**Executive Summary**
This document is an answer given in Lok Sabha on February 13, 2026, to an unstarred question (No. 2530) regarding ambulance services in Rajasthan. The question pertains to the salary and working conditions of EMTs and pilot employees, and government oversight in the public-private partnership (PPP) model of the ambulance services. The response outlines the support provided under the National Health Mission (NHM) and clarifies the roles and responsibilities of both the Central and State Governments.
**Key Points / Main Content**
* **National Health Mission (NHM) Support:**
* The Ministry of Health and Family Welfare provides technical and financial support to States/UTs for healthcare facilities, including emergency medical services, through the National Ambulance Service (NAS).
* This includes the toll-free numbers 108/102. Dial 108 attends to critical care, trauma, and accident victims, while Dial 102 caters to pregnant women, children, and basic patient transport.
* Operating expenditure is provided by the Central Government through Record of Proceedings (RoP).
* **Decentralized Planning Process:**
* The NHM provides need-based support to strengthen the public health system.
* States prepare and submit Programme Implementation Plans (PIPs) to MoHFW.
* Proposals are reviewed by the National Programme Coordination Committee (NPCC), and approvals are accorded in the form of Record of Proceedings (ROP).
* The NHM supplements human resources by filling gaps in secondary and primary care facilities.
* **Human Resources Management:**
* Contracts for contractual HRH under NHM are executed by State Health Societies (SHS) according to state policies.
* The budget requirement for annual increments is proposed by states/UTs in their PIPs, with 5% of the total HR budget approved as a lump sum for annual increment of NHM HRH.
* **Responsibilities and Oversight:**
* Implementation, monitoring, and strengthening of ambulance services is primarily the responsibility of the State Governments.
* The Government of India provides financial and technical support, including guidelines, recommendations, periodic meetings, field visits, and reviews.
* **Rajasthan Ambulance Services:**
* Ambulance services are operated and managed on a contract basis by service providers selected through tender.
* A lump sum payment covers vehicle operation, maintenance, human resources, fuel, and medicines.
* Third-party audits are conducted on the management and operation of ambulance vehicles.
* Penalties are imposed for violations.
* District and block-level officials conduct regular inspections via mobile apps.
**Impact Analysis**
**Stakeholder: EMTs and Pilot Employees**
**Impact:** The document acknowledges their salary concerns and lack of explicit promotion systems, but clarifies that these aspects are managed at the state level and through the NHM framework.
**Action Required:** No direct action is required by EMTs and pilot employees based solely on this document.
**Stakeholder: State Governments (Specifically Rajasthan)**
**Impact:** The document reinforces their primary responsibility for ambulance service implementation, monitoring, and human resources management.
**Action Required:** Continue to operate and oversee ambulance services, including human resource management, according to established state policies and NHM guidelines. Address concerns related to salaries and promotion systems within the existing framework.
**Stakeholder: Central Government (Ministry of Health and Family Welfare)**
**Impact:** The document reiterates the Ministry's role in providing financial and technical support, as well as setting guidelines and conducting reviews.
**Action Required:** Continue providing support through the NHM, reviewing State PIPs, and monitoring ambulance service performance.
Key Entities Referenced
National Health Mission (NHM): A program under which the Ministry of Health and Family Welfare provides support to States/UTs for healthcare facilities, including ambulance services.
Ministry of Health and Family Welfare: The ministry providing financial and technical support to States/UTs for healthcare facilities including emergency medical services.
Rajasthan: The state where ambulance services' employee salaries and working conditions are being questioned.
National Ambulance Service (NAS): A network linked with a toll-free number 108/102 for healthcare and emergency medical services provided under NHM.
GOVERNMENT OFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENT OFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 2530
TO BE ANSWERED ON13th FEBRUARY2026
AMBULANCESERVICES IN RAJASTHAN
†2530. SHRIKULDEEPINDORA:
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate:
(a) whether the Govemment is aware that EMTs and pilot employees working in 108 ambulance
services, operating on PPP mode in Rajasthan are working on a meager salary of Rs. 10,000-14000 in
spite of 24 hours of life-saving duty and there is no explicit system available for their service, security
andpromotion;
(b) whether the Govemment iscontemplating tofix the minimummonthlysalary of these employeesto
Rs. 20,000 and implement the promotion and increment system as per the service period of these
employeesandif so, the details thereof;
(c) whether the Union Government is contemplating to bring these services under the direct control of
the State Government rather than third party or include them in the permanent structure of the Health
Department/RLSDCandif so,the detailsthereof; and
(d) the steps proposed by the Government to strengthen Government oversight on the functioning of
GVK-EME toensure transparency inPPmode?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILY
WELFARE
(SHRIPRATAPRAO JADHAV)
(a) to(d): Under National HealthMission (NHM), the Ministry of Health andFamily Welfareprovides
technical and financial support to the States/UTs for healthcare facilities including emergency medical
services through a functional National Ambulance Service (NAS) network which is linked with a toll-
free number 108/102. Dial 108 is primarily designed to attend to patients of critical care, trauma and
accidentvictims etc.Dial 102 services includesbasic patient transport that aims tocatertothe needsof
pregnant women and children and others too. The Operating Expenditure to State is provided by the
Central Government through Record of Proceedings(RoP).
Under the National Health Mission (NHM), need based technical and financial support is
provided to States/UTs to strengthen the public health system. This is based on a decentralised
planning process wherein the states prepare and submit proposals in the form of Programme
Implementation Plans (PIPs) to MoHFW. The proposals are reviewed and discussed by the National
Programme Coordination Committee (NPCC) and approvals are accorded in the form of Record of
Proceedings (ROP). The NHM supplements the regular human resources by filling up the gaps inhuman resources in secondary and primary care facilities (District Hospital and below) as per Indian
Public Health Standards (IPHS). The contracts for all contractual HRH under NHM are executed by
the respective State Health Societies (SHS), in accordance with the policies and administrative
frameworks of the concerned States/UTs. The budget requirement for annual increment is proposed by
the states/ UTs in their Program Implementation Plans. In principle 5% of the total HR budget is
approvedaslumpsum for annualincrement of NHM HRHinplace inthe state ROPs.
As Health is a State subject, the primary responsibility for implementation, monitoring, and
strengthening of ambulance services lies with the respective State/Union Territory Governments.
However, under NHM, Government of India provides need based financial and technical support
including development of guidelines, recommendations, periodic meetings, field visits, and reviews
toensure qualityof services andtransparency:
As per the information provided by the State Government of Rajasthan, under the National
Health Mission’s Ambulance Project, ambulance services are operated and managed on a contract
basis byservice providersselectedthrough tender.Alumpsum paymentismade tothe selected service
provider for the ambulance vehicle’s operation, maintenance, human resources, fuel and medicines.
Further, under the National Health Mission’s Ambulance, a third-party audit is being conducted of the
management and operation of ambulance vehicles operated by 108 ambulance service provider.
Penalties are being imposed as per the provisions of the RFP if any violation is found. District and
block-level officials are conducting regular inspections via mobile apps and time to time conducting
special drivestomonitorambulance services.
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