The Committee urged regulating capitation fees to make private medical education affordable for meritorious students from disadvantaged backgrounds and recommended offering higher pay and benefits to retain specialist doctors at PHCs and CHCs
Published Mar 17, 2025 | 8:00 AM ⚊ Updated Mar 17, 2025 | 8:00 AM
Representative image of a medical student
Synopsis: The Parliamentary Standing Committee on Health has raised concerns about the district-wise allocation of medical colleges, suggesting population density should be the basis for sanctioning them. The committee also recommended regulating capitation fees to make private medical education more affordable and proposed offering incentives to retain specialist doctors at Primary Health Centers. It also stressed the need for better-equipped Ayushman Arogya Mandirs (AAMs)
In recent years, multiple new medical colleges have been established across the country, primarily in district headquarters. These colleges are being set up as part of a policy to ensure that each district has at least one medical college.
Many of these institutions are being developed by upgrading existing district or referral hospitals, a cost-effective approach that helps utilise existing infrastructure efficiently.
However, the Parliamentary Standing Committee on Health and Family Welfare has raised concerns about this approach, stating that the sanctioning of medical colleges should be based on population density rather than a district-wise allocation.
The Committee warned that the current policy creates an imbalance in the hospital-to-population ratio, leading to inequitable access to medical education and healthcare services.
The Committee further emphasised the need to make private medical education more affordable, recommending that capitation fees be regulated to ensure that meritorious students from financially weaker backgrounds can access medical education.
To address the shortage of doctors at Primary Health Centers (PHCs) and Community Health Centers (CHCs), the Committee suggested offering lucrative pay and benefits to specialist doctors to ensure their retention in government hospitals.
“Department may persuade the States/UTs to overcome the shortage of doctors at PHCs/CHCs through various measures including the creation of separate Medical Services Recruitment Boards, specialist cadres, and providing flexibilities under NHM for recruitment and retention,” said Parliamentary Standing Committee on Health and Family Welfare presented in Rajya Sabha, on 12 March.
The Committee also stressed the importance of ensuring that Ayushman Arogya Mandirs (AAMs) are adequately equipped, calling for the provision of sufficient staff, essential diagnostic services, and high-quality generic medicines to improve healthcare delivery at these centers.
The Parliamentary Standing Committee on Health and Family Welfare has recommended a significant expansion of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), urging the government to lower the eligibility age for senior citizens under the Ayushman Bharat PMJAY Vay Vandana scheme from 70 years to 60 years, regardless of their socio-economic status. The panel believes that this revision would ensure wider coverage and greater access to healthcare for the elderly, benefiting a larger segment of India’s aging population.
“The Committee is of the view that age criteria of 70 years and above for Ayushman Vay Vandana Cards should be rationalised to 60 years and above irrespective of their socio-economic status for widening the coverage of the scheme in the better interest of common masses,” reads the report.
In the recent expansion of AB-PMJAY to cover six crore senior citizens aged 70 and above from 4.5 crore families, ₹1,443 crore was allocated for their treatment under the Ayushman Vay Vandana Card scheme.
The Committee also said that keeping in view the high costs of critical healthcare, the Committee has strongly recommended that the existing health coverage of ₹5 lakh per family per year be doubled to ₹10 lakh per family. With rising medical expenses and the increasing burden of non-communicable diseases, the panel believes that the current financial protection is inadequate, particularly for families requiring specialised treatments and long-term medical care.
The Committee also noted that many expensive procedures, advanced diagnostics, and high-end interventions are not covered under AB-PMJAY, forcing patients to bear significant out-of-pocket expenses. It recommended a comprehensive review of the scheme to include:
The Committee emphasised that these essential medical services should be incorporated directly into the scheme, rather than leaving them as optional add-ons, which often limit accessibility for economically weaker patients.
The Parliamentary Standing Committee on Health and Family Welfare has criticised the government’s stagnant health expenditure, warning that the goal of increasing health spending to 2.5 percent of GDP under the National Health Policy (NHP) remains a distant dream. The Committee, which had previously recommended raising health expenditure to 5 percent of GDP by 2025, expressed disappointment over the slow pace of budget increases, stating that the lack of financial commitment is preventing the healthcare sector from achieving sustainable growth.
“India being the most populous country, and given the inflationary pressures and the National Health Policy’s target of increasing government health expenditure to 2.5 percent of GDP by 2025, the Committee believes that the allocation to the health sector, particularly to the Department of Health and Family Welfare, should have been much higher,” reads the report.
A detailed analysis of the health budget revealed a declining trend in allocation as a percentage of GDP between 2020-21 and 2024-25, which the panel believes is inconsistent with the targets set under the NHP. The Committee emphasised that adequate health financing is crucial for reducing Out-of-Pocket Expenditure (OOPE) and ensuring equitable access to healthcare. The COVID-19 pandemic further reinforced the urgent need for sustained investment in public health, particularly in preparing for future health crises.
Despite some progress in social security schemes and financial protection, the Committee noted that OOPE on healthcare remains high, dropping only from 48.8 percent in 2017-18 to 39.4 percent in 2021-22. While the panel expressed hope that current figures might be even lower, it stressed that a 39.4 percent OOPE remains a significant barrier to quality healthcare.
The report also referenced the Global Multidimensional Poverty Index 2024, which identifies India as home to 234 million poor people, the largest number of impoverished individuals in the world. Unlike other nations with high poverty levels, India is the only country in the top five with a medium Human Development Index (HDI). The Committee warned that without increased government health spending, a significant portion of the population will continue to struggle with access to affordable healthcare.
The Committee pointed out that Government Health Expenditure (GHE) as a percentage of GDP in India is just 1.84 percent, significantly lower than developed countries such as the United States, United Kingdom, Japan, and Germany. In comparison, high-income countries (HICs) allocate nearly 70 percent of their healthcare spending through public funding, ensuring greater financial protection for their citizens.
The panel urged the government to adopt best practices from these nations and take sustained efforts to increase GHE, which would further lower OOPE and improve access to essential medical services.
The Committee recommended that the government prioritise healthcare in budget allocations, ensuring sufficient resources for infrastructure, medical research, and service delivery. It also called for an annual budget increase for healthcare, maintaining momentum to strengthen India’s public health system.
(Edited by Ananya Rao)
