42% manpower shortage cripples health services across Haryana: CAG
No obstetrics and gynecology specialist was posted in District Hospital (DH) and Sub Divisional Civil Hospitals (SDCHs) of Kaithal despite OPD cases of 52,365, while just one each was posted in Kurukshetra and Narnaul, even though the OPD cases were 27,086 and 62,004 in 2022-23 respectively.
There was one pediatrician posted in Bhiwani’s DH and SDCHs despite OPD cases of 33,191 in 2022-23, and one in Narnaul despite OPD cases of 38,320. There was no medicine specialist posted in DHs and SDCHs in Fatehabad despite an OPD of 20,745, in Narnaul despite an OPD cases of 1.39 lakh, none in Palwal despite an OPD of 1.03 lakh, and none in Yamunanagar despite an OPD cases of 1.45 lakh in 2022-23. Non-specialists handled these OPDs. These facts were revealed in CAG’s report, ‘Public Health Infrastructure and Management of Health Services’, tabled today in Vidhan Sabha.
Not in pink of health
Under the DMER, which includes sanctioned strength of five medical colleges at Karnal, Faridabad, Sonipat, Agroha and Nuh, and the University of Health Sciences, Rohtak, there is a shortage of 40.20 per cent vacancies of doctors, 23.9 per cent of nurses, and 62.5 per cent of Paramedics
There is an overall 41.82 per cent shortage in permanent staff deployed in the health department in Haryana as 17,409 of the 41,628 sanctioned posts were vacant, says CAG.
Taking data as of October 2022, the CAG pointed out that the Food and Drugs Administration has 56 per cent vacant posts while Ayush has 55 per cent. There is 46 per cent vacancy in the Department of Medical Education and Research (DMER) that comprises government medical colleges, and 40 per cent under Director General Health Services (DGHS).
In DGHS, against a sanctioned strength of 5,721 doctors, 1,640 posts are vacant as of October 2022, which comprises 28.7 per cent of the sanctioned strength. Among nurses, 1,905 posts are vacant which comprises 34.8 per cent of the total strength, while 3,725 posts of paramedics are vacant which amounts to 40.9 per cent of the total posts.
Pointing out the uneven distribution of available manpower, CAG said that vacancies of doctors, paramedics, and nurses ranged from 14.92 per cent in Rohtak to 57.48 per cent in Yamunanagar. “The posts of doctors were lying vacant in all the districts except in Panchkula district where 12 doctors are posted in excess of the sanctioned strength. Vacancies at district level range from lowest (12) in Rewari to highest (121) in Hisar,” said the CAG.
“… shortage of Radiographer/Ultrasound Technicians against the sanctioned strength varied from 37.5 per cent in Rohtak district to 100 per cent in Fatehabad district. Availability of staff nurse against sanctioned strength varied from excess by 0.65 per cent in Rohtak to 51.62 per cent in Ambala district,” said the CAG
The CAG noted that the Specialists were in excess in 300-bedded District Hospitals (DHs) by 22 per cent, in 200-bedded DHs by 45 per cent, and in 100-bedded DHs by 18 per cent when compared to IPHS norms. However, there is an uneven distribution that has resulted in a shortage of 41 per cent in Charkhi Dadri, 35 per cent in Kaithal, and 29 per cent in Fatehabad.
Overall, there is a 63 per cent shortage of Specialists in Sub Divisional Civil Hospitals (SDCHs), mainly in 100-bedded and 50-bedded ones. Here too, there is uneven distribution. “Out of 179 Specialists deputed in SDCHs, 78 were deputed in four SDCHs having 375 IPD beds i.e. Ambala Cantt, Ballabhgarh, Bahadurgarh and Mahendragarh. In the remaining 37 SDCHs (1,963 available IPD beds) only 101 Specialists were deployed. In SDCH, Deverala (two IPD beds), no doctor was found deputed,” said the CAG.
It added, “Due to a shortage of Specialists, the available bed capacity could not be utilised. Further, due to non-availability of Specialists in many specialties, services could not be provided to the patients,” said CAG.