Opinion

FM has rightly focussed on healthcare fundamentals

Suneeta Reddy | Updated on February 04, 2020 Published on February 04, 2020

Healthcare as a sector is critical for nation-building in India from several perspectives. Firstly, it is the fifth largest sector in the economy, with a significant contribution to GDP and foreign exchange earnings. Secondly, it is an important job creator — directly employing over five million people, and several million more indirectly. And, thirdly, and most importantly, it is the sector that cares for the health of the people.

A healthy, productive workforce is at the heart of a healthy economy, and so healthcare must take centre-stage in Budget discussions.

Ayushman Bharat

In the last few Budgets, it has — especially with the announcement of the flagship programme Ayushman Bharat. That signalled the start of India’s journey towards universal healthcare. In every Budget after that, we have moved further ahead.

And in Budget 2020 too, the Finance Minister has moved forward, by focussing on the fundamentals. The allocation for healthcare was increased by 6 per cent, to ₹69,000 crore. This is a reasonable increase, in line with growth estimates, and we believe the government will continue to increase allocations until we reach at least 2.5 per cent of GDP.

The allocation for Ayushman Bharat was increased to ₹6,400 crore. More importantly, the focus was on creating bed infrastructure for Ayushman Bharat in Tier 2 and Tier 3 cities, and especially in the 112 aspirational districts. The framework for PPP with viability-gap funding was announced, and the private sector is enthused that the narrative around Ayushman Bharat has landed on the creation of bed capacity.

The Budget also recognised the acute shortage of skilled talent in healthcare — be it doctors, nurses or paramedics. To fully serve India’s need, we need to double the number of doctors, triple the number of nurses and quadruple the number of paramedics. The Budget offered the first set of steps in resolving this shortage, by talking about medical colleges being attached with district hospitals, and bridge education courses for skilling of nurses and technicians. It was appropriate that the Finance Minister combined the section on wellness with that of sanitation, water supply and Swachh Bharat. In that, was the acknowledgement that we need to pay attention to the social determinants of health at a very early stage, while continuing to work on the tertiary and quaternary infrastructure.

We had looked forward to hearing more about the operationalisation of the 1,50,000 wellness centres that was announced earlier, as creating primary health infrastructure and screening mechanisms are critical to fight the burden of non-communicable diseases, which threaten large swathes of our population.

The announcement about DNA screening was forward-looking, and if done well, India can have the world’s largest bio-repository and become a centre for translational research, leading the way for the rest of the world.

The additional health cess on imported medical devices was unexpected, and perhaps could have been taken up at a point in time when the indigenous medical device capability had fully matured.

Bed capacity

There were a few misses too. There was no incentive for the creation of bed capacity for the private sector, which has contributed to 80 per cent of the bed additions of the last decade. There was also no announcement to broaden the insurance cover for private individuals, and for geriatric citizens who are high-risk and vulnerable. We would also have been enthused had there been a Budget reference to preventive health and early screening and detection, along with an increased tax deduction for a preventive health check-up.

Overall, the Budget measures will help the country move towards universal healthcare.

The writer is Managing Director, Apollo Hospitals Enterprise Ltd

Published on February 04, 2020
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