The Bhore Committee, formally known as Health Survey and Development Committee, was appointed by the Government of India in 1943, Chaired by Sir Joseph Bhore, it submitted its landmark report in 1946.
This report is often described as the “blueprint” for the modern Indian healthcare system, as it was the first comprehensive attempt to survey health conditions and suggest a structured national health program.
Primary Objectives
The committee was established during British era with two primary goals:
- To assess the existing health conditions and the state of health organizations in British India.
- To make specific recommendations for the future development of a health system that could meet the needs of the population.
The committee operated on the fundamental principle that “no individual should fail to secure adequate medical care because of inability to pay for it.”
Key Recommendations
The Bhore Committee’s recommendations were visionary, focusing on the integration of services and rural accessibility.
Integration of Health Services
- The committee proposed a unified approach where preventive, promotive, and curative services were integrated at all administrative levels.
- They argued that medicine should not just treat sick but actively prevent disease.
Three-Tier Health Structure
To ensure reach into rural areas, committee proposed a hierarchical system:
- Primary Level: Primary Health Centres (PHCs) to provide basic care.
- Secondary Level: Secondary Health Centres to serve as supervisory and referral institutions.
- Tertiary Level: District Hospitals providing specialized care.
Short-term vs. Long-term Plans
The committee recognized that full implementation would take time, so they proposed two schemes:
| Features | Short-term Measure (Immediate) | Long-term Measure (The “3 Million Plan”) |
| Population Coverage | 1 PHC for every 40,000 people. | 1 Primary Health Unit for every 10,000 – 20,000 people. |
| Hospital Capacity | Minimal bedside facilities. | 75-bed hospitals at primary level; 650-bed at secondary; 2,500-bed at district. |
| Staffing | 2 Doctors, 4 PH Nurses, 4 Midwives, etc. | High ratio of “social physicians” and support staff. |
Medical Education Reforms
- “Social Physician”: Suggested a 3-month training in Preventive and Social Medicine (PSM) to make doctors more aware of community needs.
- Abolition of Licentiate: Recommended replacing the “Licentiate in Medical Practice” with a single national standard: the MBBS degree.
- AIIMS: Proposed the creation of a major central institute for postgraduate medical education and research, which eventually led to the establishment of AIIMS in 1956.
Impact on Health Reforms
Although many recommendations were not fully implemented immediately due to the financial constraints of a newly independent India.
Foundation of PHCs:
- The concept of the Primary Health Centre, which remains the backbone of rural Indian healthcare today, originated here.
Five-Year Plans:
- India’s First and Second Five-Year Plans heavily borrowed from Bhore Committee’s suggestions, particularly the focus on mother and child health.
Public Model:
- It established idea that State must be primary provider of healthcare, moving away from a purely private or charitable model.
Criticisms
- The “3 Million Plan” was financially out of reach for the 1940s.
- It focused almost exclusively on Western medicine, neglecting traditional systems like Ayurveda and Unani.
- Many of the “socialized medicine” ideas were initially opposed by private medical practitioners who feared state control.