India’s public healthcare is in “serious decline” due to non-availability of medical and paramedical staff, diagnostic services and medicines, says a Planning Commission report. The report, released last month by Planning Commission Deputy Chairman Montek Singh Ahluwalia, noted that hospitalised treatment has gone down in government hospitals while the reverse has happened in private ones. A high-level group under the chairmanship of Anwarul Hoda, Planning Commission member (International Economics), compiled the report, which suggested an increase in public expenditure on health. “It is proposed to raise the public health expenditure level from one percent of the GDP at the end of the Tenth Five Year Plan to two percent of the GDP at the end of the Eleventh Plan,” it said. The report said public institutions had played a dominant role in the Indian healthcare sector in the past in urban as well as rural areas. But they have been on a serious decline in the last two or three decades. Although there is a wide network of healthcare services, many don’t have medical staff, it said. There are 3,910 community health centres (CHCs), 22,669 primary health centres (PHC) and 144,988 sub centres in the country. The report said a shortfall of medical staff was found in the CHCs in March 2006. It said 59.4 percent of surgeons, 45 percent of obstetricians and gynaecologists, 61 percent of physicians and 53 percent of paediatricians were not in place in these centres. “Equally distressing is the fact that essential therapeutic drugs are not supplied in most public health institutions with the exception of some states.” “An essential component of strengthening primary health facilities will be a system of guaranteeing essential drugs,” it added. Quoting the Eleventh Five Year Plan document, the report summed up the situation: “Despite higher costs in the private sector, this shift shows the people’s growing lack of trust in the public system.” It also noted that critical shortage of health personnel, inadequate incentives, poor working conditions, lack of transparency in posting of doctors in rural areas, absenteeism, long wait, inconvenient clinic hours, poor outreach, time of service, insensitivity to local needs, inadequate planning, management and monitoring of service are the other reasons for low turnout in government hospitals.