The Comptroller and Auditor General of India (CAG) has recently released a report exposing major deficiencies in Gujarat’s public healthcare sector. The report highlights critical issues such as shortages of medical professionals, inadequate infrastructure, and insufficient budgetary allocations, which severely impact the state’s ability to provide effective healthcare services.
Human Resource Shortages in Healthcare
A significant concern raised by the CAG is the acute shortage of healthcare personnel across Gujarat’s public health institutions. Despite recruiting thousands of healthcare workers in recent years, the state continues to struggle with vacancies.
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Doctors: There is a 23% shortfall in doctor positions, with 22 out of 33 districts reporting that over 25% of doctor posts remain unfilled.
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Nurses: A 6% vacancy rate exists in nursing positions, which is crucial as nurses play a vital role in patient care.
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Paramedics: A 23% shortage in paramedic staff, with 19 districts experiencing vacancies exceeding 25%.
The situation is particularly alarming in specialist doctor positions:
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Sub-District Hospitals (SDHs): 51% of specialist doctor positions are vacant.
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Community Health Centres (CHCs): 49% of specialist roles remain unfilled.
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District Hospitals (DHs): Vacancies include 36% for specialist doctors, 18% for general doctors, 7% for nurses, and 46% for paramedics.
Additionally, under the National Health Mission, 31% of specialist doctor posts and 32% of paramedic positions remain vacant. The shortage extends to nursing education, with a 76% deficiency in teaching staff across Nursing Colleges and Schools, which falls significantly short of the Indian Nursing Council’s standards.
Infrastructure Deficiencies
The CAG report also highlights substantial gaps in Gujarat’s healthcare infrastructure, affecting the availability and quality of medical services.
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Hospital Beds: In most district hospitals, the number of beds is below the required standards, leading to severe capacity issues.
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Emergency Services: Only a few district hospitals provide full emergency care, while others offer only partial services, limiting their ability to handle critical cases.
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Operation Theatres (OTs): Several hospitals lack adequate operation theatres, affecting surgical care.
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Blood Banks: Some district hospitals lack blood bank facilities, which are essential for medical emergencies.
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Pathology Services: Most district hospitals provide only partial pathology services, reducing diagnostic capabilities.
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Ambulance Services: Many hospitals offer only limited ambulance services, impacting timely patient transportation.
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Mortuary Services: Some district hospitals lack proper mortuary services, affecting the respectful handling of deceased patients.
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Dietary Services: A few hospitals do not have dietary services, which are crucial for patient nutrition and recovery.
Financial Allocation and Policy Gaps
The report points to financial constraints that worsen these challenges:
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Health Budget Allocation: Gujarat allocated only 5.42% of its total state budget to health in a recent financial year, significantly lower than the recommended 8% under the National Health Policy.
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Capital Expenditure: A relatively small portion of the health budget has been spent on infrastructure development, limiting long-term improvements in the healthcare sector.
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Lack of a Comprehensive Health Policy: The absence of a well-defined health policy has resulted in uncoordinated efforts, inefficient use of resources, and gaps in healthcare service delivery.
Recommendations and the Way Forward
To address these pressing concerns, the CAG has made several recommendations:
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Improve Human Resource Management: Develop and implement a structured policy for recruiting and retaining healthcare professionals.
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Increase Budgetary Allocation: Enhance healthcare funding to align with national recommendations, ensuring sufficient resources for both operational needs and infrastructure expansion.
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Strengthen Infrastructure: Prioritize the completion of pending healthcare projects to improve service delivery.
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Enhance Medical Services: Expand essential healthcare services such as emergency care, intensive care units, operation theatres, and diagnostic facilities.
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Formulate a Comprehensive Health Policy: Establish a strategic plan to guide healthcare development and ensure coordinated efforts.
The CAG’s findings reveal critical weaknesses in Gujarat’s healthcare system, including human resource shortages, infrastructure deficiencies, and inadequate financial investment. Addressing these challenges requires a comprehensive approach that includes strategic planning, increased funding, and policy reforms. By implementing these recommendations, Gujarat can work towards building a more efficient and resilient healthcare system that meets the needs of its growing population.
