Poor doctor-population ratio blocking way to healthcare for all in Assam

GUWAHATI: Even as the state observed the International Universal Healthcare Day on Monday, a wide gap in the doctor-population ratio besides the unwillingness of medical practitioners to be posted in rural areas have become the major stumbling blocks in making healthcare accessible for all. Against the WHO norm of one doctor against a population of 1,000, the corresponding figure in Assam stands close to 1:1500, health department sources said.
Data procured by TOI from the Assam Council of Medical Registration revealed that there are 28,650 registered health practitioners or doctors serving in government and private hospitals as well as engaging in private practice. Based on the 2011 census, Assam has a projected population of 3.48 crore, which makes the latest doctor-population ratio of the state 1:1216. However, considering the demise and retirement of doctors from government jobs, the actual ratio is around 1:1500, the source added.
Moreover, many doctors from the state with Assam registration IDs are serving outside the state and even abroad with another registration of that state or province. But in papers, they also figure in the state registry.
While the posts of about 500 doctors are lying vacant at the district level, the lack of the creation of more doctors’ posts even after a sizeable population growth over the years has deprived a bulk of the patients of the state of timely medical care.
“We demand the creation of more posts at the district-level where about 700 posts, including the administrative ones, are lying vacant. Out of these, about 500 posts are scattered in hospitals in villages and small towns,” Makhan Saikia, general secretary of the Assam Medical Service Association (Amsa), a leading organisation of doctors, said.
While the vacancies in the district civil hospitals and healthcare facilities in the peripheral areas remain the prime concern for the medicos’ bodies, the health department sources said an estimated 250 doctors’ posts are lying vacant in the medical colleges too.
Assam CM Himanta Biswa Sarma plans to have 24 medical colleges in the state in the next five years, which will churn out 2,700 MBBS doctors every year. At present, 900 MBBS doctors pass out of the six medical colleges of the state each year. Fifteen percent of them study under the central quota and many of them leave the state after obtaining the degree.
However, health practitioners feel that in order to achieve the WHO-prescribed ratio and serve the neediest population in the rural and far-flung areas, the government must ready infrastructure in the vast rural belt.
“Doctors don’t want to go to the rural areas mainly because of the lack of a proper health and social infrastructure. A better social infrastructure, which will fulfil the educational and other primary needs of the doctors, has to be developed so that doctors go to villages and small towns to practice,” Abhijit Neog, the chief operating officer of a Guwahati-based hospital, said.
Neog, who is also the principal assessor at the National Accreditation Board for Hospitals (NABH), warned that the reluctance of doctors to go to districts and villages is resulting in the mushrooming of chambers of fake doctors. Based on Neog’s complaints alone, the state police have arrested 25 fake doctors in Assam in the last five years.