According to information provided by the Union Minister of State for Health and Family Welfare Anupriya Patel, in a written reply to the Rajya Sabha recently, of the total 25,650 primary health centres (PHCs) in the country, 15,700 (61.2%) function with one doctor each. As many as 1,974 (7.69%) PHCs do not have even a single doctor.

As per to the Indian Public Health Standards (IPHS) guidelines, each 24/7 PHC should have a minimum of two doctors apart from a desirable third, apart from three nurses, one lab technician and one pharmacist.

While 9,183 (35.8%) of the total number of PHCs do not have a lab technician, 4,744 (18.4%) do not have a pharmacist.

Gujarat worst

Among the big States, where the number of PHCs are more than 600, Gujarat tops the list with 100% of its 1,392 centres having one doctor each. In Karnataka, 1,973 of the 2,359 PHCs in the State have just one doctor each. Karnataka stands fifth (in terms of PHCs with single doctor) with 83.6%, followed by Kerala with 81.7%.

In terms of percentage, Gujarat is followed by Sikkim, Himachal Pradesh and Mizoram, where PHCs functioning with one doctor each range between 84% and 87%. However, Sikkim, Himachal Pradesh and Mizoram have the least number of PHCs.

Among the better performing States are Tamil Nadu and Maharashtra, where only 14.4% of 1,362 PHCs and 23.8% of 1814 PHCs, respectively, have one doctor each.

Sylvia Karpagam, public health researcher, said it was unfortunate that over 61% of the total PHCs in the country function with one doctor each. “The closer health facilities are to people, the more likely they are to access it and the less expensive they will be. Primary health centres are the first point of contact for patients. They are the core of preventive, promotive, curative and rehabilitative healthcare,” she said.

She alleged that the agenda of the private sector was to move healthcare further and further away from people. “A fully functional primary health centre can meet most healthcare needs, and only complicated cases need to be referred to secondary or tertiary facilities. This makes budgetary sense and healthcare sense,” she said.

Telemedicine suggested

Dr. C.N. Manjunath, Director, Sri Jayadeva Institute of Cardiovascular Sciences, Bengaluru, said that lack of safety and adequate protection for doctors, and political interference, were the chief reasons for doctors keeping away from working in rural areas. “The best way is to keep these primary health centres connected is through telemedicine,” he added.