ANSWER
THE MINISTER OF HEALTH AND FAMILY WELFARE
(DR. HARSH VARDHAN)
(a): Public Health and hospitals being a State subject, it is responsibility of the States/UTs to set up health centres as per their requirements and felt need. The number of rural health centres like Sub-centres, Primary Health Centres and Community Health Centres in position vis-à-vis requirement during the last ten years including the current year as per Rural Health Statistics, are placed at Annexures I to III. The present status is as per 2019 figures of Annexures I to III. The amount of expenditure under Hospital Strengthening which includes new constructions of health centres during the period, as reported by the States/UTs, is as at Annexure-IV.
(b): Public health and hospitals being a State subject, the primary responsibility for proper assessment of progress in providing in public health infrastructure, lies with the State/UT Governments. However, the Government of India have taken several steps to monitor the implementation and assessment of progress of NHM in the States/UTs including Telangana, which are as under:
o Performance Audit by the CAG,
o Annual Statutory Audits by CAG empanelled major Chartered Accountant audit firms;
o Examination of quarterly Financial Monitoring Reports (FMR) furnished by the States;
o Visits by the teams of the Financial Management Group of the Department to the States/UTs for periodic review.
o Annual visits to States by Common Review Mission (CRM) which inter-alia, looks at financial systems and mechanisms as well as review of progress of NHM. Usually, one performing district and one under performing district of each State are taken for review. So far 12 CRMs have been held out of which Telangana figured in 8th, 11th and 12th CRM. The detailed reports can be accessed at https://nhm.gov.in/index1.php?lang=1&level=1&sublinkid=795&lid=195
o Integrated monitoring visits by senior officials of the Ministry and National Health System Resource.
(c): Public health and hospitals being a State subject, it is their prerogative to provide basic facilities and engage Health Human Resource consisting of doctors and other staff. Financial and technical assistance is provided under National Health Mission to supplement their efforts in strengthening healthcare infrastructure.
The position of shortage of facilities and shortage of doctors and staff in the rural health centres based on Rural Health Statistics(RHS) as on 31.03.2019 is placed as per Annexures V to XIV. As regards availability of medicines, it is stated that Public health & hospitals being a State subject, the primary responsibility of ensuring the sufficient supply of medicines is that of respective State Government. Under the National Health Mission (NHM), the central government supplements the efforts of state governments to strengthen their healthcare system including for provision of free essential medicines in public health facilities, based on proposals of the State Governments.
(d): NHM support is provided to States/ UTs for setting up of new facilities as per norms and upgradation of existing facilities for bridging the infrastructure gaps and to fill up the vacancies of Human Resource on contractual basis based on the requirement posed by them
As per the budget announcement 2017-18, 1.5 lakh Health Sub Centres and Primary Health Centres are being transformed into Health and Wellness Centres across the country under Ayushman Bharat (AB-HWCs) for provision of comprehensive primary care that includes preventive healthcare and health promotion at the community level with continuum of care approach.
The AB-HWCs will provide an expanded range of services to include care for non – communicable diseases, palliative and rehabilitative care, Oral, Eye and ENT care, mental health and first level care for emergencies and trauma as well as health promotion and wellness activities like Yoga apart from services already being provided for maternal and child health including immunization and communicable diseases.
As regards provision of better health services in Telangana, since the creation of the State, a total amount of Rs. 4039.71 crore has been approved under NHM upto 2018-19. 193 Sub-Centres and 613 Primary Health Centres have been converted into Health and Wellness Centres and are functioning as on 3rd March, 2020. Till 2019-20 approvals for 987 Sub-health Centres and 636 Primary Health Centres have been accorded. The State has reported total expenditure of Rs. 602.31 crore till 31.12.2019 towards hospital strengthening.
Further steps taken for better health services which include:
• Implementation of National Health Mission Free Drugs and Free Diagnostic initiative to provide essential drugs and diagnostics free of cost in public health facilities.
• Screening and Management of 5 common NCDs of hypertension, diabetes, and cancers of oral, cervix and breast.
• Kayakalp : As part of contribution towards the Swachh Bharat Abhiyaan launched by the Prime Minister on 2nd October 2014, the Ministry of Health & Family Welfare, Government of India launched “Kayakalp - Award to Public Health Facilities.
• LaQshya : Ministry of Health & Family Welfare, Government of India launched an ambitious Reduce maternal and newborn morbidity and mortality program LaQshya to improve quality of care during delivery and immediate post-partum period and to reduce maternal and newborn morbidity and mortality.
• The States have issued guidelines for specialist appointment under National Health Mission which includes:
• Flexible/negotiable remuneration for doctors and specialists as per the market reality for that area/facility and for the specialty.
• Hard area allowance to doctors especially specialists, for serving in tribal/remote/difficult area.
• Performance based payment to specialist.
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