There was hardly any mention of healthcare in Union Minister of Finance Nirmala Sitharaman’s maiden budget speech. It did not touch upon even flagship schemes of the Narendra Modi government as expected by experts.
Instead, Sitharaman just gave a passing reference to the sector, stating that according to the vision presented in the interim budget, a healthy society would remain an area of attention for the government, which she attributed to factors like Ayushman Bharat and well-nourished children and women.
The budgetary allocation for the Department of Health and Family Welfare has been increased 15 per cent to Rs 62,659 crore (BE 2019-20) from the Revised Estimate for 2018-19.
Unlike last time, when allocation for the National Rural Health Mission (NRHM) fell, this it was increased to Rs 27,039 crore. The 7.11 per cent raise, however, may not be enough to better rural health infrastructure. The government’s own Economic Survey said rural health infra was crying for care.
Sixty per cent of primary health centres (PHCs) in India have only one doctor while about five per cent have none, and, only 20 per cent of existing PHCs fulfill Indian Public Health Standards norms, according to the Survey tabled July 4. There is an acute shortage of human resource in these peripheral health institutions, the Survey added.
Allocation for the National Urban Health Mission has gone up to Rs 950 crore from Rs 875 crore previously.
The fact that tertiary care programmes have been at the centre stage of policymaking was also reflected in this year’s budget. The allocation to these programmes saw an increase of 60 per cent from the previous year’s revised estimates.
This is the highest increase among all component of the health sector’s budget. In a way, it confirms that while it is primary care which needs the utmost attention, tertiary care gets the most.
One of the important components where the allocation has gone south is upgrade of district hospitals to medical colleges. Against the revised estimates of last year, a reduction to the tune of 36 per cent has happened, with the component being allocated Rs 2,000 crore this year.
This is significant because the government recently announced it would convert another 75 district colleges to medical colleges and hosptials and this promise was also a part of the Bharatiya Janata Party’s manifesto in the recently concluded Lok Sabha polls.
The allocation to ‘Upgradation/Strengthening of Nursing Services (Auxiliary Nurse Midwives (ANMs)/General Nurse Midwives (GNMs)’ has also gone down from Rs 66 crore (2018-19 BE) to Rs 64 crore (2019-20 RE).
Another important department in the health sector is the Department of Health Research. Its allocation has gone up to Rs 1,900 crore (2019-20 BE), an increase of nine per cent, as compared to last year’s revised estimates.