The Union health ministry recently stated that there is a dearth of over 3,000 doctors in Central government hospitals in rural as well as urban areas. Shockingly, some of the prestigious hospitals in the country, including the All India Institute of Medical Sciences, New Delhi, have vacancies. Further, the shortage is more pronounced among nursing and support staff: there are over 20,000 posts lying vacant in these hospitals. This is disconcerting as it puts a severe strain on public healthcare delivery, the impact of which can be particularly adverse in the villages where the shortage of medical infrastructure and healthcare staff is considered acute. For instance, according to the Rural Health Statistics 2021-2022, there is an 80% shortfall in paediatricians and surgeons and more than 70% paucity in physicians, obstetricians and gynaecologists in these areas. Worse, the total staff strength in community health centres, health sub-centres and primary health centres — crucial first points of contact in the rural healthcare network — was thinner than even in 2020-21. These twin datasets unveil formidable challenges for the health management system. Some of the consequences are obvious: India’s high infant and maternal mortality rates can be attributed to the paucity of medical carers in remote areas. The absence of doctors in the hinterland also puts pressure on hospitals in cities to which patients are usually sent.
The ratio of allopathic doctors to India’s population is 1:1445, which is significantly lower than the World Health Organization’s prescribed standard of 100 doctors per one lakh people — the Centre’s claim of 1:834 is inflated to include Ayush doctors. Districts with poor doctor density are concentrated mostly in Northeast and central India. These regions need special attention. The government has tried to solve the imbalance by increasing the number of medical institutions in the interiors. However, this has not been able to serve its purpose as doctors often prefer urban postings because of professional incentives and better infrastructure even though the stipulations demand that medical students should serve in rural areas for a particular period required by the state government which runs the government medical college. Perhaps a mixture of stringent regulations and appeals to the conscience could make the difference for a community whose members are supposed to honour the spirit of the Hippocratic oath.