- Health outlay should increase from 1.2% to at least 1.9% of GDP: Experts
- COVID-19 has highlighted the need of improving mental healthcare: Expert
- Experts expect massive allocation towards improving access to healthcare
New Delhi: In a statement last month, Union Finance Minister Nirmala Sitaraman said that ‘Health’ would take top priority and investment in health is going to be absolutely critical in the upcoming Budget 2021-22. She said that the government would be looking to not just provide buildings for hospitals but also the technology and infrastructure apart from improving the availability of doctors and nurses to service the sector and reduce out-of-pocket expenditure for the people. According to experts, after a year dominated by COVID-19 pandemic that has till date caused over 1.5 lakh fatalities in the country and over 21.7 lakh deaths worldwide, it is indeed expected that health expenditure will be a focus of the Union Budget that will be presented on Monday (February 1).
Here are some of the major expectations of doctors and medical experts from the budget:
Increase In Public Healthcare Expenditure
The High Level Group On Health Sector constituted by Fifteenth Finance Commission, which includes eminent experts such as Dr Randeep Guleria, Director, AIIMS, New Delhi, Dr Devi Shetty, Chairman, Narayana Health Sciences, Pune and Dr Naresh Trehan, Chairman, Medanta City, Gurgaon has proposed a plan for a phased increase in health expenditure to achieve the target of 2.5 per cent of Gross Domestic Product (GDP) by 2025. GDP is the value of goods and services produced within the geographic boundaries of a country during a year. According to the group’s estimates, allocation towards health should be increased to 1.92 per cent of GDP in the budget for FY 2021-22.
Professor Dileep Mavalankar, Director, Indian Institute of Public Health, Gandhinagar said that the budget for health and family welfare must increase by at least 50 per cent at the state and central level. He said,
Our aim should be to reach 3 per cent of GDP for health from the current 1.2 per cent in the next 5 years.
Professor Mavalankar said that an increased health budget is required so that the healthcare system can be strengthened in the villages and in urban areas. He also added that the increased expenditure is required for improving medical colleges and institutions dedicated to public health like National Centre for Disease Control (NCDC), All India Institute of Hygiene and Public Health (AIIHPH), , Indian Institutes of Public Health and other schools of public health as well as public health divisions in the Ministry of Health.
According to Dr Aviral Roy, Consultant Critical Care, Medica Superspecialty Hospital in Kolkata, while the rapid actions of the government and tireless efforts of healthcare workers have helped in the fight against COVID-19, the pandemic has, however, highlighted the gap in the healthcare system and has underscored the need to invest in infrastructure. He said,
Our hospital infrastructure is very poor. COVID-19 has shown how we lacked on the required beds for patients almost everywhere in the country. All the government and private hospitals ran out of bed. Make-shift arrangements had to be done to keep the patients.
The lack of adequate public health infrastructure along with high out-of-pocket expenditure imposes a high financial burden on household and there increasing the healthcare budget allocation is of utmost importance, added Dr Roy.
Upsurge In Investment In Medical Research And Development
Experts said that massive investment is required for research and development in the healthcare sector. According to Dr Roy, currently there is one government body – Indian Council for Medical Research (ICMR) and the institutions under it where all the research happen. He said,
Apart from ICMR, medical research is largely done by private pharmaceutical companies and all pharma companies are profit-oriented entities looking to sell their drugs. Therefore, we urgently need more government support towards research and build public research institute armed with capable minds.
Dr. K K Aggarwal, President of the Confederation of Medical Association of Asia and Oceania (CMAAO) and Former President, Indian Medical Association (IMA) said that instead of relying only on private players, the government must set-up its own lab for researching and developing its own vaccine against diseases. He said, this will not only reduce government spending on buying vaccines from entities but will also ensure equitable access of vaccines for all.
Improvement In Healthcare Facilities At Primary Level
Dr Roy highlighted that in order to aim for improvement in health status of the people, increased investments are needed in the primary healthcare. He said,
Unfortunately, the programmes that we have right now like Ayushman Bharat, Swasth Sathi are not able to make much of a difference at the grassroots level. This is because reimbursing government hospitals with public funds under the name of Ayushman Bharat for surgeries will not be helpful to a patient because they will be getting it for free anyway. That was always the point of government hospitals- to provide subsidised healthcare to the needy. But what we really need is more budget allocation on health at the primary level. We need to upscale the services being provided currently and increase the type of health services at the primary level so that people do not have to risk their lives in order to access better care at hospitals that are far.
Archana Sharma, Accredited Social Health Activist (ASHA), working at L.D. Bhatt Government Hospital at Kashipur district of Uttarakhand, said that in the upcoming budget, she expects to see an increased allocation towards the remuneration for frontline workers such as her. She said,
ASHAs have been on the frontline in the fight against COVID-19 at the community level, risking our lives. Our role should be recognised and we should get better regular remuneration instead of current incentive-based system. We get Rs. 400 per delivery for taking pregnant women to hospital for institutional delivery, Rs. 100 per card for Measles immunization, Rs. 100 per day for polio camps, Rs. 150 for conducting monthly meetings for reporting on the work we did in the month and only Rs. 2,000 per month as honorarium.
Meena Ganesh, Managing Director and Chief Executive Officer, Portea Medical, a consumer healthcare brand said that Budget 2021 will most likely dedicate some amount to building telemedicine infrastructure in the country, especially in the rural areas. She said,
Despite about 75 per cent of the Indian population residing in rural areas, the healthcare system is extremely inadequate in rural areas. This is where the delivery of health services in the rural areas through e-health/e-medicine and other such technology-driven means is going to play a transformational role. To make this happen, the government must ramp up the medical as well as training infrastructure in a big way. Funds must be allocated towards skill development of teachers, nurses, paramedical staff and caregivers. Further, by making budget allocations for the development of telemedicine and home-based healthcare ecosystem in the country, it is possible to best harness the available resources to cover the whole country.
According to Shumita Kakkar, Founder, United We Care, a digital platform for providing mental healthcare to people, mental health needs to become a part of primary healthcare. She said that the pandemic has changed the way people live and interact with each other in the society and has highlighted the dire need of improving mental healthcare services in the country.
Promoting Affordable Healthcare For Women In India
Dr. Surbhi Singh, Gynaecologist and Founder of ‘Sachhi Saheli’, a Delhi-based NGO that works towards raising awareness about menstruation said that the upcoming health budget must have a provision for affordable healthcare for women. She said,
Affordable Healthcare for women in India is absolutely indispensable as not only will their health help them live better, well-adjusted lives but will also enable them to contribute towards society.
She said that while planning for healthcare for women, the government must focus on providing the following:
– free health checkup at least once in a year
– insurance to all women to cover pregnancy and delivery costs
– free of cost cancer screening after the age of 40 years
– free cervical cancer vaccine for women and girls
– subsidised sanitary pads/menstrual cups to all women and girls
Better Allocation Towards Preventive Care
According to Dr Roy, the ongoing COVID-19 pandemic has underlined the need to invest in and ensure proper implementation of programmes that help in strengthening preventive care. He said,
The government must focus on increasing people’s access to clean drinking water, sanitation, nutrition, immunisation, treatment of diseases like Tuberculosis, measures to prevent malaria, dengue and other such diseases.
Vikas Bagaria, Founder, Pee Safe, sanitation and personal care brand said that the government must continue promoting preventive care by promoting hand-hygiene, thorough and regular sanitization of the public as well as private spaces and ensure ample availability of the hygiene products for the public.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.