Executive Summary:
The Ministry of Health and Family Welfare addressed a query regarding medical staff shortages in Kerala, outlining steps to address the issue, funds allocated to strengthen healthcare centers, and centrally sponsored schemes to improve healthcare infrastructure. The information includes financial data from FY 2022-23 to FY 2025-26. Several schemes like NHM, PMABHIM, FCXV, and PMSSY are underway to improve healthcare infrastructure.
Key Points / Main Content:
* **Availability of Medical Staff Details:** Information on doctors, nurses, and other medical professionals in rural and tribal areas of Kerala is available on the Ministry's website.
* **State Government Responsibility:** Filling healthcare facility vacancies is primarily the responsibility of State/UT Governments.
* **National Health Mission (NHM) Support:**
* The Ministry provides technical and financial support to States/UTs to strengthen public healthcare in rural areas through Programme Implementation Plans (PIPs) under the NHM.
* NHM supplements regular human resources by filling gaps in secondary and primary care facilities.
* Incentives under NHM:
* Hard area allowance for specialist doctors serving in rural areas.
* Honorarium to Gynecologists, Pediatricians, and Anesthetists with specific training.
* Incentives for timely Antenatal Checkups (ANC) and Adolescent Reproductive and Sexual Health activities.
* Negotiable salaries ("You Quote, We Pay") to attract specialists.
* Non-monetary incentives like preferential admission in postgraduate courses and improved accommodation.
* Support for multi-skilling of doctors and skill upgradation of existing HR.
* **Funds Approved and Expenditure (in Lakhs):**
| Financial Year | PHCs Approvals | CHCs Approvals | PHCs Expenditure | CHCs Expenditure |
| -------------- | -------------- | -------------- | --------------- | --------------- |
| 2022-23 | 2,953.05 | 2,916.31 | 971.62 | 943.44 |
| 2023-24 | 5,350.38 | 3,315.50 | 744.01 | 1,021.07 |
| 2024-25 | 1,498.80 | 1,836.15 | 2,310.87 | 1,081.60 |
* Expenditure includes Central Releases, State Releases, and unspent balances.
* **Funds Approved for Infrastructure Development (in Lakhs):**
| State | 2025-26 | 2024-25 | 2023-24 | 2022-23 |
| ------- | ------- | ------- | ------- | ------- |
| Kerala | 2941.32 | 6,464.94 | 17,943.60 | 12,632.88 |
* **Additional Schemes for Healthcare Improvement:**
* PM Ayushman Bharat Health Infrastructure Mission (PMABHIM): Aims to increase investments in public health and health reforms. Administrative approvals for Kerala from FY 2021-22 to 2025-26 amount to Rs. 404.63 Cr.
* Fifteenth Finance Commission (FCXV): Approved Rs. 2958.02 Crore for Kerala from FY 2021-22 to FY 2025-26, with Rs.1694.74 Cr. released for various healthcare units.
* Pradhan Mantri Swasthya Suraksha Yojana (PMSSY): Aims to correct regional imbalances and augment medical education facilities. Approvals for upgradation of four Government Medical Colleges/Institutions in Kerala.
Impact Analysis:
* **State Government of Kerala:**
* *Impact:* Expected to strengthen the public healthcare system by filling vacancies and utilizing funds effectively.
* *Action Required:* Utilize financial and technical support from the central government, create regular posts, and implement incentive schemes to attract and retain medical staff in rural and tribal areas. Submit Programme Implementation Plans (PIPs) to avail funds.
* **Medical Professionals (Doctors, Nurses, Paramedics):**
* *Impact:* Potential for improved working conditions through better infrastructure, accommodation, and incentives. Specialist doctors may receive hard area allowances and honorariums.
* *Action Required:* Consider opportunities to serve in rural and remote areas, leveraging available incentives and benefits. Engage in skill upgradation programs.
* **Citizens of Kerala (Especially in Rural and Tribal Areas):**
* *Impact:* Expected to benefit from improved healthcare infrastructure, increased availability of medical professionals, and better access to healthcare services.
* *Action Required:* Utilize available healthcare facilities and services.
Key Entities Referenced
Kerala: A state in India, focus of the question regarding medical staff shortage and healthcare infrastructure.
Ministry of Health and Family Welfare: The Indian government ministry responsible for health policy.
National Health Mission (NHM): A centrally sponsored scheme to strengthen the public healthcare system.
Primary Health Centres (PHCs): Primary healthcare facilities that the government is strengthening.
Community Health Centres (CHCs): Community healthcare facilities that the government is strengthening.
Indian Public Health Standards (IPHS): Standards used to ensure availability of HR by creating adequate number of regular posts.
PM Ayushman Bharat Health Infrastructure Mission (PMABHIM): A scheme to increase investments in public health and health reforms.
Pradhan Mantri Swasthya Suraksha Yojana (PMSSY): A scheme aimed at correcting regional imbalances in tertiary healthcare services.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 1036
TO BE ANSWERED ON25TH JULY, 2025
SHORTAGEOFMEDICALSTAFFIN KERALA
1036. SHRIK RADHAKRISHNAN:
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate:
(a) whether the Government is aware of the shortage of doctors, nurses and other medical
professionals inrural andtribal areas of Kerala;
(b) if so, the details of steps taken to address these shortages, including any special
recruitmentdrivesor incentive schemesimplementedinthe State;
(c) the details of funds allocated and utilised for strengthening Primary Health Centres
(PHCs) andCommunityHealthCentres (CHCs)inKerala during the last three years;
(d) whether the Government proposes to launch any new centrally sponsored schemes to
improve healthcare infrastructure and service delivery in backward and under-served
regionsof Kerala; and
(e) if so, the detailsthereof?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND
FAMILYWELFARE
(SHRIPRATAPRAO JADHAV)
(a) The details of doctors, nurses and other medical professionals in rural and tribal areas of
Kerala are available at website of Ministry of Health and Family Welfare at the Uniform
Resources Locator(URL) asunder:
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(b) The primaryresponsibility of strengthening public healthcare system, includingfilling up
of the vacancies in in healthcare facilities lies with the respective State/UT Governments. The
Ministry of Health andFamilyWelfareprovidestechnical andfinancialsupport tothe States/UTs
to strengthen the public healthcare system in rural areas based on the proposals received in the
form of ProgrammeImplementation Plans(PIPs) underNational Health Mission. Government of
India provides approval for the proposal in the form of Record of Proceedings (RoPs) as per
norms & available resources. States/ UTs to ensure availability of HR by creating adequate
number of regular posts as per the Indian Public Health Standards (IPHS) in the long run and
using NHM posts in the short to medium term to fill critical gaps. The NHM supplements the
regularhumanresources byfilling up the gapsinhumanresources insecondary andprimarycare
facilities(District Hospital andbelow) asperIPHS.
Under NHM, following types of incentives and honorarium are provided for encouraging
doctors and paramedics to practice in rural and remote areas of the country including Kerala to
address the shortage of staff:
Hard area allowance to specialist doctors for serving in rural and remote areas and for
their residential quarters so that they find it attractive to serve in public health facilities in
such areas.
Honorarium to Gynecologists/ Emergency Obstetric Care (EmOC) trained, Pediatricians
& Anesthetist/ Life Saving Anaesthesia Skills (LSAS) trained doctors is also provided to
increase availability of specialists for conductingCesarean Sections inrural & remote area.
Incentives like special incentives for doctors, incentive for Auxiliary Nurse and Midwife
(ANM) for ensuring timely Antenatal Checkup (ANC) checkup and recording, incentives
for conductingAdolescent Reproductive andSexualHealth activities.
States are also allowed to offer negotiable salary to attract specialist including flexibility
instrategiessuch as“YouQuote We Pay”.
Non-Monetary incentives such as preferentialadmission inpost graduate courses for staff
serving in difficult areas and improving accommodation arrangement in rural areas have
also beenintroducedunderNHM.
Multi-skilling of doctorsissupported underNHMtoovercome the shortageof specialists.
Skill upgradation of existing HR is another major strategy under NRHM for achieving
improvementinhealth outcomes.(c). State/UT wise funds approved and Expenditure for Primary Health Centres (PHCs) and
Community Health Centres (CHCs) under National Health Mission from the FY 2022-23 to FY
2024-25 for the state of Kerala isasunder:
(Rs. In Lakhs)
Approvals Expenditure
Financial PHCs CHCs PHCs CHCs
Year
2022-23 2,953.05 2,916.31 971.62 943.44
2023-24 5,350.38 3,315.50 744.01 1,021.07
2024-25 1,498.80 1,836.15 2,310.87 1,081.60
Note:
1. TheabovedataisasperavailableFinancialManagementReportssubmittedbytheStates/UTs.
2. Expenditure includes expenditure against Central Releases, State Releases & unspent balances at the
beginningoftheyear.ExpenditureisasperFMRssubmittedbyStates/UTsandisprovisional.
(d) & (e). Details of funds approved during the current FY2025-26 & for the last three FYs
i.e 2024-25; 2023-24; 2022-23 for development of building infrastructure under NHM to the
Stateof Kerala are asunder:
(Amount in Lakhs)
State 2025-26 2024-25 2023-24 2022-23
Kerala 2941.32 6,464.94 17,943.60 12,632.88
In addition to the National Health Mission, Government of India has allocated the
following funds toimprove the healthcare infrastructure and service delivery in backward and
under-servedregionsof Kerala:
PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) envisages
increased investments in public health and other health reforms to provide better access
to health in rural areas. Administrative approvals have been accorded to the State of
Kerala for five years (i.e. FY2021-22 to 2025-2026) for an amount of Rs. 404.63 Cr. for
construction/ strengthening of 14 IPHLs at District level and 14 CCBs at District
Hosopitals andMedical college level. Under Fifteenth Finance Commission (FC-XV) for the State of Kerala, Rs. 2958.02
Crore has been approved for the five year period from FY 2021-22 to FY 2025-26 and
Rs.1694.74 Cr. has been released so far for establishment and strengthening of 1205
Building less SHCs, 116 Building less PHCs, 41 Building less CHCs, 152 Block Public
HealthUnits, and380Urban- AAMs.
The Pradhan MantriSwasthyaSurakshaYojana(PMSSY) aimsat correctingregional
imbalances in the availability of affordable tertiary healthcare services and to augment
facilities for quality medical education in the country. Under the Scheme approvals has
been accorded upgradation of four Government Medical Colleges/ Institutions (GMCIs)
at Thiruvananthapuram, Kozhikode,Alappuzha andTrivandrum for the Stateof Kerala.
****