How effective are the health services in the State? If the number of serving doctors is any indication, the health system is in a total disarray.
As per the national average, there are 59.7 doctors per one lakh population. This means one doctor is available for 1,666 persons while in Orissa the the doctor-population ratio is 1:7462.
The State requires at least 18,000 doctors to reach the national average while sanctioned strength of doctors is 4,500. Nearly 800 posts are lying vacant and if 300 doctors will be either on leave or attending seminars in or outside the State, their effective strength on any given day will be around 3,400 or less.
On an average three percent (135) doctors retire every year. While doctors are not ready to take up rural posting, the annual vacancies due to retirement is difficult to replenish.
It is easy to blame the Government for the large number of the vacancies and the resultant poor health services, the problem lies at the planning level. The existing three medical colleges, having an intake capacity of 360 students, are not enough to meet the demands either.
There is a yawning gap between supply and demand of doctors in the State while all the four southern States produce surplus doctors. This is because of private players entering the medical education, which is lacking in the State.
The medical colleges in Cuttack, Berhampur and Burla have 360 seats for MBBS and 238 seats for MS and MD courses. The State quota in MBBS seats is 175 while it is 119 in the post-graduate studies. The remaining seats are for outsiders. Taking into account the number of seats in MS and MD, the net medical graduates available for the State each year is 55.
While some of them go out for higher studies, others opt for better opportunities because of the low remuneration provided by the State Government. Hardly any of the graduate doctors prefer to do State service, the sources said.
As per the national count, one medical college is required for every 50 lakh population. By that criterion, the State needs eight medical colleges as against the existing three.
Although a medical college in the private sector has come up, it will take another five years to get the benefit. Comparatively, Andhra
Pradesh has 11, Karnataka 20, and Tamil Nadu and Kerala have seven each surplus medical colleges.
The Government has decided to construct staff quarters for medics and para-medics working at block levels with a Rs 350-crore budget.
Resources will be mobilised through loans from the NABARD under Rural Infrastructure Development Fund (RIDF) and Central assistance from backward region grants fund (BRGF). Although the State Government claimed to have completed the infrastructure development of rural health-care institutions under the World Bank-aided Orissa Rural Health Development Programme, there is acute shortage of staff quarters block level downwards.
Most of the doctors and paramedics are averse to rural postings primarily due to lack of housing and absence of better education for their children and recreational facilities.
Doctors working in interior areas might be allowed to retain government accommodations in urban centres for education of their children, sources said. Change in the services rules for doctors has been approved. Agreement will be made with doctors passing out from the government medical colleges to work for at least seven years within the State.
A high-level meeting chaired by Chief Minister also approved changes in the cadre rules to give timely promotion to doctors.
Lack of timely promotion has been a major disincentive for which most are preferring private jobs. An OAS officer will be posted as administrative officer in district headquarters hospital.
With a population of nearly four crore, the State requires minimum eight medical colleges - one for 50-lakh population each - as against the existing four, including one in private sector.
The neighbouring Andhra
Pradesh having a population of 7.8 crore has 27 medical colleges against the requirement of 15.
The State is facing acute shortage of specialists in Anatomy
, Physiology
, anaesthesiology, Forensic
medicine and toxicology, Microbiology
and skin and venereal diseases.
Student intake in these subjects at PG level will be increased in the three government medical colleges.
Besides, PG diploma courses will be introduced in radiology and anaesthesiology to overcome the crisis of doctors in the two disciplines.
Each medical college and hospital will have a hospital manager having specialisation in hospital management. About 800 nurses will be appointed on contract to fill up the vacant posts.
Expenditure on health services being 3.2 percent of the total budget, the Government has decided to budget six percent by 2012.
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