Special cadre for health services mooted

23 Oct

NEW DELHI: India must put in place a new army of health workers – the Public Health Service Cadre – to fight the public health threats.

The Planning Commission’s high-level expert group (HLEG) on universal health coverage (UHC) says, a national and state-level Public Health Service Cadre and a specialized state-level Health Systems Management Cadre needs to be put in place. This will help provide greater attention to public health and also strengthen the UHC system’s management.

A new cadre, comprising public health professionals with multi-disciplinary education, would improve the functioning of the system by enhancing the efficacy, efficiency and effectiveness of healthcare delivery.

“We recommend the creation of an All India Public Health Service Cadre that should be responsible for all public health functions starting at the block level and going up to the state and national level. This cadre should be supported by a state level public health cadre. This would be akin to the civil services, which provide for both all India and state-level officers,” the HLEG’s final report, submitted to the government on Saturday, said.

The state-level cadre will provide the operational framework of public health services, the All-India cadre will not only health strengthen state services with a high level of professional expertise, but also provide strong connectivity between state and Central planning.

The HLEG has recommended the creation of a new Health Systems Management Cadre.

Quality assessment and assurance for health facilities will be a key function for the cadre. The health system managers would take over many of the administrative responsibilities in areas such as IT, finance, human resources, planning and communication that are currently performed by medical personnel.

“We further recommend the appointment of appropriately trained hospital managers at sub-district, district hospitals and medical college hospitals so as to improve the managerial efficiency and also enable medical officers to concentrate on clinical activities. Appropriate training of these new cadres is likely to significantly enhance the management capacities at all levels and end the practice of untrained personnel being assigned to manage health institutions,” the report added.

India faces an acute shortage of allopathic doctors. HLEG’s estimates say the number of allopathic doctors registered with the Medical Council of India has increased since 1974 to 6.12 lakhs in 2011 – a ratio of 1 doctor for 1,953 people or a density of 0.5 doctors per 1,000 population.

It will take India at least 17 more years before it can reach the World Health Organization’s recommended norm of one doctor per 1,000 population.

The HLEG has predicted the availability of allopathic doctors to one doctor per 1000 population by 2028, which can be achieved by setting up of 187 medical colleges in 17 high focus states during the 12th and 13th Five Year plan.


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