Pune: Public health activists and NGOs TOI spoke to on Monday said the nearly 6per cent drop in healthcare allocation in this budget was “disappointing” and had the potential to push tens of thousands of people into poverty due to high treatment costs. The proposed expenditure went from last year’s revised estimate of Rs 28,906.92 crore to Rs 27,164.91 crore for this financial year — a reduction of 6.03per cent.
“Given the rate of inflation and the increase in healthcare needs, the allocation should’ve gone up. It has dipped to 3.7per cent of the overall budget from last year’s 4.2per cent,” said health activist Dr Abhijit More, adding that this was despite national health mission mandates that require states to allocate 8per cent of their total budget to people’s healthcare needs.
“After the Covid pandemic and the recent GBS outbreak, it was expected the state would increase spend on health. So this was disappointing. Studies have shown that high treatment costs often push people into debt traps and eventually poverty,” Dr More added.
Dr Abhay Shukla, national co-convenor of Jan Swasthya Abhiyan said: “When we talk in terms of percentage, the state is indeed projected to spend less than 4per cent of the entire state budget on public healthcare, which is less than the spend in Uttar Pradesh, Bihar and Jharkhand. This would also mean more out-of-pocket expenses by people.”
Dr Shukla said the post-Covid expansion of public health systems has also not happened. “Our govt hospitals remain overcrowded and class 3 and class 4 staff who’ve worked for 10 years as nurses and sanitation workers are yet to be regularised, because we don’t have the budget for it,” he said.
Dr Ravi Duggal, a health economist with the NGO Jan Swasthya Abhiyan, pointed to the decline in urban health services. He said: “For instance, hospitals and dispensaries have moved down from the revised estimate of Rs 6,098 crore to Rs 4,709 crore. We need to compare budget estimates to revised estimates to understand how much is needed. There is a sharp decline. So, urban areas where the infrastructure already exists will not be receiving funds to maintain it. In rural health, there is an increase in some sub-heads, but the NHM budget has dropped from Rs 3,805 crore to Rs 2,860 crore.”
The medical education department budget has also seen a decline, from Rs 9,667 crore to Rs 9,057 crore. “The budget will lead to business as usual. There is no expansion of the public health sector, no improvement in terms of medicine supplies. Even for the HBT clinics (operated by BMC in Mumbai), there is a decrease, as the revised estimate was Rs 196.79 crore, but they have allocated only Rs 100 crore,” Dr Duggal said.
