DNA: Wanted: 6 Lakh Docs, 3 Lakh Nurses: April 09, 2008

India’s healthcare system is crumbling due to acute shor-tage of doctors and paramedics. According to the latest report by the Planning Commission, there is a requirement of at least six lakh doctors, one lakh nurses and over two lakh dental surgeons. There is also a huge shortage of paramedical staff such as radiographers, x-ray technicians, physiotherapists, laboratory technicians, dental hygienists, orthopaedists and opticians.

Compared to the requirements, supply is quite less. About 30,000 students pass out from the medical colleges, 20,000 from dental colleges, 45,000 from nursing colleges and 60,000 from nursing schools (auxiliary nurse midwives) every year. The number of doctors registered by different state medical councils was 6,68,131 during the year 2006, giving a doctor to population ratio of 60:1,00,000 (1:1,700). In addition, there are more than six lakh practitioners of Indian Systems of Medicine and Homoeopathy. Taking all these numbers together, the doctor-population ratio comes to 1:870. This is well short of the ratio prevalent in developed countries: Australia – 1:249, Canada – 1:209, United Kingdom – 1:166.5, and United States of America – 1: 548.9.

A high-level group that submitted its report to the prime minister on service sectors observed that public healthcare has been on a serious decline during the last two decades because of non-availability of medical and paramedical staff, diagnostic services and medicines.

“Critical shortage of health personnel, inadequate incentives, poor working conditions, lack of transparency in posting of doctors in rural areas, absenteeism, long waits, inconvenient clinic hours, poor outreach, time of service, insensitivity to local needs, inadequate planning, management and monitoring of service and facilities appear to be the main reason,” the report said.

Incidentally, India ranks at the top among nations whose physicians are working in developed countries and holds the second position to Philippines with respect to nurses. India has also emerged as a supplier of other categories of healthcare professionals to a number of countries, particularly radiologists, laboratory technicians, dental hygienists, physiotherapists and medical rehabilitation workers.

The group, headed by Anwarul Hoda, has recommended opening of the medical education sector for private sector participation to increase the supply of human resources at all levels. It also suggested allowing private companies to establish medical and dental colleges just as they have been allowed to open nursing colleges. Other entry barriers such as land and built-up space should be lowered to realistic levels, the report said.

Other recommendations include filling up vacant posts to improve quality of teaching in government medical colleges and enabling them to provide higher incentives. The paramedical council for regulatory purposes and the proposed institute of paramedical sciences should be established to cope with the shortage of paramedical staff. The government should also draw from the rich pool of NRIs by recognising degrees awarded by other countries.

Acknowledging the severe crunch, health minister Dr Anbumani Ramadoss said that the government has already decided to recognise post-graduate medical degrees issued by five English-speaking countries. “This would also help us in some way as we hope that doctors would come to India to work here,” Ramadoss said.