In the 2020-21 Budget, the allocation for the Ministry of Health and Family Welfare and the Ministry of AYUSH
has been increased marginally - from `66,466 crore in 2019-20 to `69,234 crore. However, the ` 2,768 crore additional allocation cannot compensate for the price rise in the health sector. Keeping the inflation rate in mind, some have observed that the actual allocation in health has been lowered by 4.3% and the central government’s share of GDP in the health sector has gone down from 0.33% to 0.31%.
The health sector is primarily the concern of the government and the country has achieved some significant milestones regarding birth and death rates, infant mortality rate, neonatal mortality rate, maternal mortality rate, and the rate of vaccinations.
The recent National Health Profile 2019 (NHP) released by Dr. Harsh Vardhan, Union Minister of Health and Family Welfare, shows mixed results. For example, the profile depicts that while life expectancy in India has risen to 68.7 years, there is only one government doctor for more than 10,500 people in India. It also mentions that the disease burden due to communicable, maternal, neonatal, and nutritional diseases, as measured using disability-adjusted life years (DALYs) - a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death – has dropped from 61% to 33% between 1990 and 2016. But there is an accelerated rise
in the prevalence of chronic non-communicable (NCD) diseases. As per the report, the disease burden due
to non-communicable diseases such as cardiovascular diseases (CVD), diabetes, chronic obstructive pulmonary disease (COPD), cancers, mental health disorders, and injuries increased from 30% to 55% between 1990 and 2016. The report also points to the significant progress made in reducing maternal mortality ratio (MMR) by 77%.
Under the Left Front government, the health sector in West Bengal was one of the under-performers. Current government statistics indicate some improvements. The plan budget in this sector was increased by more than six times to reach `5,530 crore in 2018 as compared to 2010-11. Complete immunisation has increased from 80% to 94% and
institutional delivery has increased from 65% to 96% - showing an enhanced focus on maternal and child health. Maternal mortality ratio fell to 112 per thousand and infant mortality ratio fell to 25 by the end of 2019.
The amount of hospital beds is an important indicator. It has increased to 83,991 in 2017 from 55,942 in 2010 and the number of blood banks has increased to 76 in 2018 from 55 in 2010. In 2018, the number of Neonatal Care Units (NCUs) was 68. There were no NCUs in 2010.
The Government of West Bengal has decided to implement a ‘Universal Free Treatment’ policy in all state-run hospitals. This policy is aimed to reduce the out-of-pocket expenditure of the patients - irrespective of their income levels. This includes the cost of medicines, consumables, implants, diagnostic expenses, bed charges, and all other incidental expenditure. The focus on establishing fair price medicine shops and fair price diagnostics centres has been widely appreciated. Moreover, the creation of new health districts and new nursing training schools has aided the public health system in West Bengal.
In recent times, health insurance has been one of the most talked about areas in healthcare. The central government is also proactive in this respect and the Government of West Bengal has its own insurance schemes. Swastha Sathi and Rashtriya Swastha Bima Yojana cater to lakhs of families. Despite various efforts taken by the state government, there is a need to scale-up operations as West Bengal receives a significant number of outstation patients – from neighbouring states – putting a constant pressure on the state’s health infrastructure.
Role of the private sector in health
The private health sector provides for almost 80% of outpatient and 60% of inpatient care in our country. The government is planning to reduce out-of-pocket costs for patients - which drive some 55 million Indians into poverty each year.
The private sector acts as a major force in the Indian healthcare industry with over 70% contribution in healthcare delivery. India currently spends 4.2% of its GDP on healthcare, with just 1.4% contribution from the government - which is among the lowest, globally. A smart health system is a must for India’s global aspirations. In order to achieve this, the private sector must be involved in a bigger way.