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GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
RAJYASABHA
UNSTARREDQUESTION NO. 2036
TO BE ANSWERED ON10.03.2026
SHORTAGE OFSPECIALISTS AND DIAGNOSTIC EQUIPMENTS IN DISTRICT
HOSPITALS
2036. DR. ASHOKKUMAR MITTAL:
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate:
(a) whether district hospitals across multiple States continue to suffer from shortages of
specialists, diagnostic equipments, ICU bedsandemergency-care infrastructure despite
increasedallocations,the detailsthereof;
(b) whether Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
beneficiaries often face denial of cashless treatment, delayed claim approvals and lack
of accountabilityamongempanelledhospitals, if so, the detailsthereof;
(c) whether India’s exceptionally high out-of-pocket expenditure signals insufficient
publichealthprovisioning, if so, the detailsthereof; and
(d) whether the Ministry plans structural reforms to strengthen workforce distribution,
regulatory oversight and timely utilisation of health-sector funds, if so, the details
thereof?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND
FAMILYWELFARE
(SHRIPRATAPRAO JADHAV)
(a) Public Health & hospitals isstate subject. The primary responsibility of strengthening
public healthcare system, including strengthening of healthcare facilities, including
addressing gaps in human resources, infrastructure and equipment at district hospitals lies
with the respective State/UT Governments. Under National Health Mission (NHM), the
Ministry of Health and Family Welfare provides the technical and financial support to the
States/UTs to strengthen their public healthcare system, based on the requirements posted by
States/UTs in their Programme Implementation Plans (PIPs) and within the overall resource
envelope.
Health Dynamics of India (HDI) (Infrastructure & Human Resources), 2022-23 is an
annual publication, based on health care administrative data reported by States/UTs. Details
of specialist in public health facilities including district hospitals can be assessed at thefollowing linkof HDI 2022-23:
(a)
https://mohfw.gov.in/sites/default/files/Health%20Dynamics%20of%20India%20%28Infrastr
ucture%20%26%20Human%20Resources%29%202022-23_RE%20%281%29.pdf
This Ministry supports the Free Diagnostics Service Initiative (FDSI) programme
underthe National Health Mission (NHM) toprovide free diagnostic services at public health
facilities including district hopitals, thereby reducing out-of-pocket expenditure.Currently 14
tests are available at SHC-AAM, 63 at AAM-PHCs, 97 at CHCs, 111 at Sub-District
Hospitals and134 tests at District Hospitals.
In addition, the Government is strengthening public health infrastructure and service
delivery across districts through the Pradhan Mantri–Ayushman Bharat Health Infrastructure
Mission (PM-ABHIM), launched with an outlayof ₹64,180 crore for FY2021-22 toFY2025
-26. The mission aims to build capacities across primary, secondary and tertiary levels of
healthcaretoimprove preparedness andresponse topandemicsandhealthemergencies.
Under the Centrally Sponsored Scheme (CSS) component of PM-ABHIM, 621
CriticalCare Hospital Blocks(CCBs) of 50/100bedshave beenapprovedindistrict hospitals.
These blocks are equipped with ICUs, oxygen-supported beds and infection control systems,
which will strengthen emergency and critical care services and improve district-level
preparedness.
Further, 744 Integrated Public Health Laboratories (IPHLs) have been sanctioned
across districts to strengthen diagnostic capacity, disease confirmation and public health
surveillance. These laboratories are integrated with the Integrated Health Information
Platform (IHIP) to enable real-time disease surveillance, early warning and coordinated
response tohealththreats.
(b): As per the empanelment guidelines under AB PM-JAY, empaneled hospitals
cannotdenytreatment toeligiblebeneficiaries.
In cases of denial of treatment by an empanelled hospital, beneficiaries can register
theirgrievancesthrough theCentralizedGrievance Redressal Management System(CGRMS)
or the 24×7 toll-free helpline number14555.
Under AB PM-JAY, such grievances are monitored through a three-tier grievance
redressal mechanism at the District, State, andNational level.At each level,designated nodal
officers and Grievance Redressal Committees are in place to examine and resolve the
grievances.
Under the scheme, settlement of claims is a regular and uninterrupted process and
claims are settled by respective State Health Agencies (SHA) as per claim adjudication
guidelines issued by National Health Authority (NHA). Further, for timely settlement of
claims, the permissible turnaround time is within 15 days of claim submission for intra-statehospitals (hospitals located within the State) and within 30 days of claims submission in case
of portabilityclaims (hospitals locatedoutside the State).
(c) As per National Health Accounts (NHA) estimates, the share of Out-of-Pocket
Expenditure (OOPE) in Total Health Expenditure has declined from 62.6% in 2014-15 to
39.4% in2021-22.
The Government is making efforts to reduce the OOPE as a percentage of Total
Health Expenditure (THE). There has been a significant increase in Government Health
Expenditure (GHE) as percentage of THE, which has increased from 29.0% in 2014-15 to
48.0% in2021-22.
Concurrent to this increase in GHE, the share of OOPE has declined from 62.6% to
39.4% during the same period. This declining share of OOPE is indicative of increasing
accesstohealthservices.
(d) Public Health is a State subject and the management of Human Resources for Health
falls under the purview of State. Under NHM, States have been advised to reorganize the
distribution of workforce for efficient and optima utilization of resources. States have also
been advised to use digital platforms like HRMIS and Biometric attendance for HR
management and improve monitoring. Further, funds under NHM are released under
Flexipool, to provide flexibility to States and SNA SPARSH release mechanism is
implementedunderNHM for Just inTime release of funds.
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