The Estimates Committee of Parliament has in a recent report expressed serious concern over the shortage of doctors and specialists in the country and recommended steps to increase the number of medical personnel. While the World Health Organisation (WHO) has recommended a doctor-population ratio of 1:1,000, India has only one doctor for 1,625 persons, and even that figure is disputed. As worrying as the shortage of general doctors is the shortage of specialists. This is particularly serious because the top 10 causes of death in the country, like diarrhoea, tuberculosis and heart and kidney diseases, have to be treated by specialists and their shortage increases the risks to patients. Primary healthcare is most important in a poor country, but in a country of 125 crore people, the health sector should be equipped to handle all challenges, especially the mass killers. But the shortage is too big to be addressed in the next few years.
The requirements for specialists like cardiologists, endocrinologists and paediatricians is 10 to 15 times of the present availability. The government health sector should be able to offer adequate specialist treatment to all those who need it. But in four states and UTs there is not a single specialist, and a major state like Karnataka has only 70 of them, which is the lowest in the southern states. Though there are more specialists in the private sector, the ordinary patient cannot afford them. There are major hurdles in the way of producing the needed number of specialist doctors. Medical colleges offer very few seats in post-graduate courses which lead to specialisation. India has the largest number of medical colleges in the world but is unable to produce enough number of doctors and specialists. The inadequate number of seats in colleges is the main reason for the malpractices in medical admissions, which in turn result in the lowering of standards of education.
The committee has recommended an increase in the number of seats of post-graduate courses. But it is not easy to ensure adequate number of qualified teachers and infrastructure for these courses. The quality of education should not be compromised while trying to produce more specialists and doctors. No easy way out should be tried either. At present, only specialists are legally allowed to treat non-communicable diseases and to perform surgeries, anaesthetic procedures, etc. The rule is often violated. The central government has a plan to recognise diplomas from some reputed institutes as equivalent to specialist qualifications for MBBS doctors. This should be done with care and it should not be misused.