Healthcare - The Top Priority

Healthcare has become the top priority across all platforms for over a year, due to the coronavirus disease-2019 (COVID-19) pandemic. As India looks forward to rising to the new normal after the unprecedented disruption caused by the Covid-19 pandemic, there is growing demand to push for timely healthcare facilities. This would demand the government and private institutes to be on par with the evolving regulatory guidelines and policies. Thus, there is a need for the healthcare sectors (tertiary care hospitals, university-based teaching institutes and research centres) to keep themselves abreast with the various health- related programmes and budgetary allocations planned by the government of India, to make informed decisions.

As per the Economic Survey 2020-21, there has been an increase in the financial allocations from `94,452 crore to `2,23,846 crore for health- and well-being–related programmes such as provision of drinking water and sanitation (`60,030 crore), nutrition (`2,700 crore) and COVID-19 vaccination (`35,000 crore). The allocation for COVID-19 vaccination was declared as a one-time allocation and was not included in the annual budget. Although according to the National Health Policy (NHP; 2017) and the Parliamentary Standing Committee (March 2020) reports indicated that the Union Government would have to allocate `1.6 lakh core in 2021-22 for these programmes. Surprisingly, the figures mentioned in the recent budget report did not add up to even half of this amount. As the primary healthcare services were affected during the pandemic, there is a pertinent need to increase the expenditure in those areas.

When the controversy surrounding the astonishing 137% increase in health expenditure was care- fully investigated, it was found that `2,23,846 crore was actually allocated to “Health and Well-being and Allied Sectors” instead of only to “Health and Wellbeing”. The spending on Central Road and Infrastructure Fund was also incorporated into the Health and Family Welfare budget of `3,000 crore. In 2021-22, the allocation for health-related programmes, such as Saksham Anganwadi and Poshan 2.0 schemes, was nominally increased to `24,557 crore (from `20,105 crore), while it was `64,180 crore to the novel centrally sponsored scheme, Pradhan Mantri Aatmanirbhar Swasth Bharat Yojana, which is yet to make an impact on the healthcare sector. Provision of new laboratories, virology centres and critical care hospitals is planned under this new scheme

Overall, after analysing all the possibilities and subgroupings of the various planned schemes, the financial allotment for the health sector was noted to be `76,902 crore, which is `7,668 crore more when compared with the previous planned budget. Further the Union health budget for this year remains at 0.34% of the gross domestic product (GDP), which is barely above the 2020-21 allotment (0.03% to 0.31%). Thus, it is evident from these figures that the claim of 137% increase in the health budget is not likely to help in achieving the target of 2.5% GDP by 2025, as stated in the NHP of 2017. The Finance Commission estimated that India needs to spend 0.68% of the GDP on health in 2021-22 to achieve this goal. These analyses demonstrate a huge gap between the targeted and actual spending, which raises an important question – “given the nominal changes in the financial allotments, can we win the battle against the pandemic?”

The massive budgetary changes and allocations made due to the COVID-19 pandemic, seem to be good from the human capital perspective. Health policies are indispensable for a nation’s progress as they impact human development directly and economic growth indirectly as healthy people are more productive and contribute significantly to the GDP growth through increased productivity. The COVID-19 has undoubtedly claimed many lives and the society might never be the same in its aftermath, however, it blatantly reminded us that “without good health, economic development of the nation has little value”.

The financial allocations for healthcare will strengthen the preventive health and ensure the allied health care workers skill building. The country is looking for professionals to bridge the gap in demand for healthcare and undoubtedly opportunities are coming up for allied health professionals in a large way

I thank Rev. Dr. Fr. John Thekkekara, HOD, Department of Hospital Administration, SJMC for suggesting the topic, HealthMinds team for the assistance in preparation of the editorial and the editors Dr. Archana Bhat and Dr. Pavithran P for reviewing the editorial.