Total outlay for healthcare rises, but fall in capex

The budget estimates, however, show a decline in allocation for capital expenditure in health, with lower allocation for key health infrastructure programmes — despite Finance Minister Nirmala Sitharaman identifying overall infrastructure and investment as a priority area.

The estimate for health capital expenditure has reduced by nearly Rs 332 crore (to Rs 5,300.34 crore) for FY24 from FY23. (PTI)

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Three years after the pandemic broke out, the FY24 healthcare budget has marginally increased to Rs 89,155 crore from the previous year’s estimate of Rs 86,200 crore. This health outlay stands at 2.1 per cent of the GDP, crawling towards the government’s aim of increasing healthcare spending to 2.5 per cent of the GDP by 2025.

The budget estimates, however, show a decline in allocation for capital expenditure in health, with lower allocation for key health infrastructure programmes — despite Finance Minister Nirmala Sitharaman identifying overall infrastructure and investment as a priority area.

The estimate for health capital expenditure has reduced by nearly Rs 332 crore (to Rs 5,300.34 crore) for FY24 from FY23. The allocation for one of the flagship schemes of the government — Pradhan Mantri Ayushman Bharat Infrastructure Mission — fell to Rs 645.8 crore from the previous estimate of Rs 978 crore. The utilisation of the fund had been low, with the revised FY23 estimate standing at Rs 281.6 crore. The mission focuses on strengthening health and wellness centres, setting up critical care blocks and creating surveillance units.

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There was a significant decline in allocation for Pradhan Mantri Swasthya Suraksha Yojna — from Rs 10,000 crore to 3,365 crore.

With Covid-19 case numbers low for nearly a year, the allocation for health insurance for healthcare workers under the Pradhan Mantri Garib Kalyan package fell from Rs 226 crore to Rs 0.01 crore.

This budget saw an increase in allocation for a flagship government programme, the National Digital Health Mission. With the mission to set up a cloud-based database of health records gaining ground — over 10 crore ABHA accounts have been created — the allocation to the programme increased to Rs 341 crore from the previous year’s Rs 200 crore.

The finance minister also announced a mission to eliminate sickle cell anaemia by 2047. The programme will include awareness creation, counselling, and universal screening of 7 crore persons between the ages of 0 and 40 years in affected tribal areas.

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Focusing on research in the health and pharmaceutical sector, Sitharaman announced that select laboratories of the Indian Council of Medical Research will be opened up for medical colleges and private R&D teams. The minister also announced a scheme to promote research and innovation in the pharmaceutical sector through centres of excellence, while encouraging the private sector to also invest in research and development in specific priority areas.

The minister also announced dedicated multidisciplinary courses for medical devices in existing institutes. She said, “Dedicated multidisciplinary courses for medical devices will be supported in existing institutions to ensure availability of skilled manpower for futuristic medical technologies, high-end manufacturing and research.” This is significant as India is trying to become self-reliant in medical devices after the pandemic, with the government also proposing a new act for better regulation of medical devices separately from drugs.

This, however, will not reduce the 80 to 85 per cent medical device import dependence of India immediately, said Rajiv Nath, forum coordinator at the Association of Indian Medical Device Industry (AIMeD). He said that the industry was expecting a graded increase in the custom duty on imported products from the current 0 to 7.5 per cent to 10 to 15 per cent and a reduction in the GST from 18 per cent to 12 per cent as medical devices are not luxury goods.

“Though our honourable Prime Minister urges India to become Atmanirbhar in medical devices, yet the medical devices imports continued to grow at an alarming level by 41 per cent in FY22. Sadly, the government didn’t even implement the recommendations made by the parliamentary committee on health. It is very painful to see the plight of domestic industry players shutting shop as the local industry cannot compete with cheaper Chinese imports,” said Nath.

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The finance minister also announced 157 new nursing colleges, which will be set up in “co-location” with the existing medical colleges established since 2014. The 157 new medical colleges were established in three phases covering 39 aspirational districts under a centrally-sponsored scheme of the government along with existing district or referral hospitals.

“Setting up 157 nursing colleges is a welcome step as there is a huge shortage of qualified nurses in our country, much more than doctors,” said Ravi Wankhedker, former president of the Indian Medical Association.

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Anonna Dutt

Anonna Dutt is a Principal Correspondent who writes primarily on health at the Indian Express. She reports on myriad topics ranging from the growing burden of non-communicable diseases such as diabetes and hypertension to the problems with pervasive infectious conditions. She reported on the government’s management of the Covid-19 pandemic and closely followed the vaccination programme. Her stories have resulted in the city government investing in high-end tests for the poor and acknowledging errors in their official reports. Dutt also takes a keen interest in the country’s space programme and has written on key missions like Chandrayaan 2 and 3, Aditya L1, and Gaganyaan. She was among the first batch of eleven media fellows with RBM Partnership to End Malaria. She was also selected to participate in the short-term programme on early childhood reporting at Columbia University’s Dart Centre. Dutt has a Bachelor’s Degree from the Symbiosis Institute of Media and Communication, Pune and a PG Diploma from the Asian College of Journalism, Chennai. She started her reporting career with the Hindustan Times. When not at work, she tries to appease the Duolingo owl with her French skills and sometimes takes to the dance floor. ... Read More

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