Shocking findings from Punjab have served to highlight one of the biggest issues confronting public health in India: the country’s lack of specialist doctors.
Doctors untrained in the field of forensics perform eighty percent of autopsies in the state. This is resulting in “poor quality of work”, warns Dr D S Bhullar, president of the Punjab Academy of Forensic Medicine and Toxicology. This can have far-reaching implications, from threatening the outcome of legal cases to obstructing effective health policy planning by policymakers.
Shortages of forensic doctors is not an issue confined to Punjab. In Andhra Pradesh, sixty percent of postgraduate seats were vacant in 2015, leading The Times of India to question whether forensic medicine was “on its deathbed” in the state. In Mumbai all of the state’s ten postmortem facilities experience shortages of forensic medicine personnel or are at least partially dependent upon class IV staff to ensure autopsies are performed, as of 2016.
“Forensic medicine is not only the discipline to suffer from shortages of personnel in India. Primary healthcare centres suffer 81 percent shortfalls of specialist staff”
Forensic medicine is not the only discipline to suffer from shortages of personnel in India. Primary healthcare centres suffer 81 percent shortfalls of specialist staff. Community health centres report staff shortages as high as 84 percent for surgeons and 83.2 percent for general physicians.
This provides a barrier for patients availing healthcare, especially those in rural areas. They may be forced to travel considerable distances to have their ailment appropriately treated by the correct specialist doctor. It can also increase the burden on properly equipped facilities, who may be stretched beyond capacity. This can have the effect of extending waiting lists and placing ever greater pressure on doctors.
Staffing shortages pose a challenge even when tackling India’s biggest killers. Even though heart disease is the country’s leading cause of death, India employs just 4,000 cardiologists. It needs 88,000.
Mental healthcare also prominently suffers from staffing shortages. Even as 13.7 percent of Indians grapple with mental health disorders, India has just 898 psychiatrists when it needs 2,500. The end result of this is that a mere ten percent of the 150 million Indians in need of mental health treatment can avail it.
Whether in mortuaries, operating theatres, or health clinics, it is clear specialist shortages are a significant threat to the sustainability and functioning ability of India’s public health system. Incentivising uptake of specialist positions, recruitment drives for positions with enormous vacancies, and expanded accessibility to specialist training could go some way to alleviate the burden on patients and doctors alike. Without measures being taken, the crisis is one which will be felt both by India’s dead and its living.