Context

On July 8, 2021, the Union government announced the “India COVID-19 Emergency Response and Health Systems Preparedness Package: Phase II”. But it lacks provision for the medical workforce.

Objectives of the package

• The stated purpose of the package is to boost health infrastructure and prepare for a possible third wave of COVID-19.
• There is plan to increase COVID-19 beds, improve the oxygen availability and supply, create buffer stocks of essential medicines; purchase equipment and strengthen paediatric beds.

What is lacking in the package?

• Workforce shortage: The package barely has any attention on improving the availability of health human resources.
• As reported in rural health statistics and the national health profile there are vacancies for staff in government health facilities, which range from 30% to 80% depending upon the sub-group of medical officers, specialist doctors to nurses, laboratory technicians, pharmacists and radiographers, amongst others.
• Interstate variation: In addition, there are wide inter-State variations, with States that have poor health indicators with the highest vacancies.

Way forward

• Package for filling the existing vacancies: The COVID-19 package II needs to be urgently supplemented by another plan and a similar financial package (with shared Union and State government funding) to fill the existing vacancies of health staff at all levels. 
• An objective approach to assess the mid-term health human resource needs could be the Indian Public Health Standards (IPHS).
• IPHS prescribes the human resources and infrastructure needed to make various types of government health facilities functional.
• The pandemic should be used as an opportunity to prepare India’s health system for the future.
• Scrutiny of the progress on policy decision: The progress on key policy decisions, for the last few years, to strengthen India’s health system, including those in India’s national health policy of 2017, need to be objectively scrutinised.
• These two sets of policy decisions should be reviewed and progress monitored, through a meeting of the Central Council of Health and Family Welfare, of which the Health Ministers of the States are members.

Conclusion

India’s health system will not benefit from ad hoc and a patchwork of one or other small packages. It essentially needs some transformational changes.

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