Prof. (Dr.) Dharmakanta Kumbhakar
(drkdharmakanta1@gmail.com)
A much higher allocation has been made for the health sector this year compared to previous fiscals – Rs 99,858.56 crore – which amounts to 1.97% of the total budget estimates (Rs 50.65 lakh crore). This represents a 9.79% increase over the budget estimates of Rs 90,958.63 crore and a 10.99% rise over the revised estimates of Rs 89,974.12 crore for the 2024-25 fiscal. Rs 3,992.90 crore has been allocated to the Ministry of Ayush separately, which will also contribute to the health sector.
Of the total health sector outlay for the 2025-26 fiscal, Rs 95,957.87 crore has been allocated to the Department of Health and Family Welfare. The allocation for the government’s flagship insurance scheme, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), under which nearly 12 crore families (nearly 50 crore beneficiaries) receive cashless hospitalisation benefits up to Rs 5 lakh per annum per family on a floater basis in empanelled hospital across India, has been raised to Rs 9,406 crore from last year’s Rs 7,300 crore. The scheme aims to reduce the out-of-pocket private healthcare expenses, which have pushed many people into poverty.
In the budget speech for FY 2021-22, the Finance Minister had announced the launch of a new centrally-sponsored scheme ‘PM Atmanirbhar Swasth Bharat Yojana’, now renamed as ‘Pradhan Mantri Ayushman Bharat Health Infrastructure Mission’ (PMABHIM), with a total outlay of Rs 64,180 crore over a period of five years from the FY 2021-22 to 2025-26. This year, Rs 4,200 crore has been allocated for this scheme. The funds will be used to support wellness centres, set up of integrated public health laboratories, and establish critical care hospital blocks in districts with population exceeding five lakh. If implemented effectively, the scheme could transform India’s health scenario.
For the National Tele-Mental Health Programme, launched by the government in FY 2022-23 to improve access to quality mental health counselling and care services, the budget has allocated Rs 79.60 crore. Additionally, Rs 340.11 crore has been allocated to the National Digital Health Mission, popularly known as Ayushman Bharat Digital Mission (ABDM), in this budget. The Finance Minister launched the National Digital Health Mission in 2022-23 to unify the entire healthcare network, facilitating better access for both healthcare providers and the public. The budget allocation of Rs 3,442.77 crore for the National AIDS and STD Control Programme will undoubtedly aid in ensuring safe blood transfusion services and controlling HIV and STD cases in India.
A separate allocation of Rs 3,900.69 crore has been allocated for the Department of Health Research for medical and biotechnical research. The use of advanced machines and artificial intelligence in disease detection and prevention, which will stem from such research, will greatly benefit healthcare practitioners.
Presenting the budget, Finance Minister Nirmala Sitharaman announced that the government will set up day-care cancer centres at all district hospitals over the next three years. Two hundred of these centres will be established in FY 2025-26 itself. This is a timely move as India is witnessing an alarming rise in the number of cancer patients in recent years. This initiative will enable cancer care closer to patients’ home, thus mitigating the hassle of travel and reducing the cost burden.
To make life-saving treatments more accessible and reduce the financial burden on patients’ families, 36 life-saving drugs for treating cancer, rare diseases, and severe chronic diseases have been fully exempted from basic customs duty in the budget. Additionally, the custom duty for six more medicines has been reduced to 5%. Further, 37 medicines and 13 new patient-assistant programmes run by pharmaceutical companies have been fully exempted from basic custom duty if supplied free to patients. Removing customs duty on these drugs will definitely provide relief to affected individuals. The government should consider exempting all drugs for treating cancer, rare diseases, and chronic diseases from GST to lower treatment cost. The removal of import duty on drugs for rare and critical diseases has been a long-standing demand. Typically, medicines attract a 10% basic customs duty, while certain life-saving drugs and vaccines benefit from either a 5% duty or a full exemption. The government should seriously consider this demand.
Sitharaman also announced that 10,000 seats would be added in medical colleges next year as part of the goal of adding 75,000 seats in the next five years. Over the past decade, there has been a 130% increase in undergraduate medical seats, with nearly 1.1 lakh seats and almost double of postgraduate seats. The establishment of new medical colleges to increase seats is well-intentioned and much needed, as it will help produce more doctors to meet the World Health Organisation standard of one doctor for 1,000 people, while also enhancing healthcare facilities and reducing demand-supply gap. The Union government already has a goal of having at least one medical college in every district, for which it has introduced a scheme to set up new medical colleges affiliated with existing district/referral hospitals in underserved areas of the country. The government has also made progress towards establishing an AIIMS in every State, increasing their number from six to 22. But this expansion is accompanied by a crisis- a shortage of teaching faculty and lack of proper infrastructure, which have negatively impacted the quality of medical education and could have serious implications on health care system in the long run, producing in underskilled doctors. The government must ensure that the students are taught by qualified and skilled teachers in institutions with proper infrastructure.
The announcement regarding the promotion of medical tourism and the “Heal in India” initiative in partnership with the private sector will certainly bring substantial foreign exchange and help the private sector, but it holds little significance for public health.
The budget is a significant one in the health sector, and it underscores the government’s forward-looking approach to providing affordable, quality healthcare services to the people of India. However, there is a dire need to increase health budget allocation, as India continues to face numerous health challenges and a strained health infrastructure. This budget allocation seems insufficient to address current challenges such as upgrading infrastructure and ensuring accessibility and affordability of quality healthcare. Increased government spending on the health sector is the only assured way to make healthcare services affordable and prevent people from falling into poverty. The government should consider increasing public spending in the health sector, and, hopefully, this will be addressed in future budgets. n