Introduction to the Bhore Committee

The Bhore Committee was one of the most influential health committees in India’s history, created to study the country’s medical and public health needs during the final years of British rule. It laid the foundation for India’s modern healthcare system by proposing a long-term national plan focused on accessible, affordable, and preventive health services.

Why the Committee Was Formed

During the early 1940s, India faced widespread health challenges—high mortality rates, frequent epidemics, and extremely poor medical infrastructure. To understand these problems scientifically and design a structured improvement plan, the Government of India appointed the Health Survey and Development Committee in 1943.

Chairperson and Leadership

The committee was chaired by Sir Joseph Bhore, an experienced civil servant known for his administrative expertise and commitment to public welfare. His leadership guided the committee in creating a comprehensive blueprint for healthcare reform.

Purpose of the Committee

The central aim was to:

• Evaluate the existing health conditions in India
• Identify gaps in medical facilities, manpower, and public health services
• Recommend a nationwide strategy to improve health access, particularly for rural communities
• Propose a long-term vision for an integrated and equitable healthcare system

Historical Context: India’s Health Situation Before the Bhore Committee

Before the Bhore Committee was formed, India’s health system was in a severely underdeveloped state. Understanding this background is essential because it explains why such a large-scale health reform committee became necessary.

Poor Public Health Infrastructure

Most of the country lacked basic medical facilities.

• Hospitals were very few and mostly located in big cities.
• Rural regions—where the majority lived—had almost no access to trained doctors or medicines.
• Sanitation systems were weak, increasing the spread of infections.

High Mortality and Morbidity

People suffered and died from diseases that were preventable or treatable.

• Communicable diseases like malaria, cholera, tuberculosis, and plague were widespread.
• Infant and maternal death rates were extremely high due to lack of proper maternity services and nutritional awareness.

Shortage of Medical Professionals

India had a very small number of trained doctors, nurses, and health workers.

• Medical colleges were limited.
• Most trained doctors worked in urban areas, leaving rural populations underserved.
• Public health officers were not available in sufficient numbers to manage outbreaks.

Limited Government Investment in Health

Before independence, health was not considered a major priority by the British administration.

• Funding for hospitals and public health programs was minimal.
• No long-term national health planning existed.
• Preventive health services were nearly absent.

This historical backdrop shows how urgent the health crisis was and why the Bhore Committee had to take a deep, holistic approach. Without understanding these challenges, the importance of its recommendations becomes harder to appreciate.

Objectives of the Bhore Committee

Its objectives focused on understanding the country’s real healthcare needs and creating a long-term roadmap for improvement.

1. Assess the Overall Health Conditions in India

The committee’s first goal was to study the nation’s health status in detail.

• Identify major diseases affecting the population
• Understand gaps in public health facilities
• Examine environmental and social factors contributing to illness

This helped create a factual foundation for future health planning.

2. Recommend a Systematic National Health Program

The committee aimed to design a nationwide plan that could improve the health of all citizens.

• Focus on preventive measures as well as treatment
• Ensure government-led public health development
• Promote long-term planning instead of temporary solutions

3. Strengthen and Expand Health Infrastructure

A major objective was to address the shortage of hospitals, clinics, and trained workers.

• Suggest expansion of medical colleges
• Increase doctors, nurses, and field health workers
• Improve hospital facilities at district and block levels

4. Ensure Fair and Easy Access to Healthcare

The committee wanted healthcare to reach every person, especially those in rural areas.

• Reduce health disparities between rural and urban areas
• Propose services that were free or affordable
• Integrate primary, secondary, and tertiary care for smooth patient support

5. Promote Integration of Services

Instead of having separate systems for public health and medical services, the committee sought to merge them.
This was meant to create a unified, coordinated, and efficient health network.

Key Recommendations of the Bhore Committee Report

The Bhore Committee presented one of the most comprehensive healthcare reform plans in India’s history. Its recommendations focused on building a nationwide system that was preventive, accessible, and publicly funded so that every citizen could receive essential health services.

1. Establishment of Primary Health Centres (PHCs)

The committee proposed creating Primary Health Centres across the country as the first point of contact for people.

• Provide basic medical care
• Offer maternal and child health services
• Conduct immunization and disease prevention programs
• Serve populations of roughly 40,000 people

This became the foundation of India’s public health structure after independence.

2. Development of a 3-Tier Healthcare System

To make healthcare organized and efficient, the committee recommended a three-level structure:

• Primary Level: PHCs for basic services
• Secondary Level: District hospitals for more complex treatment
• Tertiary Level: Teaching hospitals and specialty centers for advanced care

This model is still used in India today.

3. Integration of Preventive and Curative Services

Earlier, public health and curative services were handled separately.
The committee insisted on merging these systems so people could receive:

• Disease prevention
• Treatment
• Follow-up care
  all in one coordinated network.

4. Universal and Free Health Services

A revolutionary recommendation:

• Healthcare should be free for all citizens
• Government should finance and manage health services
• No one should be denied treatment due to money

This idea shaped India’s later national health programs.

5. Strengthening Medical Education

To solve the severe shortage of trained professionals, the committee proposed:

• Increasing the number of medical colleges
• Improving training quality
• Introducing postgraduate programs
• Creating more nursing and paramedical schools

6. Creation of Health Units

The committee suggested organizing healthcare through “health units,” each serving around 40,000 people with:

• A primary health center
• Sub-centers
• Field workers
• Preventive and curative staff

7. Long-Term National Health Planning

The committee envisioned a phased plan that would improve the system over many years.
This included building more hospitals, improving sanitation, and expanding manpower.

Why These Recommendations Were So Important

These ideas transformed the way India approached healthcare. Most of India’s health policies, programs, and institutions today are built on the foundation created by the Bhore Committee.

Structure of the Proposed 3-Tier Healthcare System

This structure aimed to make healthcare organized, efficient, and evenly distributed across India.

1. Primary Level: Primary Health Centres (PHCs)

PHCs were designed to be the first contact point for people.
They offered essential, preventive, and basic curative services such as:

• Treatment for common illnesses
• Maternal and child healthcare
• Immunization services
• Health education and awareness
• Basic diagnostic support

Population Coverage: Around 40,000 people per PHC.
This level reduced the pressure on big hospitals by solving most issues locally.

2. Secondary Level: District and Taluka Hospitals

If a patient needed more specialized care, they would be referred to the secondary level.
These hospitals provided:

• More advanced diagnostics
• Minor and major surgeries
• Specialist consultations (OBGYN, pediatrics, surgery, medicine, etc.)
• Management of cases beyond PHC capacity

This level acted as the backbone for bridging primary and tertiary services.

3. Tertiary Level: Teaching Hospitals and Specialty Institutes

The highest tier consisted of large, well-equipped institutions designed for complex treatment and advanced medical care.
They handled:

• Complicated surgeries
• Intensive care
• Rare diseases
• Specialized treatments like cardiology, oncology, neurology
• Medical research and teaching

These institutions also trained future doctors, nurses, and health professionals, ensuring continuous improvement in healthcare quality.

Why This 3-Tier System Matters

This structure created a clear, logical pathway for patients—starting from basic care at PHCs to advanced care at tertiary hospitals when needed.
It reduced overcrowding in big hospitals and made healthcare more accessible and affordable for rural populations.

Phases of the Bhore Committee Implementation Plan

The Bhore Committee recommended that India should develop its healthcare system gradually, in well-organized phases.

This step-by-step approach was designed to make the reforms practical, affordable, and easier for a newly independent country to manage.

Phase 1: Short-Term Plan (Immediate Action Plan)

This phase aimed to address the most urgent gaps in the healthcare system soon after independence.

Key Focus Areas

• Strengthening district hospitals
• Improving maternity and child health services
• Increasing preventive programs like vaccination, sanitation, and disease control
• Recruiting additional health workers for rural areas
• Upgrading medical training standards

Objective

To quickly reduce disease burden and improve basic healthcare access while long-term infrastructure was being planned.

Phase 2: Intermediate Plan (3–5 Years)

This phase worked as a bridge between urgent needs and the long-term vision.
It focused on preparing the country for a large-scale structural transformation.

Key Focus Areas

• Expanding the number of Primary Health Centres
• Developing health units serving around 40,000 people
• Strengthening laboratory and diagnostic services
• Increasing the number of medical and nursing colleges
• Improving supervision and management systems

Objective

To gradually build the foundation for the complete 3-tier healthcare system across India.

Phase 3: Long-Term Plan (10–20 Years)

This was the committee’s most ambitious and visionary phase.
It represented a complete transformation of India’s healthcare system.

Key Focus Areas

• Establishing a full network of PHCs across all rural areas
• Developing secondary and tertiary hospitals in each district
• Creating specialty hospitals and medical research centers
• Ensuring universal, free healthcare for all citizens
• Achieving adequate manpower: doctors, nurses, midwives, technicians
• Full integration of preventive and curative services
• Standardizing health services nationwide

Objective

To create a modern, equitable, and accessible healthcare system that provides universal health coverage to every citizen—especially the poor and rural communities.

Why These Phases Matter

These three phases show how deeply the Bhore Committee thought about India’s needs.
Instead of rushing into reforms, it created a realistic and gradual plan that balanced:

• available resources
• the country’s size
• long-term national goals

Even today, many of India’s health policies follow this phased, step-by-step development model.

Impact of the Bhore Committee on India’s Health System

1. Foundation of the Primary Health Centre (PHC) System

One of the biggest impacts was the creation of the PHC-based healthcare network.

• PHCs became the backbone of rural health services.
• Millions of people gained access to basic healthcare close to home.
• Preventive healthcare received more importance—like immunization and nutrition programs.

2. Influence on National Health Planning

The committee’s recommendations formed the base for health planning in independent India.

• First Five-Year Plan took guidance from the Bhore report.
• Policies for maternal health, child health, malaria control, TB control, sanitation, and nutrition were shaped using its framework.
• Health became a recognized priority for national development.

3. Expansion of Medical Education

The committee’s emphasis on training and manpower development led to:

• Establishment of new medical and nursing colleges
• Improvement in curriculum quality
• Increase in the number of doctors, nurses, midwives, and paramedical staff
  This helped reduce the severe shortage of qualified professionals.

4. Development of Public Health Programs

Many national programs started later were inspired or guided by the committee.
Examples include:

• National Rural Health Mission (NRHM)
• Universal Immunization Program
• Integrated Child Development Services (ICDS)

All of these reflect the committee’s focus on prevention, equity, and accessibility.

5. Strengthening of Government-Led Healthcare

Before independence, healthcare was not prioritized by the government.
The Bhore Committee changed this mindset by recommending:

• Government-funded free health services
• Strong role of the public sector
• Health as a social responsibility, not a market commodity

This shifted India toward a welfare-oriented healthcare vision.

6. Long-Term Vision for Universal Health Coverage

The idea that healthcare should be accessible to all came from this committee.
Its vision continues to shape modern policies like Ayushman Bharat and Health & Wellness Centres.

Why This Impact Matters

The Bhore Committee didn’t just give recommendations—it gave India a philosophy for health: equitable access, preventive care, and a strong public system.
Even after decades, its blueprint remains relevant.

Limitations and Criticism of the Bhore Committee

While the Bhore Committee was visionary, some of its recommendations were difficult to implement in the real world.

1. Highly Idealistic and Cost-Heavy Recommendations

Many proposals required large financial investment, which was not possible for a newly independent nation with limited resources.

• Building PHCs everywhere
• Establishing district and tertiary hospitals
• Training huge numbers of doctors and nurses

Because of high cost demands, several recommendations were delayed or only partially implemented.

2. Slow Implementation Due to Economic Constraints

India was struggling with poverty, food shortages, and rehabilitation after independence.

• Health sector funding was low
• Other sectors like agriculture and industry took priority
• Many states lacked capacity to execute reforms

This slowed down the full rollout of the committee’s plan.

3. Infrastructure Goals Not Fully Achieved

The goal of a PHC for every 40,000 people could not be achieved quickly.

• Many rural areas still lacked proper facilities
• Existing PHCs lacked adequate staff or equipment
• Secondary and tertiary care expansion was slower than expected

This kept the rural-urban healthcare gap wide.

4. Limited Focus on Local Diversity

India is a diverse country with different health needs in each region.
Some critics felt the committee’s recommendations were:

• Too centralized
• Less flexible for state-level variations
• More suited to uniform planning rather than regional customization

5. Weak Attention to Non-Allopathic Systems

India has a strong tradition of Ayurveda, Unani, Siddha, and other systems.
The committee largely focused on Western biomedical models, giving less attention to indigenous systems of medicine.
This created an imbalance in recognizing India’s holistic health traditions.

6. Inadequate Immediate Solutions

The Bhore Committee emphasized long-term planning, but:

• Some short-term, urgent health needs were not addressed fully
• Immediate disease burden control required faster, temporary solutions
• Health worker shortages remained in many areas for years

Why These Limitations Matter

Despite challenges, the committee still laid a historic foundation—but it also showed how difficult large-scale health reforms can be in developing nations.

Conclusion

The Bhore Committee remains a landmark in India’s health policy history because it provided the first comprehensive blueprint for a fair, accessible, and community-based healthcare system. Even though it was created during the final years of British rule, its vision shaped the direction of independent India’s health planning for decades to come.

Why the Bhore Committee Still Matters

The committee is remembered not just for its report, but for its philosophy:
healthcare should be accessible, equitable, and centered around people’s needs.
This message continues to inspire policymakers, educators, and healthcare professionals across the country.