There is an extreme shortage of doctors in the country, with perhaps only one doctor available for 2000 patients, found the Parliamentary Standing Committee report on the Medical Council of India. The report, that came out Wednesday, went beyond just pointing out how the statutory body had failed to regulate medical education in the country, it dug up many glaring lapses in public health in India, not least this alarming deficit of doctors.
The report is stringent in its criticism of the body's workings, and laid down that the doctor to patient ratio was far worse than what MCI admitted, most probably 1:2000 as compared to 1:1674. The latter ratio was calculated based on the number of practising doctors in MCI's records, of 9.29 lakh registered in the Indian Medical Register. Even that does not hold up to the norm set by the World Health Organisation of 1:1000.
However, as the report points out, the number of 9.29 lakh includes doctors who have gone abroad, or retired from service or even passed a way. Thus the Committee called itself "highly sceptical" of the Ministry's claim of one doctor for 1674 patients, pegging it at one for 2000 patients.
Much of the pressing need for doctors is because of India's spiralling non communicable disease burden of cardiovascular disease, cancer, diabetes, chronic respiratory disorders, etc. The Committee, scathingly, noted that "the MCI has been unresponsive to health system needs with the result that shortage in number of basic doctors and specialists, mal-distribution of medical colleges and doctors across the states continue to plague the delivery of effective and equitable health care".
The Standing Committee's concern is thus not only for the shortage of doctors but the skewed distribution across the country. It states that nearly 65 percent of the medical colleges are situated in western and southern states , while the north, the north east and central parts of the country suffer from a lower number of doctors due to a lower number of colleges. The Committee finds that since doctors tend to settle in the cities they go to study in, and not necessarily return to their own "urban or rural" areas, where and how medical colleges are placed matters. This makes the following statistic even more worrying: six states with 31 percent of the country's population account for 58 percent of the MBBS seats, while eight states with 46 percent of the country's population have 21 percent of the seats.
The report states that experts who deposed before the Committee reckoned if the country added 100 medical colleges a year for the next five years, then by 2029 would there be adequate number of doctors. However, as the then health secretary submitted it took Rs 200 crore to set up a college and Rs 1500 crore to set up an AIIMS, making it "not possible to set up enough colleges and AIIMS like institutions to take care of the backlog".
Interestingly, the day the report was released, union health minister JP Nadda was quizzed by reporters as to how his ministry would clear the immense backlog in government hospitals, especially AIIMS in New Delhi. He only answered that AIIMS capacity was being doubled to 3000 beds, the ministry was working on human resources and people would see the results soon.
Pinching hard
Ratio of doctor to patient based on MCI records: 1:1674
Ratio of doctor to patient based on Committee's observation: 1:2000
Six states with 31 percent of India's population have 58 percent MBBS seats
Eight states with 46 percent of India's population have 21 percent MBBS seats
