Even as the Union Health Ministry is going ahead with the proposal to introduce the B.Sc. (Community Health) course to meet the demands of healthcare personnel in the rural areas, the Parliamentary Standing Committee attached to the Ministry has strongly opposed the idea that would create second rung practitioners.

The panel, headed by Brajesh Pathak, instead asked the Government to devise new strategies to overcome the shortage of manpower in the rural sector and increase the intake for MBBS course in the country.

“In view of the opinion of majority of the Members being against the introduction of B.Sc. (CH) course, the Committee recommends that the Government should not go ahead with the proposal for introduction of the course. The Committee is, however, constrained to note that a very substantial portion of primary healthcare is provided by untrained providers and often by quacks and there is acute shortage of health care professionals in rural areas,” the panel said.

“The Committee would, therefore, like the Ministry to devote its energies towards devising new strategies to overcome this gigantic problem. Keeping these facts in view, the Committee recommends that the Government should continue its focus on strengthening the existing Health care infrastructure by increasing intake of MBBS graduates and make provision for one year compulsory rural posting for them after internship which would help in providing healthcare for rural people,” the recent report by the committee said.

The panel also suggested several measures to improve healthcare infrastructure in rural areas. More number of medical colleges, increase in number of nursing graduates in sub-centres, more intake in nursing schools, and appointment of graduates and post-graduates in the Ayush stream in the rural areas are among the measures.

It may be noted that the Government had already finalized curriculum for the course and was planning to launch from the next academic year, against the severe shortage of manpower. In the present scheme of things 1.4 lakh Sub-Centres in the country are being manned by ANMs designated with the functions of prenatal and ante natal care of children. The aim of the course is to strengthen the middle-level health workers at the sub-centres.

The Medical Council of India (MCI) had constituted a Committee under the chairpersonship of Prof Vinod K Paul (head, Department of Paediatrics, AIIMS) to develop a curriculum for the B.Sc. (CH) course. The Committee was apprised that the said graduates would not be called ‘doctor’ and would be designated as Community Health Officers (CHOs), who would man the SCs. He also submitted that the course would be regulated through MCI in all aspects.

However, some members of the Parliamentary panel felt that some B.Sc. (CH) Graduates may not be able to distinguish the nuances between a simple fever and jaundice. There was no clarity about the status of a person who has passed the exams in one state and has to migrate to other state due to reasons beyond his/ her control and the validity of the degree in such a case, the panel members pointed out.

“As per the information received from the Health Department, schools for training these graduates would be attached to district hospitals thereby raising serious apprehensions on whether the Government would be able to establish such schools in all the districts and how would the Government be able to provide teachers who would teach such graduates keeping in view the shortage of teaching facility in the country. Serious apprehensions were raised on the clinical competencies of graduates who would be churned out of these schools. How would the Government ensure that such graduates would not carry on private practice as can be seen from the fact that Government has not been able to rein in the government medical doctors from carrying on private practice,” the panel report said.