This budget session for the year 2018 year saw the issues revolving around the rural health sector being taken up by the members of the Parliament.
The Number Of Medical Doctors Available In The Country
To a question on the number of medical doctors available in the country, the government said that as on September 30, 2017, there were 10,41,395 doctors registered under different state medical councils. Minister of State for Health and Family Welfare, Ashwini Kumar Choubey said, “Assuming 80% availability, it is estimated that around 8.33 lakh doctors may be actually available for active service.” That turns out to be one doctor per 1,597 persons. According to the World Health Organisation (WHO) recommendations, one doctor is required per 1,000 people of the population. That means India needs 4,97,189 more doctors to meet the WHO standards.
And every year we have around 67,532 students enrolling for the MBBS programme. This number is to rise when the last date for the approval of final Undergraduate Medical seats is going to be done on 31.05.2018.
Status of the Vacancies in Primary Health Centres and Community Health Centres
To a question on the number of vacancies of doctors at villages and remote areas asked by an MP, Choubey said that data for 33 of the 36 States and Union Territories was available with the government. A Primary Health Centre (PHC) is sanctioned for the rural areas. For the PHC to be functional only one doctor is needed.
For the 33 regions the minister said, 33,968 allopathic doctors were sanctioned. But still, 8,286 posts need to be filled.
The government hospitals in the larger areas have the facilities of specialist doctors - Surgeons, Obstetrics and Gynecologists, Physicians & Paediatricians. These hospitals are called Community Health Centres (CHC). As on March 31, 2017, the number of specialists required for these hospitals to be fully functional is 22,496, but only 4,156 positions are filled.
The Nursing Staff sanctioned to work in the PHCs & CHCs was at 77,956 but 11,288 posts are lying vacant. The government allots one nurse for a PHC and 7 nurses per one CHC.
Doctors Migrating Abroad To Work And Pursue Higher Education
One of the main reasons, for the PHCs and CHCs remaining vacant and the private practice non-existence by qualified doctors, is the refusal of the doctors to go and work in rural and small towns. On top of that, there is a steady migration of doctors to foreign countries, some to work and others to pursue higher education.
Choubey said that there is no central data available on the number of doctors who have gone abroad. He also mentioned that the Medical Council of India (MCI) gives a “Good Standing Certificate to Indian doctors who wish to serve abroad.”
The data provided by the Ministry of Health and Family Welfare on the number of doctors who left the country on Work is as follows:
The Ministry of Health & Family Welfare also maintains the data of the students who go to the USA to get pursuing Post Graduation degree in Medical Sciences. The US government mandates the Indian government to issue a Statement of Need (SON) Certificate and Exceptional Need Certificate (ENC) for the Indian students seeking education visa to pursue medicine abroad.
If we total the number of doctors who left the country in the three years, it amounts to 5,129.
The brain drain phenomenon is also seen among the engineering students who pass out of the elite engineering colleges like the IITs. For the rural health sector to get going there should be a policy where it becomes mandatory for the doctors to serve in the villages before they are allowed to practice in big cities. Currently, the medical services are concentrated only in the bigger cities.