Report of the Committee on Integration of Health Services

Public health services in India are rarely completely decentralised because the central government retains control – especially on matters relating to national health protection measures, relations with other countries on health issues, high-level planning, control of financial subsidies, and highly specialised matters such as radiation protection.

The report states that medical services should be specialised, but this should not lead to overspecialisation, and it is important to align various forms of specialised learning and functions with public health services.

Creating comprehensive health services demands an integration of preventive and curative medical care. The (former) USSR is cited as an example – where all local health services are unified in the district hospital under one administration.

A statistical service is essential for planning, administering and evaluating health services, notes the report.

The committee observes the growing fragmentation of health services, and the dispersal of public health services among many agencies of the government. An associated problem is the increasing tendency to create a special authority or commission to handle a single health problem. The result “is a splintering of a health function from an overall health problem.”

The committee recommends bringing all medical officers under one cadre with uniform pay scales, rotation of officers between clinical, public health, teaching and research branches, common seniority, special allowances for specialists, financial and other incentives to medical officers posted in rural areas.

The committee recommends the gradual elimination of private medical practice, beginning with teaching, research and supervisory posts in the Health Directorate, and in regional and district health organisations. The ‘non-practice allowance’, the reports says, should be a realistic and reasonable compensation for the loss of private practice.

Focus and Factoids by Abizar Shaikh.

PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.