Coming at a time when the country is still battling the Covid-19 pandemic, Union Budget 2021-22 was expected to deliver on healthcare. And on the face of it, finance minister Nirmala Sitharaman appears to have given healthcare a shot in the arm. Declaring health and well-being as one of the six pillars of ‘Atmanirbhar Bharat’, Sitharaman proposed a budget outlay of Rs 2,23,846 crore for 2021-22, marking an increase of 137% over the current financial year’s outlay of Rs 94,452 crore. Importantly, the expanded allocation includes Rs 35,000 crore for Covid vaccines with Sitharaman committing to provide more funds towards this direction if required.
But what is truly commendable is the implicit long-term commitment to healthcare. This was revealed in a new centrally-sponsored scheme, Prime Minister Atmanirbhar Swasth Bharat Yojana, which will be launched with an outlay of Rs 64,180 crore over the next six years. The main interventions under the scheme include support for 17,788 rural and 11,024 urban health and wellness centres, setting up integrated public health labs in all districts and 3,382 block public health units in 11 states, establishing critical care hospital blocks in 602 districts and 12 central institutions, strengthening of the National Centre for Disease Control, its 5 regional branches and 20 metropolitan health surveillance units.
It also includes expansion of integrated health information portal to all states/UTs to connect all public health labs, operationalisation of 17 new public health units and strengthening of 33 existing public health units at Points of Entry, that is at 32 airports, 11 seaports and 7 land crossings, setting up of 15 health emergency operation centres and two mobile hospitals; and setting up of a national institution for One Health – a regional research platform for WHO South-East Asia Region – 9 Bio-Safety Level III laboratories and 4 regional National Institutes for Virology.
All of this clearly shows that the government is finally taking healthcare seriously and looking at a holistic approach with emphasis not just on the curative but also the preventive. If there is one thing that Covid has shown it is that healthcare needs to be seen as a national economic and security imperative. Indeed, countries with better healthcare infrastructure, resolute leadership and nimble healthcare emergency response systems – think Taiwan and New Zealand – have done better at handling Covid and correspondingly cushioned the pandemic’s blow on their economies. This also means they are better placed to mount stronger rebounds in the post-Covid phase.
There’s no denying that India’s healthcare infrastructure leaves a lot to be desired. The condition of government hospitals in vast parts of the country remains pathetic to say the least. Before the pandemic hit, India had a shortage of both doctors – a doctor-population ratio of 1:1,457 as opposed to the WHO recommended 1:1,000 – and nurses – 1.7 per 1,000 population as opposed to the WHO norm of 3 per 1,000. Add to this the huge disparity in healthcare infrastructure between urban and rural India.
Taken together, while the boosted outlay for health is welcome, what’s required is efficient implementation of the funds being made available. And this requires sustained political leadership on the issue. It is likely that more funds will be required for healthcare in the years to come to cover all Indians with the requisite health services and put in place a proactive epidemic detection infrastructure. This is why this Budget’s focus on healthcare shouldn’t be a one-off. From now onwards, healthcare must be seen as an important political issue by all political parties. It must be an election platform in all elections. Covid was a rude wake-up call. Let’s not repeat the mistakes of the past in healthcare.
Views expressed above are the author’s own.
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