NEW DELHI: Despite the initial enthusiasm ten years ago, the Centre’s proposal to launch an Indian Medical Service cadre on the lines of the Indian Administrative Service and Indian Police Service is yet to take off.
The Health Ministry had set up a cadre review committee to consider the proposal to establish a dedicated central health force made more than five and a half decades ago. However, an RTI reply has revealed that the committee, which was constituted on the issue in 2015, failed to meet after 2019. Despite the committee not meeting to discuss the issue raised several times by the Indian Medical Association, the Centre insisted that “it is still considering the issue.”
The RTI filed by Dr Aman Kaushik, an RTI activist who completed his MBBS and is now pursuing NEET-PG, the ministry said, “The matter is under consideration in consultation with all the states/UTs for seeking their views.”
To a question about whether the ministry is still considering creating the cadre and how many states have offered their comments after July 2019, the ministry said, “Till date, 12 states/UTs have responded, and as far as the matter regarding supporting/non-supporting the proposal is concerned, it is under consideration.”
Kaushik asked when the last committee meeting was held. The answer, he said, was very shocking. “A committee was constituted on the matter in 2015 and no further meeting was held after 2019,” the RTI reply of March 28 by Dr Naveen Aggarwal, Deputy Secretary and First Appellate authority under section 19 (1) of the RTI Act, 2005, said.
Kaushik said, “Since 1960, many committees have recommended the creation of this cadre. But nothing has been done so far. The healthcare infrastructure of India is lacking at the primary, secondary, and tertiary levels.”
Such a central cadre existed before Independence. It was abolished in August 1947.
“Since independence, IAS has had administrative control of health issues. They might have passed the UPSC exam, but we need someone trained in public healthcare. The question is why doctors don’t prefer to work in rural areas. It is because of the lack of facilities and low salaries,” he said.
"If this cadre is introduced and facilities are provided on lines of IAS, rural healthcare can be improved because then many doctors will be ready to serve in these remote rural areas,” he added.
In fact, the issue was raised twice in the parliament—in 2018 and 2019.
On December 28, 2018, the then Minister of State of Health and Family Welfare Minister, Ashwini Kumar Choubey, in a written reply in the Lok Sabha, said, “The ministry has referred the matter of creation of All India Medical Service to a Committee constituted for Cadre Review of the Central Health Service (CHS) to examine, among others, the need for creation of an All India Medical Service."
He said that following the committee's recommendation, the ministry has requested all states/UTs to offer their views on the creation of medical services so that the ministry can firm up its proposal. The ministry had written to all the states/UTs in 2017.
The minister further said that they had received comments from six states - Andhra Pradesh, Madhya Pradesh, Kerala, Sikkim, Goa and Mizoram and two UTs - Dadra and Nagar Haveli and Andaman and Nicobar Islands.
He said while Goa, Mizoram, Andaman, Nicobar Administration, Dadra, and Nagar Haveli supported the proposal, the Kerala and Sikkim governments did not. “The government of Andhra Pradesh has requested to come up with a comprehensive proposal incorporating the best practices in other countries for addressing the manpower needs in the two sectors of health services and medical services,” the minister said.
The minister gave the same reply in the Lok Sabha on July 19, 2019.
“If the government wants to launch this cadre, they must set a timeline for states. It seems that the central government is not serious about it, despite claiming that they are still considering it in the RTI,” Dr Kaushik said.
He added that the 15th Finance Commission had also recommended the creation of the cadre. “Given the inter-state disparity in the availability of medical doctors, it is essential to constitute an All India Medical and Health Service as is envisaged under Section 2A of the All India Services Act, 1951,” it had said.
A parliamentary committee in 2021 also favoured the formation of such a cadre.
The issue was first raised in 1960 when the Health Survey and Planning Committee, known as the Mudaliar Committee, in its report in 1961, recommended the formation of a central health cadre in which senior posts in the central and state health ministries would be included.
In 2005, another report of the National Commission on Macroeconomics and Health, chaired by then Finance Minister P Chidambaram and then Health Minister A Ramadoss, made the same suggestion—forming a central health cadre on the lines of IAS/IPS.