CAG Report Highlights Critical Shortages in Gujarat’s Healthcare System

Gandhinagar: The Comptroller and Auditor General of India (CAG) has raised serious concerns about Gujarat’s healthcare infrastructure, citing a significant shortage of medical personnel, hospital beds, and essential services. The report, tabled in the state assembly on Friday, also criticized the absence of a comprehensive health policy and recommended increased budget allocation for the sector.
According to the ‘Report of the CAG of India on Public Health Infrastructure of Health Services,’ over 25 per cent shortage of doctors and paramedics was observed across 22 and 19 districts, respectively, out of Gujarat’s 33 districts.
CAG also said that Gujarat may increase the budgetary allocation for the health sector up to 8 per cent of the state budget as recommended by the National Health Policy (NHP) in 2017. The central auditor said the state’s Health and Family Welfare Department had not framed a policy for human resource management for the public health institutions.
The findings indicate that, despite the recruitment of 9,983 healthcare personnel between 2016 and 2022, vacancies persisted at 23 per cent for doctors, 6 per cent for nurses, and 23 per cent for paramedics in public health institutions as of March 2022. The overall vacancy in doctors, nurses, and paramedics in public health facilities stood at 13 per cent as of March 2022. The shortage was particularly acute for specialist doctors, with vacancies reaching 51 per cent in sub-district hospitals (SDHs) and 49 per cent in community health centres (CHCs).
“Under the National Health Mission Scheme, 31 per cent of specialist doctors and 32 per cent of paramedics posts were vacant as of March 2022. Overall, 76 per cent shortage of teaching staff was noticed in Nursing Colleges/Schools against the norms of Indian Nursing Council,” said the central auditor.
As per the report, the vacancy of specialist doctors was 28 per cent in civil hospitals, 36 per cent in district hospitals (DHs) and 51 per cent in SDHs against the sanctioned strength.
“Further, against the sanctioned strength in DHs, vacancy of 18 per cent in doctors cadre, seven per cent in nurses cadre and 46 per cent in paramedics cadre existed. Out of 8,208 posts sanctioned under the National Health Mission scheme, 1,510 posts (18 per cent) remained vacant as of March 2022,” said the report.
The CAG suggested that the state government may take “necessary steps to fill up vacant posts of doctors, teachers and paramedics”.
The national auditor also pointed to shortcomings in services like emergency, intensive care units (ICUs), operation theatres (OTs) and blood banks in healthcare facilities.
“Emergency Services were partially available in 13 DHs out of 19 DHs. Separate Operation Theatres for Pediatrics (as per Indian Public Health Standards-IPHS) were not available in three civil hospitals out of five test-checked facilities,” said the CAG.
There was a shortfall of two OTs in one district hospital out of five test-checked DHs. Blood bank service was not available in three such hospitals out of 19 DHs, it said.
“Pathology services were partially available in all 19 DHs. Ambulance services were partially available in 15 DHs out of 19 DHs. Mortuary service was not available in four DHs out of 19 DHs. Dietary service was not available in one DH out of 19 DHs,” said the report.
The CAG said the state may take steps to improve these services with the required manpower and equipment. In 16 of 19 district hospitals in Gujarat, the number of beds was less than prescribed as per the IPHS norms, it said. The report also pointed out a shortage of beds and building infrastructure.
It further said that the state government has not framed a “comprehensive health policy” to guide the development of the health sector in Gujarat. The percentage of capital expenditure to total expenditure on health was 14.17 during 2016-22. The percentage of the health budget to the total state budget for 2021-22 was 5.42, which was less than the target of more than eight per cent as laid down under the National Health Policy 2017, said the report.
“Government may take necessary steps to increase the budgetary allocation for the health sector up to eight per cent of the state budget and make efforts to augment the capital expenditure in the healthcare sector,” it added.