Report of the Health Survey and Planning Committee (Volume I)
On June 12, 1959, the Ministry of Health, government
of India, appointed the Health Survey and Planning Committee under the
chairmanship of Dr. A. Lakshmanaswami Mudaliar – the then vice-chancellor of Madras University.
The committee’s tasks included an assessment of
the field of medical relief and public health since the Report of the Health Survey and Development Committee, 1945 (this older
document is referred to as the Bhore Committee report), a review of the First (1951-56) and Second (1956-61) Five Year Plan health
projects, and formulating recommendations for future health plans.
The Committee issued 907 questionnaires to heads
of medical colleges, health departments in state governments, as well as representatives
of the nursing profession, pharmaceutical trade and industry, and scientific
bodies. It received 665 responses. Committee members also visited and conducted
interviews at several ‘representative institutions’.
The 15 chapters in this first of two volumes cover
topics such as as medical care and public health, communicable diseases,
professional education and research, the ‘population problem’, drugs and
medical supplies, legislation, indigenous systems of medicine and health
administration. The second volume consists of appendices.
Citing Census 1961, the report notes that India’s population was 436 million, and 82 per cent people lived in rural areas.
Several important changes had occurred since the Bhore Committee submitted its report in 1946. These include India’s Independence, the Partition, the merger of princely states, the re-organisation of states, the First (1951-56), Second (1956-61) and Third (1961-66) Five Year Plans, and the abolition of the Indian Medical Service, Women’s Medical Service and Medical Research Department.
Since the Bhore Committee report was released, the number of hospital dispensaries had increased from 7,400 to 12,000, that is, the report notes, from a ratio of 1:40,000 to 1:33,000. More than 3,500 maternal and child health centers were started in this period (from 1945 to 1962). The report observes that these could be considered a consequence of the recommendations of the Bhore Committee.
The report notes that the National Malaria Control Programme was inaugurated in 1953 in cooperation with the Technical Cooperation Mission, United States, and with the technical advice of the World Health Organization. In 1958-59, this programme was converted into the National Malaria Eradication Programme, with ‘spraying operations’ in 390 units and ‘surveillance operations’ in 365 units. This reduced the ‘proportional case rate’ of malaria to other diseases from 10.8 per cent in 1953-54 to 2.88 per cent in 1959-60.
The expansion of medical facilities, the report states, had not been up to the standard stipulated by the Bhore Committee. Only 2,800 of the 5,000 proposed Primary Health Centres (PHCs) had been set up. Each PHC served a population of 65,000 to 75,000 with a single doctor, ‘health visitor’, pharmacist, four midwives and six beds.
Regarding ‘morbidity patterns in India’, the report states that malaria was endemic all over the country, filariasis was a problem in coastal states and in some interior areas, intestinal infections like typhoid, dysentery and diarrhoea were widespread, cholera was endemic and smallpox continued to be a problem. Leprosy, venereal diseases, rabies, and diseases of the eye also continued to be common or endemic. Nutritional disorders due to the low calorific content of food consumed by a majority of the population, and protein, vitamin and iodine deficiency were common too.
Estimates of the Environmental Hygiene Committee, 1948, showed that roughly 6.15 per cent of India’s population had protected water supply, and 3 per cent had access to a sewerage system. In the subsequent First and Second Five Year Plan periods, urban water supply schemes were allotted most of the expenditures. The report states that there had been little or no improvement in the situation since the Environmental Hygiene Committee’s estimates.
In 1957, the total production of cereals was six per cent more than the requirement (of “14 ounces of cereals per unit, per day”), while the actual availability was about 2.8 per cent more than what was required. But for pulses, fruits, milk, sugar, fish, meat and eggs, there was a deficit between requirements and actual availability.
The committee outlined the qualifications for admission in undergraduate medical courses, and the method of selecting candidates. The report stated that other than constitutional obligations for ‘special facilities’ to Scheduled Castes and Scheduled Tribes and certain backward communities, no other reservations should be continued.
In some states (not listed in the report), there was a dearth of women studying medicine at the undergraduate level, the report observed, and they must be enabled to do so for a transitional period of 10 years. The committee recommended that 20 per cent of the seats be reserved in such states for women to study medicine.
The committee recommended establishing a separate Council of Ayurveda to set the standards of training in Ayurveda and to ensure uniformity of progress throughout the country. It suggests that similar councils for Siddha and Unani systems of medicine, as well as a coordinating committee for the three systems.
Focus and Factoids by Hetvi Dhimar.
Health Survey and
Planning Committee, under the chairmanship of Dr. A. Lakshmanaswami Mudaliar
Ministry of Health,
Government of India