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Q 40- By highlighting the important reasons that contribute to brain drain in the health-care industry, discuss the necessity for long-term solutions to manage human resources in the Indian health-care industry (250 words)

  • Paper & Topic: GS II à  Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.


  • Model Answer:


  • Introduction:


  • India has been a major exporter of healthcare workers to industrialised countries, particularly the Gulf Cooperation Council countries, Europe, and other English-speaking countries, for several decades.
  • Part of the reason for the scarcity of nurses and doctors is because of this.
  • According to government data, India has 1.7 nurses per 1,000 people and a doctor-to-patient ratio of 1:1,404, which is much below than the WHO standard of three nurses per 1,000 people and a doctor-to-patient ratio of 1:1,100.


  • Body:


  • Figures and facts:


  • According to OECD data, approximately 69,000 Indian-trained doctors worked in the United Kingdom, the United States, Canada, and Australia in 2017.
  • In the same year, 56,000 Indian-trained nurses worked in these four countries.
  • There is also a large-scale movement of health workers to the GCC countries, however there is no reliable statistics on the number of these workers in these countries.
  • As with low- and semi-skilled migration, there is no real-time data on high-skilled migration from India.


  • Reasons for India's brain drain:


  • Resident doctors are overworked and underpaid: Residents in MD and DM programmes are required to work more than 90 hours a week. They are either paid a pittance of less than $50,000 a month, which is insufficient to compensate for their stress and pressure.
  • As a result, people who complete their MBBS seek greater prospects in the United Kingdom, the United States, and Europe.
  • In terms of higher compensation and better possibilities in the destination countries, there are substantial pull forces connected with healthcare worker migration.
  • The UK has awarded eligible overseas healthcare workers and their dependents free one-year visa extensions if their visas were set to expire before October 2021.
  • During the outbreak, France extended citizenship to frontline immigrant healthcare personnel.
  • However, there are a number of compelling reasons for these workers to relocate abroad.
  • Low earnings in the private sector, along with limited chances in the public sector, encourages people to look for work outside of the country.
  • The lack of government investment in healthcare, as well as long wait times for appointments at public health institutions, is a driving force behind such migration.


  • Stopping the brain drain in India:


  • The government has tried for years to stop the brain drain of healthcare employees, but with little or no success.
  • It ceased granting No Objection to Return to India (NORI) certificates to doctors relocating to the United States in 2014.
  • The NORI certificate is a requirement of the US government for doctors who come to America on a J1 visa and want to stay longer than three years.
  • The doctors will be forced to return to India at the conclusion of the three-year period if the NORI is not issued.
  • Nurses have been added to the Emigration Check Required (ECR) category by the government.
  • This decision was made in order to increase transparency in nursing recruiting and decrease nurse exploitation in destination nations.
  • The government's efforts for preventing brain drain are restricted and do not provide a long-term solution to the problem.


  • Next Steps/Conclusion:


  • We need to make systemic reforms, such as investing more in health infrastructure, assuring appropriate compensation for workers, and creating an overall atmosphere that encourages them to stay in the country.
  • The government should focus on developing regulations that encourage healthcare personnel to return home after completing their training or study.
  • It might also work on drafting bilateral agreements to help define a "brain-share" strategy between sending and receiving countries.
  • According to the 2020 Human Development Report, India has five hospital beds for every 10,000 people, which is one of the lowest rates in the world.
  • Increased healthcare spending, particularly in the public sector, is thus urgently required.
  • As a result, health-care employees would have more job opportunities.
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