By Dr Arun Mitra
We have faced serious health crisis in the last two years particularly due to the COVID Pandemic which has cost dearly precious lives, economy and pushed millions of people into joblessness and loss of livelihood adding to the already existing poverty. Large number of population could not get required treatment for COVID due to lack of preparedness on the part of the government. They were unable to go to the private hospitals due to exorbitant cost. In addition, the already existing diseases, both communicable and non-communicable faced serious the resource crunch. Whereas the affluent section of the society could get treatment for the above the lower income group, who are largely dependent on the state for their health needs were deprived of the treatment for diseases like Tuberculosis, Dengue, Malaria, Diarrhoea and even Vaccination to the children.
The WHO has pointed out time and again that to meet the health needs it is important that the public health spending should be 5% of the GDP. But unfortunately the public health expenditure in our country has been hovering around 1.1% for several years. According to the Oxfam’s “Commitment to reducing inequality report 2020” India ranks 154th in health spending, 5th from the bottom. It was therefore expected that the government would be serious in budgetary allocation towards health. But it was not to be.
The budgetary allocation to health in this year’s budget is Rs.82600 crore out of total fiscal budget of Rs.39.45 lakh crore. This amounts to 2.07% of the total budget. Last year this allocation was 2.04%. This miniscule increase is not even sufficient to meet the inflation. As percentage of the GDP the allocation to health budget has in fact come down. This is a serious issue which concerns health of our people. People close to the government claim that there has been a constant increase in the health budget. They forget that health budget has increased along with the total budget. For example, in the 2013 – 14 budget health was allocated Rs.37335 Crore out of a total budget of Rs.16.65 lakh crores, this amounts to 2.24%. Then in the next two years this budget fell to1.95%, 1.86 % and 1.93%. In the subsequent years it was raised to 2.20% and 2.16 % in 2017-18 and 2018-19. Now in fact it has come down again.
There has been special mention of Mental Health. It is true that the mental health has always been a serious issue. The situation during COVID Pandemic pushed people into poverty due to joblessness caused serious problems among the people. Children who lost school days have been the worst sufferers. The digital solution offered may not serve the desired purpose. There is need to increase the number of personnel in the field. A meager increase of budget allocation from Rs. 597 crore to Rs. 610 crores is too low.
Similarly a minor increase from Rs.2663 crore to Rs.3200 on Health research should have been increased much more. Faced with several health problems we need to develop our own innovative methods through research and development. This needs more monetary allocations.
Various studies have concluded that to ensure comprehensive primary healthcare there is need to enhance public health spending on health to minimum of 5% of the GDP. Government had committed that it will spend 2.5 % of the GDP on health. If that is to be done there has to be increase in budgetary spending to 3.5 lakh crore rupees.
Much has been talked about digitalization of healthcare system. This would mean maintaining digital record of the people. But this is not the priority. What is needed is creation of trained manpower in health sector at all levels. Health is a multi-sectoral issue which requires better nutrition, education, maternal and child healthcare, job opportunities, better work environment, housing, clean drinking water supply, sewerage facilities etc. With food security being undermined and spending on schemes like MGNREGA reduced, it would be naïve to expect health of the people to improve.
It is a matter of satisfaction that we have successfully vaccinated large number of our population. But still our record is less than global average of 52.56 persons fully vaccinated per 100 people. Our number stands at 50.23 whereas China has vaccinated 83.27 persons fully per 100 population. Many more countries have done better than us.
The budget has completely failed to meet the expectations for a direction towards comprehensive universal healthcare rather there seems to be a hidden agenda of corporate push in the healthcare through PPP mode which has been so much talked about by the present dispensation in power. (IPA Service)