India’s states should create a multidisciplinary public health management chart, the Health Ministry proposed on Saturday, offering a framework to separate the clinical chart from the public health chart, leading to more effective public health care delivery. , since doctors will be free from administrative tasks.
The clinical role would be separated from managerial roles to improve overall efficiency, according to the framework released by Health Minister Mansukh Mandaviya.
“In order to best utilize experience and talent to ensure health for all, it is necessary to segregate service providers based on clinical and public health functions among various cadre types with flexibilities based on state functional requirements,” the guidelines said. .
The Ministry of Health has proposed four verticals: specialist cadre, public health cadre, health management cadre, and teaching cadre, at the state, district, and block levels.
“This is meant to have separate roles assigned for better health care delivery,” a health ministry official familiar with the matter said on condition of anonymity.
Specialists will be clinical specialists with postgraduate degrees or diplomas in fields such as medicine, surgery, orthopedics, obstetrics and gynecology, dermatology, psychiatry, etc. The public health cadre will be made up of professionals with an MBBS degree and a postgraduate qualification in preventive and social medicine, or public health. All new MBBS doctors will need to acquire public health qualification within a certain time (3-5 years).
The health management cadre will be composed of health and other professionals with relevant qualifications and support to execute various national health programs and public health functions. Admission will be at the block level and will consist mostly of graduates with a graduate degree in public health (70%) or MBA with specializations in human resources, purchasing and supply chain, finance, operations and hospital and health management.
States will have the flexibility to change the percentage based on local context and requirements, according to the guidelines.
The teaching staff will be according to the guidelines of the national medical commission.
The career progression for each cadre will be distinct in their own respective streams with flexibility for deputation between cadre, if one person has the required qualification.
To implement the framework, the guidelines propose a mapping of existing public health personnel, including general medical officers and specialists at various levels in the current health cadre, and the identification of positions in various facilities.
States have been advised to prepare a roadmap for delivering public health training to serving candidates; hire required doctors according to sanctioned positions by establishing a recruitment board; and prepare a structure for the health management cadre with a mix of public health professionals and MBAs.
The framework, however, is advisory in nature and is not mandatory for states to follow.
The proposed framework would help improve healthcare delivery on the ground and is badly needed, experts said.
“It was sorely needed because clinicians should be able to focus solely on clinical activities and not be really burdened with administrative work, procurement, finance, etc., which consumes a significant amount of time,” said Dr. KK Talwar, former director of Postgraduate. Institute of Medical Education and Research, Chandigarh.