Rajasthan’s Healthcare Crisis: 40 percent Doctor Deficit, 38.5 percent specialists shortage
Jaipur: The Comptroller and Auditor General (CAG) of India has raised serious concerns over the shortage of doctors, nurses, and paramedical staff in Rajasthan, highlighting a 40% deficit in the required number of doctors based on the World Health Organization (WHO) benchmark.
The performance audit report on Public Health Infrastructure and Management of Health Services in Rajasthan underscores critical gaps in healthcare staffing, particularly in rural, desert, and tribal areas of the state.
Acute Shortage of Doctors in Rajasthan
The CAG report states that Rajasthan requires 82,506 doctors to meet the WHO-recommended doctor-population ratio of 1:1000. However, as per the Indian Medical Register of the National Medical Commission (NMC), only 49,242 doctors were registered in Rajasthan as of 2021, leading to an alarming doctor-population ratio of 1:1676. The report highlights:
“There was a 40 per cent shortage of doctors in the State.”
The shortage is more severe in government hospitals, with many medical institutions operating with only 65% of the required doctors.
Human Resource Deficit Across Healthcare Sectors
The CAG report identifies significant shortfalls in human resources across various healthcare levels:
Primary and Secondary Healthcare: The shortage of doctors is 35.51%, while nurses and paramedics face a deficit of 18.56% and 55.88%, respectively.
Tertiary Healthcare Institutions: There is a 21.45% shortfall of doctors, a 24.89% shortage of specialist doctors, and a 44.93% shortage of paramedics.
Contractual Staff: The most acute deficit is in contractual staff, with a 50.19% shortage.
District-Wise Disparities in Doctor Availability
The report highlights severe regional disparities, with Pratapgarh, Chittorgarh, Banswara, Dholpur, Jalore, and Barmer facing the worst shortages. In Jaipur, the sudden increase in sanctioned posts in 2021 could not be filled, worsening the crisis.
“The vacancies were more pronounced in the desert and tribal areas of the State.”
Shortage of Specialist Doctors in Hospitals
The availability of specialist doctors in government hospitals is critically low. As of March 2024, the Department of Medical, Health and Family Welfare (DMH&FW) reported a 38.55% shortfall in specialist doctors across various departments.
The highest shortages were observed in:
Orthopedic Surgeons (44.74%)
General Surgeons (41.54%)
Ophthalmologists (40.09%)
Pediatricians (28.54%)
Gynecologists (32.26%)
The report criticizes this staffing crisis, stating:
“The vacancies among Surgeon, Orthopaedic Surgeon, Ophthalmologist were more than 40 per cent.”
Non-Functional Trauma Centers Due to Staff Shortages
The state government approved 101 trauma centers across Rajasthan. However, only 74 are operational, while 27 function with minimal staff in existing hospital buildings. Shockingly, 50% of the test-checked district hospitals lacked a functioning trauma center, leading to delays in emergency care.
“A high percentage of the patients in accident cases were being referred to the nearest operational Trauma Care Centers. Precious time was thus lost in transferring the patients, which in turn delayed their medical care.”
Even in operational trauma centers, the staffing shortage remains severe, with 294 out of 498 sanctioned doctor/specialist posts vacant.
Recruitment Failures and Government Response
Despite recruiting 6,537 doctors and 28,300 nurses between 2016-2022, the staffing shortage persists, and no long-term recruitment plan has been formulated. The state government admitted that recruitment follows budget announcements and temporary directives but has no structured plan.
“The Government of Rajasthan did not have a long-term plan for recruitment and staffing in the health sector.”
The CAG rejected the government’s justification, stating:
“The reply is not tenable as the GoR did not prepare a recruitment plan for filling up the vacancies of doctors.”
Recommendations for Addressing the Crisis
The CAG has urged the Rajasthan government to prioritize doctor recruitment and distribution to improve healthcare accessibility. The report strongly recommends:
“The State Government should address the shortage of healthcare professionals in a time-bound manner by adopting a clearly defined recruitment strategy as well as ensuring their equitable distribution across the State.”
It further highlights the urgent need for increased staffing in trauma centers, medical colleges, and district hospitals to prevent delays in treatment and improve patient outcomes.