Patiala, June 11 -- Not a single community health centre (CHC) in rural Punjab has the full complement of four mandatory medical specialists required under public health norms, exposing a critical gap in the state's rural healthcare system, according to the latest Health Dynamics of India 2023-24 report released by the Union ministry of health and family welfare on May 12. Community health centres, which function as block-level government hospitals serving clusters of villages, are expected to provide comprehensive secondary healthcare services through the presence of a surgeon, physician, gynaecologist and paediatrician. However, the report reveals that none of Punjab's 84 functional rural CHCs currently has all four specialists in place. Against a sanctioned strength of 259 specialist posts, only 51 are occupied, while 208 remain vacant, translating into a vacancy rate of more than 80%. The shortage limits access to specialised healthcare for rural residents, forcing many patients to travel to district hospitals or urban medical facilities for treatment. Health experts warn that such gaps in staffing can lead to delays in diagnosis and treatment, increased healthcare expenditure for rural families and poorer health outcomes, particularly among vulnerable populations. The shortage extends beyond CHCs to sub-divisional hospitals, which serve as a crucial link between primary healthcare facilities and district hospitals. According to the report, only 388 of the 648 sanctioned specialist posts in sub-divisional hospitals are filled, leaving 260 vacancies. Punjab is also facing a shortage of medical officers. Of the 368 sanctioned posts, only 177 are occupied, while 191 remain vacant. Experts say the lack of doctors at various levels of the healthcare system places additional pressure on existing staff and affects service delivery in rural areas. The report notes that neighbouring states are facing similar challenges. Haryana has only 10 specialists against 34 sanctioned posts in rural CHCs, resulting in a vacancy rate of 70.6%. Rajasthan has 1,098 vacancies out of 1,844 sanctioned specialist posts, a vacancy rate of 59.5%. As to Himachal Pradesh, the report records nine specialists in position despite showing no sanctioned posts, indicating a surplus or reporting anomaly. At the national level, rural CHCs require 14,137 specialists but have only 5,223 in position, leaving 8,923 vacancies. Nearly two-thirds, or 63% , of specialist posts remain vacant across the country. The findings come at a time when Punjab is witnessing a growing burden of lifestyle diseases, an ageing population and increasing demand for specialised medical care. Public health experts have cautioned that shortages of surgeons, physicians, gynaecologists and paediatricians could undermine key government health programmes, particularly those related to maternal and child health, management of non-communicable diseases and emergency medical services. The absence of gynaecologists and paediatricians in many facilities is especially concerning, as it can directly affect maternal healthcare services and child health outcomes. Similarly, shortages of surgeons and physicians limit the treatment of serious illnesses and medical emergencies at the community level. Punjab has not undertaken regular recruitment of medical specialists since 2022. In an effort to address the shortage, Health Minister Dr Balbir Singh introduced the empanelment of private medical specialists for district and sub-divisional hospitals in December last year. The state government extended the scheme to community health centres in May this year. The ground situation has changed as the report mentions about 2023-24. The change would be visible when the new report comes by year-end or early next year. He said Punjab has more sanctioned specialist posts in CHCs than several states with larger populations. "We are hiring medical specialists through the empanelment scheme. We are far better than many BJP-ruled states," he said. The minister added that all specialist posts in district hospitals across Punjab had been filled. The staffing crisis is not limited to doctors. Laboratory services, a key component of disease diagnosis and management, are also understaffed. The report shows that only 367 of the 615 sanctioned laboratory technician posts in rural healthcare facilities are occupied, leaving 248 vacancies. Health experts say the shortage of laboratory personnel affects timely diagnosis, treatment planning and disease surveillance, weakening preventive healthcare efforts in rural areas....