ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)
(a): The National Rural Health Mission (NRHM) was launched in 2005 to provide universal access to equitable, affordable and quality health care which is accountable, and at the same time responsive to the needs of the people, especially those who live in the rural areas of the country. As per Rural Health Statistics (RHS) 2017, the health care infrastructure has increased after launch of NRHM in April 2005. The number of public health facilities in rural areas State/UT-wise during 2005 and 2017 is at Annexure.
(b): Public health and hospitals being a State subject. Shortage of doctors and Infrastructure in public health sector varies from State to State depending upon their policies and context. However, under the National Health Mission (NHM), financial and technical support is provided to States/UTs to strengthen their healthcare systems including support for new construction, renovation/upgradation of existing facilities and also for engagement of doctors and other professionals on contractual basis, based on the requirements posed by them in their Programme Implementation Plans (PIPs) within their overall resource envelope.
(c): The Government has taken various steps to train more health professionals and depute them in rural areas, these efforts include:
I. 50% reservation in Post Graduate Diploma Courses for Medical Officers in the Government service who have served for at least three years in remote and difficult areas.
II. Incentive at the rate of 10% of the marks obtained for each year in service in remote or difficult areas up to the maximum of 30% of the marks obtained in the entrance test for admissions in Post Graduate Medical Courses.
III. Support is provided to States/UTs for 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.
IV. The States are encouraged to adopt flexible norms for engaging specialists at public health facilities. These include various mechanisms for ‘contacting in’ and ‘contracting out’ of specialist services, methods of engaging specialists outside the government system for service delivery at public facilities and the mechanism to include requests for these in the state Program Implementation Plans (PIP) under the National Health Mission.
(d): As stated above, public health and hospitals being a State subject, the primary responsibility to improve better health care services in rural areas lies with the respective State Governments. However, under the National Health Mission (NHM), technical and financial support is provided to States/UTs to strengthen and improve their healthcare system based on the proposals made by the States/UTs in their Programme Implementation Plans (PIPs) within their overall resource envelope.
The Government has taken various steps to to improve/ provide better health care services in rural areas. These efforts include-
I. The ratio of teachers to students has been revised from 1:1 to 1:2 for all MD/MS disciplines and 1:1 to 1:3 in subjects of Anaesthesiology, Forensic Medicine, Radiotherapy, Medical Oncology, Surgical Oncology and Psychiatry in all medical colleges across the country. Further, teacher: student ratio in public funded Government Medical Colleges for Professor has been increased from 1:2 to 1:3 in all clinical subjects and for Associate Professor from 1:1 to 1:2 if the Associate Professor is a unit head. This would result in increase in number of specialists in the country.
II. Diplomate of National Board (DNB) qualification has been recognized for appointment as faculty to take care of shortage of faculty.
III. Enhancement of maximum intake capacity at MBBS level from 150 to 250.
IV. Enhancement of age limit for appointment/ extension/ re-employment against posts of teachers/dean/principal/ director in medical colleges from 65-70 years.
V. relaxation in the norms of setting up of Medical College in terms of requirement for land, faculty, staff, bed/bed strength and other infrastructure.
VI. Strengthening/upgradation of State Government Medical Colleges for starting new PG courses/Increase of PG seats.
VII. Establishment of New Medical Colleges by upgrading district/referral hospitals preferably in underserved districts of the country.
VIII. Strengthening/ upgradation of existing State Government/Central Government Medical Colleges to increase MBBS seats.
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