Report of the Health Survey and Development Committee: Vol. II

When the report was written, it was estimated that there are approximately 47,400 certified doctors in British India.

The Committee felt that health services should be available to all citizens, whether or not they can pay for them. People should be able to get medical attention at home or at a hospital, where facilities for the treatment and prevention of disease as well as the promotion of health are available.

The report says that it was difficult to introduce health insurance in India, either by itself or as part of a universal social insurance scheme. A very large section of the population lived below the subsistence level and could not afford even the small contribution for an insurance scheme.

The Committee recommended that public funds be devoted to developing health services for the general population and particular groups such as women and children, and not to providing special facilities.

It said that preventive and curative health work must be combined for maximum results. Thus, the national health plan proposed in the report needed to provide for doctors in primary rural and urban health units, who could perform these functions and work closely with communities. 

The Committee recommended that a Central Statutory Board of Health be set up. It would consist of representatives of the central and provincial governments and work towards formulating and implementing a national health policy.

It said that each primary health unit should have six medical officers, six public health nurses, and a 75-bed hospital that would provide curative and preventive health services. This unit would be only a link in the chain of the community’s health services.

Each secondary health unit would have a 650-bed hospital, two senior public health nurses, and doctors in charge of medicine, surgery, maternity, tuberculosis and pathology. These doctors and nurses would supervise the work of their counterparts in primary health units.

A district headquarter hospital would have 2,500 beds and more medical officers than a secondary unit. However, both would have better facilities and more trained personnel and so, would attend to complicated cases that could not be treated in primary units.

During the first Ten-Year programme proposed by the Committee, primary, secondary and district health units would be set up; services dealing with malaria, leprosy, venereal diseases, maternity and child welfare and nutrition would be provided; and field training centres for teaching institutions would be set up.

The Committee also recommended that every village should have a health committee of at least 5-7 voluntary workers, depending on its size and population.

It suggested that in the early stages of schooling, children should be instructed about healthy habits and personal hygiene. The condition of schools, hostels, classrooms, compounds and latrines should also be improved.

When the report was released, the ratio of beds in mental health institutions to the country’s total population (400 million) was 1:40,000.

The Committee said that the problems of mental health had, until then, received very little attention in India. It recommended the appointment of officers with experience in this field at the Centre and in the provinces, in order to formulate and implement a sound mental health programme.

Focus and Factoids by Vedika Inamdar.

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.