State Budget: Hope for Health Sector

Prof. (Dr.) Dharmakanta Kumbhakar

(The writer can be reached at drkdharmakanta@yahoo.com)

A much higher allocation has been made for the health sector in this year’s state budget compared to previous fiscal years – Rs 8902 crore, which amounts to 5.71% of the total budget estimates (Rs 1,55,985 crore). This represents an 11.25% increase over the budget estimates of Rs 8001.96 crore for the 2024-25 fiscal year. Of the total health sector outlay in 2025-26, Rs 5393 crore has been allocated to the Health and Family Welfare Department and Rs 2542 crore to the Medical Education and Research Department.

The Finance Minister, Ajanta Neog, did not announce any new major health scheme in the budget. Instead, she focused more on the continuation and effective implementation of previously announced health schemes. She assured that the government’s ongoing flagship insurance scheme, Ayushman Asom–Mukhya Mantri Jan Arogya Yojana (AA-MMJAY), will continue enrolling more beneficiaries in 2025-26. The state government launched AA-MMJAY on October 2, 2023, to provide health insurance of Rs 5 lakh and cashless treatment to supplement the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). The scheme provides free quality healthcare to beneficiaries and reduces their out-of-pocket private expenditure on health. The Ayushman Asom–Mukhya Mantri Lok Sevak Arogya Yojana (AA-MMLSAY) will provide cashless medical treatment to its beneficiaries at central government health scheme rates at all state government medical college hospitals, Assam Cancer Care Foundation Centres, and Dr B Barooah Cancer Institute.

The health budget prioritises healthcare for tea garden workers with initiatives like the ‘Healthy Garden Population-Comprehensive Health Screening’ pilot project across 20 tea gardens and continuation of the ‘Swasth Bagan’ Yojana to provide healthcare through Ayushman 67 Arogya Mandirs, mobile medical units, and PPP hospitals; child and maternal healthcare with the expansion of special newborn care units, paediatric ICUs, and kangaroo mother care units; and rural healthcare with the Durgam to Sugam initiative offering financial incentives to doctors serving in remote areas for specialist recruitment.

The FM announced that the government will establish a Proton Therapy Centre at the State Cancer Institute, Guwahati, to ensure access to cutting-edge cancer treatment. It will be the first such facility in Eastern India and the third in the country. The machine will cost around Rs 550 crore. This is a timely move, as Assam is witnessing an alarming rise in the number of cancer patients, including childhood cancer, in recent years. This will definitely enable timely access to treatment.

Neog announced that three new medical colleges are set to open in 2026-27 at Charaideo, Biswanath and Bongaigaon. Six more are under construction at Sivasagar, Sribhumi, Tamulpur, Dhemaji, Marigaon and Golaghat. She also announced that the government would establish three new medical colleges at Darrang, Hojai and Hailakandi. Currently, thirteen medical colleges are fully functioning in Assam, with 1600 MBBS, 722 PG and 46 DM/MCh seats. Another new medical college, Pragjyotishpur Medical College in Guwahati, will start functioning from the current academic year. This will increase MBBS seats to 1700 in Assam. The numbers of MBBS seats will substantially increase when all the medical colleges start functioning.

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 the demand-supply gap. The proposal for new medical colleges is excellent if the state government can provide sufficient infrastructure and faculty in these new colleges. However, the minister has proposed in the budget to procure additional CT and MRI machines for medical colleges. She also proposed to set up robotic surgery units at Assam Medical College and Silchar Medical College. This initiative will definitely help the people of Upper Assam and Barak Valley. Retention of f

aculty in medical colleges by attracting young talent has become a major challenge for the government. Bright, dynamic young medical postgraduates are reluctant to join as faculty, as teaching in government medical colleges is not rewarding in material terms, and they receive lucrative offers from the private sector. Therefore, many faculty posts in medical colleges remain vacant at the entry level. To attract fresh minds in medical teaching, the government has announced in the budget that it will cover medical college faculty under the Dynamic Assured Career Progression Scheme, subject to meeting the National Medical Commission criteria for promotion. It will sponsor two national conferences annually, one international conference every two years for Asian countries and one every four years for non-Asian countries. It will also provide interest-free loans for newly appointed medical college faculty members to purchase a vehicle. Additionally, the government will introduce an easy home loan scheme for them soon. Neog also proposed to establish seven new nursing colleges across various districts of Assam. Investment in establishing nursing colleges is a progressive move considering the severe shortage of nurses in Assam. This will definitely improve the nurse-patient ratio and help make quality healthcare accessible to a larger population. However, the current condition of existing nursing colleges needs to be evaluated for upgrading.

With the announcement that Assam aims to be a hub of medical tourism in the future, the FM mentioned in the budget that the government is actively pursuing leading hospitals to establish their presence in Assam by offering land at concessional rates and other incentives.

The announcement in the budget to revise the honorarium/state incentive of ASHA workers, PM POSHAN cooks, Anganwadi workers, and helpers from October 1, 2025, along with a one-time grant, will definitely motivate these frontline health workers in recognition of their selfless services.

The FM announced that efforts will be made to motivate citizens to focus on their fitness and adopt healthier lifestyles and nutrition. Continuation of the PM POSHAN scheme, Jal Jeevan Mission, Swachh and ODF+ villages, National Food Security Act (NFSA), and the new scheme announced to provide one kg of masur dal (an additional one kg to a family of more than 5 members), one kg of sugar and one kg of salt at subsidised rates (Rs 25 per kg masur dal, Rs 20 per kg sugar and Rs 10 per kg salt) to all NFSA ration card holders will definitely improve the health status of the beneficiaries.

The budget is expressed to provide enhanced coverage of preventive, promotive, curative and quality healthcare services to the people. However, the allocation needs to be increased substantially. The current amount seems insufficient to overcome the challenges of upgrading infrastructure and providing affordable, quality healthcare. The government should focus more on primary healthcare investment and increase public spending in the health sector to make quality health services accessible to all.