Big Modi govt push for health? Key schemes face cut in funds

NEW DELHI: Contrary to the impression of an increased focus on health in the budget for 2018-19, not only has the overall allocation for health gone up only marginally over the revised estimates for the current year, the allocation for important programmes has actually been slashed. For instance, the allocation for the National Health Mission is down by 2.1% coming down from Rs 31,292 crore to Rs 30,634 crore.

Moreover, while the budget speech said the new initiative for upgrading 1.5 lakh health and wellness centres’ envisioned as “the foundation of India’s health system” was being allocated Rs 1,200 crore, a reading of the detailed expenditure budget shows that this too is coming out of the NHM outlay. If this amount were to be excluded, the NHM budget would be almost 6% less than the current year’s.

Thus, some continuing programmes under NHM will get less funds than they did. In any case, Rs 1,200 crore may be too little to fund 1.5 lakh such centres, according to Dr T Sundararaman, Dean of the school of health systems studies at the Tata Institute of Social Sciences.

“A health and wellness centre requires, by current government projections, about Rs 17 lakh to operationalise and so Rs 1,200 crore would pay for only about 10,000 of these,” he pointed out. He also noted that this was similar to finance minister Arun Jaitley’s announcement of a National Dialysis Programme in the 2016-17 budget to ensure that every district hospital dialysis facilities.

About 2,000 new dialysis centres were to be started but there was no separate allocation for it. That too was to come from NHM money. While Jaitley’s budget speech this year announced the setting up of 24 new government medical colleges and hospitals by upgrading existing district hospitals, the budget allocation for this head was slashed from Rs 3,300 crore in the current year to Rs 2,888 crore in 2018-19, a decline of 12.5%.

Another important central sector scheme is the National AIDS and STD Control Programme. The outlay for this too is down about 3% from Rs Rs 2,163 in RE 2017-18 to Rs 2,100. There have been frequent reports of HIV drugs being unavailable suggesting that even the amount spent this year was inadequate. Yet, funding will be further down on this crucial central public health programme.

Allocation for the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), which is for setting up AIIMS-like institutions and upgrading existing medical colleges, was slashed from Rs 3,975 crore in the budget estimates for 2017-18 to Rs 3,825 crore, a decline of about 4%.

However, the allocation is 20% more than in the RE for the current year. Six AIIMS are functional though with several deficiencies in infrastructure and faculty shortage. Yet, governments have announced new AIIMS in every budget.