Blog

The Bhore Committee, officially known as the Health Survey and Development Committee, was appointed by the Government of India in 1943 under British colonial rule. It was chaired by Sir Joseph William Bhore, a senior Indian civil servant, and was established with the primary objective of assessing the existing health conditions in the country and recommending a plan for the development of a comprehensive health system. This committee was a landmark initiative in the history of Indian public health, as it laid the foundation for the structure of modern healthcare services in post-independence India.

At the time, India was facing numerous public health challenges such as widespread poverty, poor sanitation, malnutrition, high maternal and infant mortality rates, and limited access to medical facilities—especially in rural areas. The healthcare system was fragmented and heavily urban-centric. The Bhore Committee was entrusted with the responsibility of reviewing this situation and formulating recommendations for a more organized, equitable, and accessible healthcare framework for the entire population.

The report of the Bhore Committee, submitted in 1946, became a guiding document for India’s health policy and planning after independence. It emphasized the importance of preventive care, universal access, integration of health services, and state responsibility in ensuring health as a basic right for all citizens.

Aims of the Bhore Committee 

The Bhore Committee was established in 1943 with the aim of transforming India’s inadequate and fragmented healthcare system into a structured and accessible public health service. The committee’s vision was based on principles of social justice, equity, and the belief that healthcare should be a right for all citizens. Below are the major aims of the Bhore Committee explained in detail:

1. To Survey the Existing Health Conditions in India

One of the primary aims was to conduct a comprehensive survey of the prevailing health conditions across the country. This included:

• Assessing the availability and quality of medical facilities.
• Reviewing the state of public health, sanitation, nutrition, and disease prevalence.
• Identifying gaps in services across rural and urban areas.

2. To Propose an Integrated Health Service

At the time, healthcare in India was largely uncoordinated, with curative services (treatment of illness) dominating, while preventive services (like sanitation, health education, vaccination) were neglected. The committee aimed to:

• Recommend a unified healthcare structure that integrates both preventive and curative aspects.
• Ensure that all healthcare institutions offer a complete package of services including disease prevention, health promotion, and treatment.
• Promote a three-tier system of health delivery – Primary, Secondary, and Tertiary – for effective referral and continuity of care.

3. To Ensure Equitable and Universal Access to Healthcare

A key objective was to make quality healthcare accessible to all, regardless of socio-economic background, caste, religion, or geographic location. The committee emphasized:

• Removing disparities in healthcare access between urban and rural areas.
• Making healthcare services available free of cost to everyone.
• Ensuring that the rural majority, which had the least access to medical services, receives adequate attention through infrastructure and manpower development.

4. To Recommend Reforms in Medical and Nursing Education

The committee recognized that medical education at the time was disconnected from the public health needs of the country. To address this, it aimed to:

• Reform medical and nursing education to produce professionals with a public health orientation.
• Include preventive and social medicine in the curriculum.
• Encourage medical professionals to serve in rural and underserved areas.
• Increase the number of training institutions and set a target of one medical college per one million people.

5. To Develop a Long-Term National Health Policy

The Bhore Committee did not aim for temporary or short-term relief measures. Instead, it focused on designing a sustainable health system that could serve the nation for decades. The goal was to:

• Provide a long-term development plan for health services over a 30–40 year period.
• Create a roadmap for infrastructure expansion, manpower development, and administrative reform.
• Establish the foundation for India’s future national health policy and planning.

Recommendations of the Bhore Committee (1946) 

The Bhore Committee, after an extensive study of India’s health conditions, presented a comprehensive set of recommendations in its 1946 report. These recommendations aimed to build a unified, state-funded, and accessible healthcare system for all citizens.

The committee’s suggestions focused on strengthening healthcare delivery, improving medical education, promoting public health, and planning for long-term development. Below are the major recommendations explained in detail:

1. Establishment of a Three-Tier Healthcare System

The committee proposed a well-organized three-tier system of healthcare delivery to ensure comprehensive and coordinated medical services across the country:

• Primary Health Centres (PHCs):

  • One PHC for every 10,000 to 20,000 people in rural areas.
  • Staffed with general practitioners, nurses, public health workers, and midwives.
  • Provided integrated preventive, promotive, and curative services.

• Secondary Health Units (District Hospitals):

  • Hospitals with bed capacity of 650 or more.
  • Offered specialist care and acted as referral centres for PHCs.
  • Responsible for supervision, monitoring, and staff training.

• Tertiary Health Units (Teaching Hospitals and Medical Colleges):

  • Advanced hospitals attached to medical colleges.
  • Provided specialized treatment, research, and training.
  • Played a key role in national-level health policy and planning.

2. Integration of Preventive and Curative Services

The committee emphasized that all health centres must deliver both preventive and curative services under one roof. This meant:

• Medical officers and health workers should be trained to provide health education, sanitation services, vaccination, maternal and child health care, and treatment of illness.
• Breaking down the artificial separation between public health and clinical care to improve efficiency and effectiveness.

3. Universal Free Healthcare Services

A major recommendation was the provision of free healthcare to all citizens, irrespective of their economic status. The committee suggested:

• All health services should be state-funded and free of cost at the point of use.
• Medical care should be treated as a public service, not a commercial activity.
• Financial barriers must be removed to ensure equality in access.

4. Focus on Rural Health Services

Recognizing that the majority of India’s population lived in villages, the committee strongly recommended:

• Priority development of rural health infrastructure, especially PHCs and sub-centres.
• Training and deployment of village-level health workers and midwives.
• Introduction of mobile health units to serve remote and inaccessible areas.

5. Reforms in Medical and Nursing Education

The committee proposed a complete transformation of medical education to suit the country’s health needs:

• Include preventive and social medicine in the medical curriculum.
• Establish one medical college for every one million population.
• Encourage the creation of multipurpose health workers trained to deliver a wide range of basic health services.
• Promote community-based and socially oriented training for doctors and nurses.

6. Long-Term and Short-Term Health Development Plans

The committee suggested two key phases of implementation:

• Short-Term Program (10 years):

  • Strengthen existing health facilities.
  • Begin construction of PHCs and training centres.
  • Increase production of doctors, nurses, and paramedics.

• Long-Term Program (30–40 years):

  • Achieve full coverage of the population through the three-tier system.
  • Expand medical colleges and public health schools.
  • Implement nationwide universal healthcare.

7. Health Manpower Planning

To meet the future demands of healthcare services, the committee recommended:

• Increase in the number of trained health personnel, including doctors, nurses, midwives, and paramedical staff.
• Establishment of new training institutions.
• Provision of incentives for serving in rural and remote areas.

8. Strengthening Health Administration

Efficient delivery of health services required strong administration. The committee advised:

• Decentralization of health management by establishing local health authorities.
• Strengthening the role of state and central governments in planning, policy-making, and supervision.
• Recruitment of trained public health administrators and managers.

9. Development of Public Health Research and Statistics

For effective health planning and disease control, the committee recommended:

• Promotion of research in epidemiology, nutrition, and social medicine.
• Establishment of a Central Health Intelligence Bureau to collect, compile, and analyze health data and statistics.

10. Promotion of Health Education and Public Awareness

The committee emphasized the importance of educating the public on health matters:

• Introduce health education programs in schools and colleges.
• Use mass media to spread awareness about hygiene, disease prevention, nutrition, and family planning.
• Involve community participation in health programs to encourage responsibility and cooperation.