Bangalore - The nation's healthcare sector faces significant gaps as its facilities grapple with a shortage of essential healthcare workers. On the 7th of November, the High Court of Karnataka expressed deep concern about the scarcity of doctors and medical personnel within government-operated hospitals in the state. In response to this pressing issue, the court took proactive steps by initiating a Public Interest Litigation (PIL) of its own accord. The overseeing bench, comprised of Chief Justice Prasanna B Varale and Justice Krishna S Dixit, has appointed advocate Shreedhar Prabhu as the amicus curiae to provide valuable legal assistance and insights on this matter to the court.
Referencing a report published on October 16th by the Federation of Indian Chambers of Commerce and Industry (FICCI) in collaboration with the State Government, the Karnataka High Court highlighted the uneven distribution of medical staff and primary health centers across the state. This revealed a significant shortage of healthcare personnel in 30 districts of Karnataka. Specific districts such as Bengaluru Urban, Belagavi, Mysuru, Tumakuru, Hassan, and Mandya collectively accounted for 39.1% of the shortage of nursing staff.
The state lacks 16,500 medical employees. The report's findings emphasize the gravity of the healthcare personnel deficit, revealing shortages of various medical professionals, including 723 MBBS doctors, 7,492 nurses, 1,517 lab technicians, 1,517 pharmacists, 1,752 attendants, and 3,253 Group D workers. This scarcity encompasses a wide range of medical roles, from doctors to support staff, highlighting the extensive nature of the problem.
Moreover, the report highlights a shortage of Public Health Centers (PHCs) across the state. A total of 245 urban centers and 209 rural centers face deficits in providing essential healthcare services to the public. This shortage not only signifies a lack of healthcare personnel but also an insufficient number of healthcare facilities to meet the healthcare needs of the population, particularly in both urban and rural areas.
The report underscores that while urban areas maintain adequate medical infrastructure, rural regions face a severe shortage of primary, secondary, and tertiary health centers. Additionally, the report notes the need for an additional 160,000 beds to ensure comprehensive healthcare coverage under the Ayushman Bharat National Health Protection scheme.
Dr. BL Sujatha Rathod, the Director of Medical Education, highlighted that many healthcare centers in the state only hire the minimum number of staff as per the standards set by the National Medical Council. As a result, vacant positions persist, leading to an inadequate workforce to address the increasing patient load. This situation underscores the need to create more sanctioned positions to meet the healthcare demands of the population.
Furthermore, the report reveals that individuals residing in rural areas often have to travel long distances to access medical services in the nearest urban centers. To address this issue, the FICCI report suggests the establishment of '500-bed Multidisciplinary Hospitals' in smaller towns. This strategic approach aims to ensure that medical professionals are readily available to cater to the healthcare needs of the local population. By establishing such hospitals in smaller towns, it can alleviate the burden on urban healthcare facilities and improve healthcare accessibility for those living in rural areas.
The issue at hand is the scarcity of doctors, a shortage that is becoming increasingly critical as India assumes the mantle of the world's most populous country. According to the World Health Organization (WHO), India's doctor-to-patient ratio reached a historic peak of 1.2 doctors for every 1,000 patients in 1991. However, as India's population continued to grow significantly, this ratio declined to approximately 0.7 doctors per 1,000 patients by 2020.
This decline in the doctor-to-patient ratio signifies a substantial deficit of healthcare professionals in India, highlighting the growing gap between the healthcare requirements of the population and the available medical resources. While India has been constructing more hospitals to accommodate its burgeoning population, the shortage of doctors has become a pressing issue that needs to be addressed to ensure that the healthcare system effectively meets the people's needs.
In March 2023, Health Minister Mansukh Mandaviya informed the parliament that India's doctor-to-patient ratio was 1 doctor for every 834 patients, surpassing the World Health Organization (WHO) standards. It's essential to note that this figure encompasses doctors practicing traditional forms of medicine like Ayurveda, Homoeopathy, and Naturopathy. It's important to highlight that the WHO and medical organizations such as the Indian Medical Association don't include traditional medicine practitioners in calculating the doctor-to-patient ratio. This difference in inclusion criteria can result in variations in reported ratios and interpretations of the healthcare workforce's adequacy in India.
The term "initiated public interest litigation (PIL) on its own" signifies that the court is taking the initiative to address the problem without being prompted by any external party or complaint. This proactive approach underscores the court's commitment to protecting the interests of the public and ensuring that adequate medical services are available to the citizens of Karnataka.
The term "amicus curiae" translates to "friend of the court." An amicus curiae is an impartial legal expert appointed by the court to offer expertise, guidance, and information on the case at hand. They are not a party to the case but provide valuable assistance by presenting legal arguments, conducting research, and offering their perspective to help the court make informed decisions.
The shortage of doctors and medical staff in state-run hospitals is a serious concern that can have far-reaching implications for public health and access to medical care. By initiating the PIL, the High Court of Karnataka is likely to investigate the root causes of this shortage, assess its impact on the healthcare system, and potentially issue directives or recommendations to the government to rectify the situation. This legal action demonstrates the court's commitment to upholding the right to healthcare for the people of Karnataka and its role in ensuring that the government addresses this pressing issue.