Health Workforce Shortage - COVID-19 Health Package II

What is the issue?

The Union government recently announced the “India COVID-19 Emergency Response and Health Systems Preparedness Package: Phase II”,
The package II again overlooks the need for and availability of health human resources.

What was the health policy mistake of the mid-1980s?

In the mid-1980s, there were a number of government health-care facilities across the country.
They came with new buildings, imported state-of-the-art medical equipment and at times ‘foreign made’ cars/jeeps (for health staff’s field visits).
But in the years to follow, the number of patients attending the above facilities continued to be low.
Most of such upgraded facilities had failed to meet the health needs of the poor people.
Reason - While infrastructure was upgraded, there was perennial shortage of health staff.
Doctors, nurses and others, who were supposed to be recruited by the governments were not enough in number.
Four decades later, in the COVID-19 pandemic response, the Indian government appears to repeat the same mistake.

What is the Centre’s recent financial package?

The COVID-19 health package II has come with the stated purpose to boost health infrastructure and prepare for a possible third wave of COVID-19.
There are plans to -
1. increase COVID-19 beds
2. improve the oxygen availability and supply
3. create buffer stocks of essential medicines
4. purchase equipment and strengthen paediatric beds
However, the package barely has any attention on improving the availability of health human resources.

What is the health workforce scenario?

Even before the novel coronavirus pandemic, there were vacancies for staff in government health facilities.
It ranged from 30% to 80%, depending upon the sub-groups of medical staffs.
Also, there were wide inter-State variations, with highest vacancies in states that have poor health indicators.

The shortage in the health workforce continues well after the pandemic.
There has been occasional recognition of the health workforce shortage and a few commitments to fill the vacancies.
But very few are known to fructify, even partially, at both the Union and State levels.
Among the States which announced filling vacancies of health staff, the focus was narrow on select subgroups such doctors or nurses, and not holistic.

What is needed now?

But an intensive care unit bed or ventilator is of no use unless there are -
1. trained staff to run these equipment
2. qualified doctors and nurses to attend to patients

Thehealth package II thus needs to be urgently supplemented by another plan.
The Indian Public Health Standards (IPHS) could be an objective approach to assess the mid-term health human resource needs.
[IPHS prescribe the human resources and infrastructure needed to make various types of government health facilities functional.]
Once such a need is assessed, the Union and State governments can come up with another financial package for human resources, with shared funding.
This should complement the COVID-19 health package IIand help fill the existing vacancies of health staff at all levels as well.

What is the long-term priority?

In the long term, the pandemic should be used as an opportunity to prepare India’s health system for the future.
As an initial step in this direction, the Union Minister of Health should consider getting a comprehensive review of actions.
The decisions taken and policy promises made since the start of the pandemic and the progress on last few years’policies should be reviewed.
This should happen through the Central Council of Health and Family Welfare, of which the Health Ministers of the States are members.
In all, beyond the ad hoc and a patchwork of one or other small packages, India’s health system needs some transformational changes.

Source: The Hindu