Expired Drugs, Bed Shortages, and Lack of ICU Services Plague the Himachal Health Sector
The Comptroller and Auditor General (CAG) of India has highlighted significant disparities and shortcomings in Himachal Pradesh’s healthcare system. The report, presented during the winter session of the Himachal Pradesh Assembly in Dharamsala, exposes an alarming shortage of doctors, medical specialists, and essential services across the state, with tribal districts bearing the brunt of the crisis.
According to the CAG report, there is a stark imbalance in the distribution of healthcare personnel. While districts like Shimla and Solan reported an excess of doctors and medical specialists, tribal districts such as Kinnaur and Lahaul-Spiti face nearly 100% shortages in their civil hospitals. Kinnaur recorded the highest doctor shortage at 57%, while Lahaul-Spiti’s district hospital struggled with an 89% deficit in medical specialists. In stark contrast, Kullu district reported no shortage of doctors, and Shimla recorded a 33% surplus of medical specialists.
Community Health Centres (CHCs) also reflected the inequities in staffing. Solan reported a 13% excess of doctors, whereas Una had the lowest availability, with only 14% of sanctioned positions filled. Solan fared relatively better in Primary Health Centres (PHCs) with a 5% shortfall, but Sirmaur faced a staggering 33% deficit. These figures highlight the lack of rationalisation in the posting of medical personnel, with some districts enjoying surplus resources while others struggle to meet basic healthcare needs.
The report also paints a grim picture of the availability of essential healthcare services. ICU facilities were found to be missing in district hospitals in Chamba, Kangra, Solan, and Lahaul-Spiti. None of the civil hospitals in the state had ICU services. Although ICU equipment was available, 149 out of 773 ventilators were non-functional, compromising patient care. Outpatient Department (OPD) services were also unevenly distributed. While all OPD services were available in Hamirpur district hospital, the district hospital in Lahaul-Spiti could provide only two such services.
Infrastructure deficiencies extend beyond personnel and services. Nine out of 12 district hospitals were found to have fewer beds than the sanctioned levels as of March 2022. The CAG report also highlighted significant wastage of resources, with over 341.59 lakh quantities of drugs and consumables procured by the state Health Department expiring between 2017 and 2021.
The situation in medical colleges and super-speciality hospitals is equally concerning. The Atal Institute of Medical Super Specialities in Shimla reported a 49% shortage of specialists, the highest in the state, while Indira Gandhi Medical College (IGMC) faced a 15% deficit. The shortage of specialists was not confined to colleges; the CAG noted that nine districts, excluding tribal areas, faced a 69% shortfall of medical specialists.
These findings underscore the urgent need for a comprehensive overhaul of the healthcare system in Himachal Pradesh. Rationalising the distribution of medical staff, addressing equipment and infrastructure deficiencies, and ensuring the timely procurement and utilisation of drugs are critical to bridging the healthcare gaps.
The report’s revelations highlight a healthcare system under immense strain, with inequities in resource allocation exacerbating the challenges faced by residents in tribal and remote areas. Immediate and sustained efforts are required to address these systemic issues and ensure equitable access to healthcare for all residents of Himachal Pradesh.
