How can the healthcare sector keep India’s citizens healthy enough to take the nation’s growth to 9.27 per cent, if it doesn’t get the support it needs?
As expected, Finance Minister Nirmala Sitharaman’s Union budget 2022-23 had quite a few healthcare related announcements. The FM continued the task from the previous year, of countering the impact of the COVID-19 pandemic.
Yet, the overall consensus of healthcare leaders is that Budget 2022-23 did not go the full distance. It might prove to be a missed opportunity to broaden and deepen the vision and thrust of last year’s Budget to the next logical level. If indeed the healthcare sector is expected to be one of the heavylifters to propel the nation’s growth to an estimated 9.27 per cent, more could have been done for a sector that ensures the health of India’s citizens as well as is a major source of jobs.
Although there had been a rise of 137 per cent allocation to the healthcare sector last year, the increase over budget estimates (BE) this year is just 16 per cent, up from Rs 74,602 crore in 2021-2 to about Rs 86,200 crore. With the revised estimate (RE) budget for the current financial year at Rs 85,915 crore, the 0.8 per cent increase is not significant enough. We are still nowhere near the stated vision and promise to increase healthcare expenditure to 2.5-3 per cent of GDP. Also, most of last year’s massive increase in Budget allocations to healthcare was soaked up by COVID-19 vaccinations. And this year, the FM cut support for COVID-19 vaccinations to Rs 5000 crore due to “lower requirement for vaccination.” Only around 48 per cent of India’s population has received two doses of the COVID-19 vaccines; will these funds be adequate to ensure that the rest of the population receives the second shot?
Significantly, the digital health mission got a major boost, with allocation going up from Rs 75 crore to Rs 200 crore. As a further push to digitise the healthcare sector, the FM announced that an open platform for the national digital health ecosystem will be created, consisting of digital registries of healthcare providers and facilities, as well as a unique health identity and consent framework. All this will definitely strengthen universal access to health care facilities.
The only new scheme announced was also in the digital health space, with the proposed launch of a national tele mental health programme. Anchored by NIMHANS, with IT support from the International Institute of Information Technology (IIIT), Bangalore, this will include a network of 23 telemedicine mental health centres of excellence, which will hopefully help address the mental health problems accentuated by the COVID-19 pandemic.
Two lakh anganwadis will be upgraded to ‘new generation Saksham Anganwadis’, under the Ministry of Women and Child Development, which will help improve child health with ‘better infrastructure and audio-visual aids, powered by clean energy and providing improved environment for early child development.’
But the National Health Mission (NHM) has got a meagre increase of 1 per cent over the previous year from Rs 36,575.5 crore in 2021-22 to Rs 37,000.23 crore in 2022-23. This will definitely mean that non-COVID health schemes will continue to be starved of funds. COVID has taken funds away from TB and HIV programmes, as well as routine immunisations. The hope was that with more funds, these programmes could have been brought back on track but that is not the case.
The allocation for Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PMABHIM) at Rs 978.87 crore, while a good increase from the revised budget estimate of the previous year of Rs 315.00 crore, is also being seen as insufficient to put in place the infrastructure planned out.
There is a sense of disappointment that even two years of the COVID-19 pandemic do not seem to have convinced policy makers that the healthcare sector deserves the same attention and investment as the IT sector, as a declared national priority sector. Perhaps it is enough that schemes announced last year are not rolled back, given that funds allocated may not have been completely spent. This is an indication that the sector has to focus on more efficient utilisation of allocated funds, creating infrastructure for the long term.
While the fine print is still be analysed, there is also the possibility that funds and policies can be framed outside the budget as well. We will have to wait and watch if such announcements address the concerns mentioned above. After all, with many key state elections due, we can expect surprises. Let’s hope they are good ones.