"Workforce shortages and uneven distribution of doctors, nurses, specialists and allied health professionals plague the sector," NITI Aayog said while observing that urban areas have four times as many doctors and three times as many nurses as compared to rural areas.

Government think-tank NITI Aayog has pitched for enactment of the National Medical Commission (NMC) Bill, 2017, observing that regulatory bodies the Medical Council of India and the Nursing Council of India have "failed" to ensure adequate availability and quality of health professionals. The Aayog said the quality of health professional training and adherence to standards is sub-optimal, including in the private sector.

To address the shortage of doctors in the country, the Aayog has suggested creating conditions to facilitate import of doctors, especially those of Indian origin working abroad, and also deploying teachers from universities abroad as visiting professors at AIIMS or NIEs while linking at least 40% of district hospitals with medical colleges.

"Workforce shortages and uneven distribution of doctors, nurses, specialists and allied health professionals plague the sector," the Aayog said while observing that urban areas have four times as many doctors and three times as many nurses as compared to rural areas.

Workforce management 

Pointing to the severe shortages in the category of allied health professionals (AHPs) including medical lab technicians, optometrists and radiologists, the Aayog has sought establishment of a Council to ensure standardization of education and putting in place quality control mechanisms for educational institutions, teaching methods and workforce management.

According to the report, as of March 2017, there were 10.23 lakh allopathic doctors registered with the MCI or state medical councils. Assuming 80 per cent availability, the Aayog estimated that around 8.18 lakh doctors may actually be available for active service. This gives a doctor population ratio of 1:1613 against the WHO norm of 1:1000, it said.

"Due to the sub-optimal quality of training offered by several institutions that have mushroomed over the years, limited career prospects and poor working conditions, especially in the private sector, there is a significant shortage of skilled nurses in the country," the Aayog stated.

It further said that health professionals in the public sector are inadequately compensated and motivation levels are extremely poor. Fair compensation in the private sector, for nurses, is also a challenge.

The Aayog has suggested creating a cadre of primary healthcare practitioners by introducing a three-year competency-based dynamic course for primary, community and family medicine and partner with private hospitals or private medical practitioners to skill technicians, nursing and para-nursing as well as para-medical staff to deal with paucity of health professionals.