A report by the Comptroller and Auditor General (CAG), presented during the winter session of the Haryana Vidhan Sabha, has highlighted significant disparities in the distribution of healthcare staff across the state. The report, titled “Public Health Infrastructure and Management of Health Services,” was tabled on Wednesday. It emphasizes the urgent need for a long-term strategy to address the uneven doctor-population ratio among different districts in Haryana.
The CAG auditors found that Haryana’s healthcare system faces substantial staffing issues, with 5,721 sanctioned positions for allopathic doctors under the Directorate General of Health Services (DGHS). This equates to one government doctor for every 4,431 residents. However, the allocation of these positions is not consistent with the population distribution. For instance, Panchkula has one doctor for every 2,339 residents, while Faridabad has one doctor for every 9,999 people.
The report noted that 15 districts, including Charkhi Dadri, Faridabad, Gurugram, Hisar, Jind, Kaithal, Karnal, Nuh, Palwal, Panipat, Rewari, Rohtak, Sirsa, Sonipat, and Yamunanagar, have fewer doctors than the state average. In these districts, the doctor-population ratio is significantly below the state-sanctioned average. The study also found that as of October 2022, a total of 7,270 posts for doctors, nurses, and paramedics were unfilled, with vacancy rates ranging from 14.92% in Rohtak to 57.48% in Yamunanagar.
Despite having various designations under the DGHS, including Medical Officers, Civil Surgeons, and Dental Surgeons, only 4,081 allopathic doctors are currently available out of the total 5,721 sanctioned posts. This translates to a 28.7% vacancy rate across the state. The report further indicates that doctors’ posts are vacant in all districts except Panchkula, where 12 doctors are employed beyond the sanctioned capacity. In terms of absolute numbers, Rewari has the fewest vacancies (12), while Hisar faces the most significant shortfall, with 121 vacancies.
The report draws attention to the state’s doctor shortage in the context of the World Health Organization’s (WHO) recommendation of one doctor per 1,000 individuals. Based on the 2011 Census, Haryana, with a population of 2.53 crore, would need 25,351 doctors to meet this standard. However, as of June 2022, only 20,891 doctors (public and private) are registered with the Haryana Medical Council, indicating a ratio of one doctor per 1,214 people. Public healthcare is even more stretched, with 6,006 public doctors available, leading to a ratio of one public doctor for every 4,221 residents.
The auditors emphasized that the shortfall of medical professionals, particularly doctors, nurses, radiographers, and technicians, has adversely impacted the delivery of comprehensive healthcare services in the state. It was noted that the specialist availability in District Hospitals (DHs) is generally satisfactory, but significant variation exists among districts, leading to shortages in many DHs. The report also highlighted the lack of specialists in Sub-Divisional Civil Hospitals (SDCHs) relative to the Indian Public Health Standards (IPHS).
To address these challenges, the CAG recommended that the Haryana government expedite the recruitment process to fill vacant positions and rationalize the existing healthcare workforce. In the short term, it was suggested that staff redistribution should consider the availability of infrastructure and complementary healthcare professionals in each institution. The goal should be to ensure that essential services are not disrupted due to uneven staffing.
Additionally, the CAG report revealed that 21 district hospitals in Haryana are experiencing a shortage of doctors, with Panipat facing the most severe deficit at 43%. In response to the CAG findings, the Haryana Health Department acknowledged in July 2023 that some of the vacant posts are being filled through outsourcing and contractual engagements. The department also pointed out that the National Health Mission (NHM) supports various healthcare facilities by providing specialists, doctors, nurses, and technicians. However, the auditors clarified that NHM staff are engaged for specific vertical health programs and are not intended to fill the gaps in the regular workforce.
The report concluded by urging the Haryana government to prioritize strategic planning and policy formulation to reduce healthcare disparities across districts, aiming for a more balanced and effective public health system.
References:
https://cag.gov.in/en/audit-report/details/120824
(Input From Various Sources)
(Rehash/Ankur Deka/MSM)