Saiyed Danish Jamal
The much talked about Union Health Budget is going to be tabled soon in the Winter session of the Parliament. Currently, India is facing a major health crisis due to the lack of basic healthcare infrastructure in the rural areas and small cities.
In 2019-2020 health budget, despite an increase in funding of Ayushman Bharat from Rs. 2000 crore to Rs. 6,400 crore, there was a steep drop in the funding of National Health Mission (NHM) and other programs aimed at ensuring basic health. The defence budget last year was 4.8 times of the health budget as the defence allocation was Rs 2,82,733 crore and health allocation limited to Rs 63,538.
Health Care Expenditure and GDP
Last year, the health budget outlay for 2019-2020 fiscal year was Rs. 62,398 cr, a sharp 19% increase from the 2018-19 figure of Rs. 52,800 crore.
Despite that, India’s health budget stood 14th in the list 27 major items in budget expenditures and was still below the spending of many low-income and developing countries which are spending 1.4 % of their GDP on health.
India only spends 1.2% of GDP whereas many others countries in the world are spending 6-8% of their GDP on bettering health sector, including Bangladesh and Pakistan. It is not to blame the current government as this figure of 1.2% has been constant since 1999.
In 2019, citing various health challenges, a campaign called ‘Health for All’, under which many doctors and professionals from other industries had joined hands to demand an increased health budget to 3% of our GDP which meant that the health budget should be increased to 1.5 lakh crore from 60,000 crore per year.
In the year 2019, the health crisis came knocking at the door led by infants deaths in districts like Muzaffarnagar and Gorakhpur of Uttar Pradesh which exposed everything about our health sector that is colossally wrong. As a result, we see that today the matter of infant deaths has spread across the country like an epidemic and cities like Kota, Rajkot and Ahmedabad are repeating the sad story of Uttar Pradesh with even higher number of death count.
A huge gap can be seen today between the availability of basic health facilities in the cities and rural areas.
Today, 80% doctors are taking care of 28% patients only as health facilities are increasingly getting concentrated in cities and metros. For instance, in villages, 51,000 patients depend on every 50 doctors where as in cities like Delhi only 300 patients have to depend on a doctor.
If the data provided by Rural Health Statistics Bulletin 2017-18 is to be brlieved, the country still needs 32,900 sub-centres, 6,430 primary health centres and 2,188 community health centres.
When it comes to tribal areas, the situation is much worse, where there is a shortage of 5,935 sub-centres, 1,187 PHCs and 275 CHCs.
Currently, only 7% of the sub-centres, 12% of primary health centres and 13% of the CHCs are operating across the country.
What We Need
In a nutshell, among many other issues our health care sector needs to develop human resources in medical services, universalise and expand immunisation and other programmes, share expenditure and other initiatives, primary and secondary healthcare facility in each assembly constituency, open one medical college in each Parliamentary constituency, regularising all contractual workers, open five new AIIMS facilities a year, universalising maternity benefits, tax-benefits, strengthening public health centres, medical college level healthcare, basic healthcare to be made available at sub-divisional level and better health management.
Suggestions and Recommendations
Keeping these facts and figures in view and living up to its pledge of tirelessly contributing towards a better and healthy India, Healthwire will bring to its readers a plethora suggestions and recommendations put forward by renowned doctors in the country through a series of columns detailing their wishlist for the health budget proposing various healthcare related ideas and steps which should be included in the upcoming health budget.