Healthcare Crisis in Himachal Pradesh: Severe Disparities Revealed in CAG Report

Imbalances in Doctor Distribution, Infrastructure Shortages, and Expired Drugs Impacting Rural and Tribal Areas

Shimla, December 26: A recent report by the Comptroller and Auditor General (CAG) of India has exposed serious shortcomings and disparities in Himachal Pradesh’s healthcare system, highlighting the stark contrast between well-equipped urban centers and under-resourced tribal districts. The findings, presented during the winter session of the Himachal Pradesh Assembly in Dharamsala, reveal an alarming shortage of healthcare professionals, essential services, and medical infrastructure, with the state’s tribal regions suffering the most.

The CAG report points out that while cities like Shimla and Solan have an excess of doctors and specialists, the tribal districts of Kinnaur and Lahaul-Spiti are grappling with near-total shortages in their civil hospitals. Kinnaur, for instance, faces a 57% doctor shortage, while Lahaul-Spiti’s district hospital is operating with just 11% of the necessary medical specialists. In contrast, Kullu reported no shortage of doctors, and Shimla even showed a 33% surplus of medical specialists.

The shortage extends to Community Health Centres (CHCs) and Primary Health Centres (PHCs). Solan experienced a 13% excess in doctor availability, but Una faced the lowest staffing, with only 14% of its positions filled. Similarly, while Solan managed a relatively minor 5% shortfall in PHC staffing, Sirmaur suffered a significant 33% deficit. This uneven distribution of healthcare professionals indicates poor planning and inequitable staffing across the state, particularly in remote and tribal areas.

The report also highlighted severe deficiencies in critical healthcare services, with several district hospitals lacking ICU facilities. Chamba, Kangra, Solan, and Lahaul-Spiti, for example, did not have functioning ICU services, and many ventilators were found to be non-operational. While ICU equipment was present in some hospitals, nearly 20% of the 773 ventilators across the state were found to be out of service. The availability of outpatient services also varied greatly, with Lahaul-Spiti offering only two OPD services compared to the full range in Hamirpur.

Further compounding the problem, the CAG identified significant shortcomings in hospital infrastructure. As of March 2022, nine out of 12 district hospitals had fewer beds than sanctioned levels. Additionally, the state Health Department wasted millions of rupees with over 341.59 lakh quantities of drugs and consumables expiring between 2017 and 2021, indicating poor inventory management and procurement practices.

The situation in medical colleges and super-speciality hospitals is equally dire. The Atal Institute of Medical Super Specialities in Shimla reported a staggering 49% shortage of specialists, while Indira Gandhi Medical College (IGMC) faced a 15% shortfall. Across the state, nine districts, excluding the tribal areas, experienced a 69% shortage of medical specialists, further highlighting the need for a strategic overhaul of the healthcare system.

These findings underscore the urgent need for comprehensive reforms in Himachal Pradesh’s healthcare sector, including better distribution of medical personnel, addressing infrastructure gaps, and ensuring proper procurement and usage of medical supplies. The inequities in healthcare provision—especially in remote and tribal regions—require immediate and sustained attention to guarantee that all residents, regardless of location, have access to quality medical services.

The CAG report calls for a balanced approach to healthcare delivery, one that prioritizes the most vulnerable populations and ensures the effective use of resources to prevent future wastage and system breakdowns. Without prompt intervention, the disparities in Himachal Pradesh’s healthcare system are likely to widen, leaving rural and tribal areas increasingly underserved.