New Health Sub Centres to come up with no new staff posts, basic infrastructure

Tamil Nadu is set to see the creation of 642 new Health Sub Centres (HSC) in rural and urban areas. However, there is a catch. The new facilities have been approved, but without new staff posts and basic infrastructure support. Instead, Auxiliary Nurse Midwives (ANM), who are working in Primary Health Centres (PHC), will be redeployed to the new HSCs.

This decision has raised some serious questions on how the Health department has been handling acute shortages of manpower, including some 3,000-odd vacancies of Village Health Nurses (VHN)/ANMs for the past four years, while adding on new health infrastructure.

The State currently has 8,713 HSCs, with the norms prescribing one HSC for every 5,000-6,000 population. Establishing 642 urban and rural HSCs on the basis of population was one of the announcements made by the Health Minister in the Assembly earlier this year.

In line with this, a Government Order issued on June 13 stated that the Directorate of Public Health and Preventive Medicine submitted a proposal and the list of 642 HSCs were identified for new creation on rationalisation as per population norms in rural and urban areas “with no additional fund”. Each HSC has one post of VHN.

Based on the proposal, the State government, while giving administrative nod for establishing the HSCs (617 in rural and 25 in urban), stated that creation of new posts will not be sanctioned and ANMs have to be redeployed to the HSCs as the posts of VHNs and ANMs carries identical scale of pay and are interchangeable.

The available rent-free building or any government building should be utilised for the HSCs, and for the most basic infrastructure, such as fan and furniture, the existing infrastructure available in the PHC under which the HSC is located should be utilised. But this was not all. Electricity charges for the newly-created HSCs should be managed from the funds allocated towards electricity charges for the respective PHCs.

As per official data, 2,013 posts of VHNs (of the 8,713 sanctioned) and 1,251 posts of ANMs (of the 2,057 sanctioned) are lying vacant, a source in the Health department pointed out. “This shortage remains unresolved for the last four years citing court cases. For a government that has strong legal teams, it is unacceptable that legal issues relating to health manpower are not being resolved,” he said.

Redeploying ANMs from PHCs to the new HSCs will give rise to additional vacancies in PHCs. “As of now, 806 ANMs are in place. If nearly 600 of them are shifted, then additional vacancies will rise in PHCs. Not to forget that there is a huge vacancy of staff nurses in PHCs,” he added.

“Every time we ask, the court cases are cited for delay in filling up the VHN vacancies. As a result, maternal and child health services are getting affected. When the government has been successful in many cases, they should sort out this at the earliest. Instead of redeploying ANMs, the department should create new posts and fill up the vacant posts of VHNs at the earliest,” K.S. Manimegalai, State president, Tamil Nadu Government Health Women Union, said.

A health official said they would fill up the vacancies immediately after the case was vacated in the Supreme Court. “We have already filed the counter to vacate the stay and are waiting for the judgement,” he said, adding that ANM redeployment would be done as per procedure and need.