78        |
| 27         | Punjab                              | 5,201.90       | 3,759.31    | 990.10             | 40.87             | 190.60         | 190.60      |
| 28         | Rajasthan                           | 85,616.83      | 14,112.39   | 57,577.61          | 28,782.14         | 57,736.11      | 46,950.24   |
| 29         | Sikkim                              | 391.84         | 237.11      | 52.51              | 6.44              | 64.37          | 32.18       |
| 30         | Tamil Nadu                          | 26,196.13      | 27,738.27   | 56,033.70          | 41,677.06         | 79,790.36      | 45,563.89   |
| 31         | Telangana                           | 7,640.83       | 12,909.19   | 11,534.19          | 15,478.29         | 41,042.91      | 6,920.11    |
| 32         | Tripura                             | 4,998.54       | 4,206.31    | 5,149.70           | 4,185.24          | 4,518.05       | 3,010.20    |
| 33         | Uttar Pradesh                       | 124,665.6 2    | 12,736.34   | 42,730.00          | 18,346.25         | 171,102.14     | 5,026.42    |
| 34         | Uttarakhand                         | 13,588.14      | 15,159.27   | 10,604.54          | 5,195.83          | 1,238.88       | 3,454.42    |
| 35         | West Bengal                         | 7,984.58       | 2,217.18    | 11,212.94 2,691.15 |                   | 3,005.22       | 3,506.23    |
| 36         | Ladakh                              | 3,125.00       | 470.95      |                    | 1,899.55 1,215.87 | 2,334.65       | 1,349.92    |

Note: 1. Expenditure includes expenditure against Central Release, State share & unspent balances at the beginning of the year.

2. SPIP Approval and Expenditure is as per the available Financial Management Reports submitted by State/UTs and are provisional.

Annexure-II

State/UT-wise Central Release under Pradhan Mantri Ayushman Bharat Health Infrastructure Mission since inception to FY 2023-24

Rs. In Crore

|   S. No. | Name of the State/UT                | 2021-22   | 2022-23   | 2023-24   |
|----------|-------------------------------------|-----------|-----------|-----------|
|        1 | Andaman and Nicobar Islands         | -         | 1.11      | -         |
|        2 | Andhra Pradesh                      | 3.75      | 15.76     | 35.78     |
|        3 | Arunachal Pradesh                   | 0.56      | 0.10      | 8.83      |
|        4 | Assam                               | 57.90     | 2.26      | 91.45     |
|        5 | Bihar                               | 125.86    | 7.17      | -         |
|        6 | Chandigarh                          | -         | 4.79      | 10.38     |
|        7 | Chattisgarh                         | 11.25     | 1.34      | 32.23     |
|        8 | Dadra & Nagar Haveli and Daman &Diu | -         | 0.24      | 0.28      |
|        9 | Delhi                               | -         | -         | -         |
|       10 | Goa                                 | -         | 0.06      | 3.75      |
|       11 | Gujarat                             | -         | 29.54     | 46.04     |
|       12 | Haryana                             | 11.06     | 1.31      | 17.67     |
|       13 | Himachal Pradesh                    | -         | 28.05     | 15.69     |
|       14 | Jammu & Kashmir                     | 16.11     | 1.00      | 44.01     |
|       15 | Jharkhand                           | 44.70     | 183.04    | 102.27    |
|       16 | Karnataka                           | 11.25     | 37.10     | 100.57    |
|       17 | Kerala                              | 3.75      | 24.89     | -         |
|       18 | Ladakh                              | -         | 0.00      | 0.62      |
|       19 | Lakshadweep                         | -         | 0.63      | -         |
|       20 | Madhya Pradesh                      | 22.85     | 98.70     | 228.52    |
|       21 | Maharashtra                         | 17.45     | 4.07      | 31.76     |
|       22 | Manipur                             | 4.56      | 10.92     | 13.78     |
|       23 | Meghalaya                           | 9.65      | 43.28     | 4.42      |
|       24 | Mizoram                             | 0.28      | 1.52      | 4.52      |
|       25 | Nagaland                            | 0.28      | 0.08      | 4.42      |
|       26 | Odisha                              | 32.15     | 211.46    | 174.89    |
|       27 | Puducherry                          | 0.42      | 0.19      | 2.67      |
|       28 | Punjab                              | -         | 24.16     | -         |
|       29 | Rajasthan                           | 45.37     | 83.59     | 173.06    |
|       30 | Sikkim                              | -         | 0.75      | 3.88      |
|       31 | Tamil Nadu                          | 17.45     | 150.42    | 279.36    |
|       32 | Telangana                           | 11.25     | 53.88     | 95.21     |
|       33 | Tripura                             | -         | 0.90      | 2.48      |
|       34 | Uttar Pradesh                       | 124.63    | 173.71    | 247.96    |
|       35 | Uttarakhand                         | 1.56      | 32.31     | -         |
|       36 | West Bengal                         | 9.95      | -         | 30.91     |

Note: The above releases relate to Central Govt. Grants & do not include State share contribution.