**Executive Summary**
This document addresses an unstarred question in Lok Sabha regarding the shortage of doctors and lack of diagnostic facilities, particularly in districts like Ballari in Karnataka. The response from the Minister of State in the Ministry of Health and Family Welfare clarifies that while public health is primarily a state subject, the central government supports states/UTs through the National Health Mission (NHM) with financial and technical assistance. The Ministry of Finance has introduced the New Fund Flow Mechanism i.e. SNA SPARSH which is just-in-time release of funds for all Centrally Sponsored Schemes. The question was to be answered on 06.02.2026.
**Key Points / Main Content**
* **State Responsibility:**
* Ensuring adequate doctors and healthcare professionals is primarily the responsibility of State/UT Governments due to public health being a state subject.
* **Central Government Support (NHM):**
* Financial and technical support is extended to States/UTs under the National Health Mission (NHM) to strengthen healthcare systems.
* This includes assistance for engaging doctors on a contractual basis, based on State/UT-projected requirements in their Programme Implementation Plans (PIPs).
* States are encouraged to adopt flexible norms for engaging specialist doctors in public health facilities.
* Financial support is provided for performance-based incentives and hard area allowances.
* There is sponsorship of training programs for engaged human resources to address shortages in public health facilities.
* **Available Resources:**
* Details of doctors and health facilities functioning in rural and urban areas across all States/UTs can be found in the Health Dynamics of India (HDI) 2022–23 (link provided).
* Details about NHM funding based on State Programme Implementation Plans (SPIPs) are available online (link provided).
* **New Fund Flow Mechanism:**
* The Ministry of Finance has introduced the New Fund Flow Mechanism i.e. SNA SPARSH which is just-in-time release of funds for all Centrally Sponsored Schemes based on guidelines issued by the Department of Expenditure (DoE) dated 13.07.2023.
**Impact Analysis**
**State/UT Governments**
* **Impact:** Responsible for ensuring adequate doctors and healthcare professionals within their respective jurisdictions. Benefit from central support through NHM.
* **Action Required:** Develop and implement effective healthcare strategies, including engaging doctors (potentially on a contractual basis), strengthening healthcare systems, and submitting Programme Implementation Plans (PIPs) to access NHM funding.
**Citizens / Residents of all States/UTs**
* **Impact:** Impacted by the availability and quality of healthcare services, particularly in rural and remote areas.
* **Action Required:** No direct action; however, it is possible to access information related to details of doctors and health facilities functioning in rural and urban areas across all States/UTs.
**Ministry of Health and Family Welfare**
* **Impact:** Oversees and supports the NHM, providing financial and technical assistance to States/UTs.
* **Action Required:** Continue to provide support to States/UTs through the NHM and ensure effective implementation of the NHM guidelines, including monitoring the use of funds.
**Ministry of Finance**
* **Impact:** Responsible for overseeing the allocation and timely release of funds for centrally sponsored schemes.
* **Action Required:** Ensure effective implementation of the New Fund Flow Mechanism (SNA SPARSH) for the timely release of funds to States/UTs, based on guidelines issued by the Department of Expenditure (DoE) dated 13.07.2023.
Key Entities Referenced
National Health Mission (NHM): A centrally sponsored scheme aimed at strengthening healthcare systems across States/UTs by providing financial and technical support.
Ministry of Health and Family Welfare: The central government ministry responsible for health policies and programs in India. Also, the primary subject of the parliamentary question.
Pradhan Mantri–Ayushman Bharat Health Infrastructure Mission (PM-ABHIM): A health infrastructure mission that aims to strengthen the health infrastructure in the country.
Karnataka: One of the States in India facing a shortage of doctors, lack of diagnostic facilities and non-functional public health infrastructure.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 1358
TO BE ANSWERED ON06.02.2026
SHORTAGE OFDOCTORS AND LACK OFDIAGNOSTIC FACILITIES
1358. SHRIE TUKARAM:
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate:
(a) whether the Government is aware that despite increased Central funding under health
schemes such as National Health Mission (NHM) and Pradhan Mantri–Ayushman
Bharat Health Infrastructure Mission (PM-ABHIM), districts like Ballari in
Karnataka are still facing shortage of doctors, lack of diagnostic facilities and non-
functionalpublic health infrastructure;
(b) if so, the detailsthereof;
(c) whether the Government has reviewed the implementation challenges at the Central
level that have affected timely delivery of health facilities in the country, if so, the
detailsthereof; and
(d) the steps proposed by the Government in the Union Budget to ensure timely fund
flow, stronger monitoring andtime-boundfunctioning of healthfacilities inhigh-need
districts like Ballari?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND
FAMILYWELFARE
(SHRIPRATAPRAO JADHAV)
(a) to (d): Public health being a State subject, the primary responsibility for ensuring the
availability of adequate doctors and healthcare professionals rests with the State/UT
Governments. Nevertheless, under the National Health Mission (NHM), financial and technical
support is extended to States/UTs to strengthen their healthcare systems, including assistance for
engaging doctors on a contractual basis, as per the requirements projected by the States/UTs in
their Programme Implementation Plans (PIPs). States are also encouraged to adopt flexiblenorms for engaging specialist doctors in public health facilities. In addition, financial support is
provided for performance-based incentives, hard area allowances for rural and remote locations,
and sponsoring training programmes for engaged human resources to help address shortages in
public healthfacilities.
The details of doctors & health facilities functioning in rural and urban areas across all
States/UTs, canbe accessed at the following linkof Health Dynamicsof India (HDI) 2022–23:
https://mohfw.gov.in/sites/default/files/Health%20Dynamics%20of%20India%20%28Infrastruct
ure%20%26%20Human%20Resources%29%202022-23_RE%20%281%29.pdf
Under NHM, funds are allocated to States based on the State Programme Implementation Plans
(SPIPs) submitted by the States duly appraised by National Programme Coordination Committee
(NPCC). The detailsare available overpublic domainat:
https://nhm.gov.in/index4.php?lang=1&level=0&linkid=57&lid=70
As per the guidelines issued by the Department of Expenditure (DoE) dated 13.07.2023, the
Ministry of Finance has introduced the New Fund Flow Mechanism i.e. SNASPARSH which is
just-in-time release of fundsfor all CentrallySponsoredSchemes.
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