Lucknow: The chasm between the Centre and state government, discrepancies in the utilization of allotted funds and the acute shortage of human resources are the major reasons behind the deplorable condition of the UP Health Department.

The financial indiscipline in the Health Department can be gauged by the fact that out of Rs 3,100 crore approved for various schemes of the National Rural Health Mission (NRHM) in 2010-11, only Rs 521 crore could be spent.

In the wake of the sour relations between the Centre and the state, the UPA government has deducted Rs 695 crore from the annual budget of the NRHM. Against the state government proposal of Rs 3,309 crore for NRHM projects, the Centre has approved Rs 2,615 crore.

Meanwhile, the state government has alleged the Union Government of not clearing its pending dues worth Rs 295.51 crore in the National Health Insurance Plan.

The major concern is that the country's highest mortality rate is in Uttar Pradesh, where the ratio of maternal mortality rate is 440 and infant mortality is 67. A project which intends to reduce maternal mortality and infant mortality through high-level fitness center which includes 24 hours of critical operation and the services to facilitate complex deliveries, still hangs in a lurch.

Even after spending a whopping amount on Janani Suraksha Yojana, one third of infant population of the state is deprived of vaccination and out of 100 children the delivery of only 22 children is reported in hospitals. Three fourth of the child deliveries takes place at home with inadequate medical system and under unhygienic environment. Hence the concern about the health of pregnant women remains unresolved. Nearly 80 per cent of expectant women are anemic.

Owing to the lack of planning, the deficiency of practitioners and paramedical staff in public hospitals could not be met.

Going by the official facts, the nation has one doctor for a population of 1,000 people. Whereas, UP has the facility of one doctor per 5,000 people. 4,000 posts of doctors in government Hospitals of Uttar Pradesh are lying vacant. Whether breast disease specialist or X-ray or cardiologist or Pathologist or Anesthetist surgeons, the government could not find good doctors despite vacancies.

There are 200 vacancies for Child Specialists. Due to the shortage of 150 Anesthetist Surgeons, only four public hospitals can facilitate the complex operations. It is not that the recruitment process has not been started but because of lack of attention towards the services the government could only recruit only 353 physicians.

Owing to the obstacles by the Centre, the initiative of state government to appoint doctors on contractual basis to meet the shortage failed to ameliorate the situation.

The former head of PMS, Dr UN Roy, said, “Improvement in the health services is not possible till the time the shortage of doctors is met.” Dr Roy remarked, for better health services it is extremely important to have the number of required physicians and adequate para-medical staff. “However, the situation is vice versa in UP,” he added.

Amongst the 5,222 approved posts of Pharmacists, nearly 3,000 are lying vacant. Similarly, 400 posts of lab technicians out of the sanctioned strength of 2,150 are yet to be filled. The process of recruitment is pending because of the intervention of the High Court in the matter.

Out of the sanctioned strength of 4,982 nurses, 350 posts are vacant. Whereas, as per the norms, 18,000 trained nurses should be deployed in the state.

The state government project for setting up a Highway Trauma Care Centre in government medical colleges has failed to get consent from the Union Government. The proposal of building the trauma centres in medical colleges of Kanpur, Agra, Allahabad, Meerut, Jhansi and Gorakhpur has not been approved yet.

Due to the failure of the proposed Public - Private Partnership (PPP) model, the plan to provide medical care with modern equipments and to build the highly specialized class hospitals with the help of investors from private sectors in four major cities could not be exercised.  The hospitals to be build on the PPP model was proposed at Meerut, Lucknow, Kanpur and Agra.

Under the project, the plan was to build the Super Speciality Hospitals in Lucknow and Kanpur with the investment of Rs 240 crore each, a Multi-Specialty hospital in Agra with an expenditure of Rs 100 crore and hospital cum Medical College Hospital in Meerut worth Rs 350 crore. Although advertisements in this context were published on several occasions, the investors did not take keen interest in the project.

Director General Medicine and Health services, Dr SP Ram said, “There is an improvement in medical services, therefore, the number of patients have increased in public hospitals. Constant efforts are being made to improve the health services.”  The proposal has been submitted to the Public Service Commission to meet the shortage of doctors and Para-medical staff deficiency, he added.

Union Health Secretary K Chandramauli said, “There will be a strict financial discipline, and to reduce the maternal and infant mortality rates, the government will provide adequate facilities. The Central government will extend full cooperation.”