The budget to all of us is considered to be the reflection of the policy of the government in power. In general, the Budget has always been a mechanism to display the policy framework of the government keeping in mind peoples aspiration and political compulsion of the government. The budget this time will also give an impression as to how serious the government is in facing the challenges posed by the pandemic.
Will the pandemic compel the government to redefine it approach towards healthcare? It is surprising that India, which is considered to be the emerging economy in the world in terms of its volume and size, has paid very little attention towards healthcare. It is very unfortunate that last year’s allocation of Rs 69,000 crore for the health sector was only one per cent of GDP.
Experts and leaders from health sectors and from other fields have been demanding for the past 10 years to increase the percentage share of GDP towards healthcare but the government hasn’t taken care of such demands. But will the pandemic force the government to rethink its approach towards healthcare or will it be the same old wine in new bottle.
Prof K. Srinath Reddy, President, Public Health Foundation of India (PHFI), formerly headed the Department of Cardiology at All India Institute of Medical Sciences (AIIMS). He was appointed as the First Bernard Lown Visiting Professor of Cardiovascular Health at the Harvard School of Public Health in (2009-13) and presently serves as an Adjunct Professor of Epidemiology at Harvard (2014-2023). According to him, “The Union Budget of 2021 comes when the world is in the throes of the global Covid-19 pandemic. Even though the epidemic has abated in India since mid-September 2020, the threat still remains, especially with the entry of recent variants with multiple mutations. The pandemic has provided many lessons on why India must strengthen the health system. The union budget must reflect those priorities, by raising the overall allocation by 20% in real terms, compared to last year.”
Reddy added: “The foremost priority is to increase the financing for primary healthcare in both rural and urban areas. The urban health mission has been far too long in cold storage. Whether it is early case detection and contact tracing or home care and immunisation, primary health services have emerged as the backbone of the pandemic response. Augmenting the numbers and skills of technology enabled primary care personnel, along with infrastructure strengthening and provision of free drugs and diagnostics, requires a strong budgetary push. The benefits of PMJAY must be extended to outpatient care and include more families.”
On infrastructure, he said: “District hospitals and medical college hospitals too should be strengthened. Upgraded district hospitals can become training affiliates of new colleges for medicine, nursing and allied health sciences. Public health capacity needs to be built by supporting training institutions and creation of central and state level public health cadres. Financial incentives need to be provided in the budget for such capacity building and cadre creation. Disease and risk factor surveillance systems should be strengthened, by investing more in the Integrated Disease Surveillance Programme (IDSP) and One Health eco-surveillance. Development and evaluation of affordable health technologies should be promoted through incentives for digital health and impactful use of context relevant Artificial Intelligence algorithms for application in public health and clinical settings.”
On fund allocation, Dr Rajan Sharma-MS (Ortho) former National President, Indian Medical Association, said: “We have been demanding for long to increase the budgetary allocation to around 5-to 6 per cent of the GDP, but that has not happened so far. The onslaught of Covid-19 pandemic showed the magnitude of the effect of the healthcare sector on the economy of our nation and people. As the government gears up to present the Union Budget 2021, it is imperative that enough budget is allotted for the healthcare sector which will subsequently have a considerable influence on India’s economy. The envisaged 2.5 percent of GDP spending is still a far cry from the current 1.3 percent allocation.”
Dr Wasim Ghori, Director Indian Economic Trade Organisation and Fellow of the Royal Society of Public Health London and Executive Director of Medical and Health Information Management Association, said, “The pandemic has reiterated the need for increased spending on healthcare, creating appropriate infrastructure in the form of adequate public hospitals, especially our primary healthcare infrastructure which needs significant improvement. Hence, the government schemes providing subsidized loans and land for building healthcare facilities is the need of the hour. As an invaluable component of strengthening the healthcare system, the role of Public-Private Partnership (PPP Model) becomes crucial.
In addition to higher public spending, India needs a unique solution to deal with its healthcare sector challenges and digital technology offers one of the most efficient solutions to this.”
He added: “The need to strengthen the digital health ecosystem has been fortified with the Covid-19 crisis. The pandemic has not only accelerated the adoption of technological disruptions, but it has also given momentum to the usage of digital solutions as a viable option to conventional care delivery systems. Digital health caters to the entire continuum of care, starting from admission to discharge and post-discharge period too. In the areas of primary and secondary care, diagnostics-imaging, vaccination and standardization of services, digital health plays a critical role.”
He added: “Hence, the Budget 2020-21 needs to focus on the expansion of digital healthcare solutions that have great potential to make healthcare more affordable and accessible by using technology to reach out to the last mile. It would certainly help in creating a comprehensive and an integrated healthcare ecosystem in the country and support the patients to get access to high-quality and cost-effective care. Be it efficient management of Covid-19 and vaccination or achieving the goal of Universal Health Coverage, Digital Health would be a great enabler with the right policy push.”