State budget: Hope for health sector

Prof. (Dr.) Dharmakanta Kumbhakar

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

State Finance Minister Jayanta Mallabaruah unveiled a series of major healthcare initiatives in the budget with a strong emphasis on improving medical infrastructure, maternal and child health, and expanding access to quality healthcare across the state, allocating Rs 8,998 crore to the health sector, which amounts to 3.16% of the total budget estimates (Rs 2,85,084 crore). This allocation represents a 1.08% increase over the budget estimates of Rs 8,902 crore for the 2025-26 fiscal. Of the total health sector outlay in 2026-27, Rs 4,635 crore has been allocated to the Health and Family Welfare Department and Rs 3,535 crore to the Medical Education and Research Department.

The minister announced in his budget speech that the government will launch the five-year Asom Swasthya Utkarsha Abhijan with a corpus of Rs 50,000 crore to position Assam as a leading hub for world-class healthcare. The government will also launch Sustha Asom Abhijan 2030 for prevention of lifestyle diseases through early screening and timely intervention. Geriatric wards and specialist doctors will be provided in every district hospital. For last-mile healthcare, Atal Mobile Medical Units, Arogya Biman medical drones and hospital ships will serve remote, flood-prone, riverine, tribal, sar and tea garden areas. The government will also strengthen Jan Aushadhi Kendras and expand telemedicine.

The majority of Assam’s total population resides in rural areas. Many people in the rural set-up still lack access to basic healthcare. As a part of an ambitious expansion of quality primary healthcare services in every corner of the state, the FM announced in the budget to strengthen grassroots healthcare, providing at least one MBBS doctor and the required numbers of nursing personnel at every health subcentre in the state over the tenure of this government – a move it said would be the first of its kind in the entire country. To strengthen secondary healthcare services, the government will upgrade existing First Referral Units (FRUs) and establish new ones so that every assembly constituency has access to at least one 50-bed FRU. Proper implementation of these announcements will bring better, affordable and efficient healthcare delivery to the doorsteps of the people residing in the remote areas of Assam and will save many lives.

As a part of a broader plan to strengthen tertiary healthcare infrastructure across the state, the FM announced that the government would establish four new medical colleges at Goalpara, Hailakandi, Hojai, and Bajali districts. Assam currently has 14 operational government medical colleges, while another 10 are under various stages of construction. With the addition of the four proposed institutions, the government aims to move closer to its vision of establishing a medical college in every district. The establishment of new medical colleges to improve opportunities for medical education is well-intentioned and much needed, as it will help produce more doctors to meet the World Health Organization’s standard of one doctor per 1,000 people, while also enhancing healthcare facilities by increasing the availability of trained medical professionals and healthcare services. The proposal for new medical colleges is excellent if the state government can provide sufficient infrastructure and faculty for them.

The FM also announced that the government will set up a Rs 550-crore Proton Therapy Centre at Gauhati Medical College and Hospital, expected to be operational within three years, to ensure access to world-class cutting-edge cancer treatment. This is a timely move as Assam is witnessing an alarming rise in the number of cancer patients, including childhood cancer, in recent years.

The budget plan aims to create approximately 33,240 jobs, including 6,814 MBBS doctors, 82 AYUSH doctors, 22 dental surgeons, 10,942 staff nurses, 4,669 pharmacists, 4,669 laboratory technicians, 67 radiographers, 1,283 ANMs, 4,625 LDAs/accountants, and 67 dressers for health facilities across the state, which is a significant initiative that will enhance healthcare at all levels, from basic to advanced.

The budget proposal for a comprehensive upgrade of healthcare services in tea garden areas by improving infrastructure, diagnostics, medical equipment and medicine availability, besides deploying dedicated doctors and human resources to these regions, will definitely improve the health status of tea garden people. Continuation of the scheme of providing Rs 15,000 wage compensation to the female tea garden workers during pregnancy and motherhood will ensure better maternal care and nutrition.

The budget’s announcement to resume targeted social support for HIV/AIDS-affected families with Rs. 1 lakh each for eligible children and widows will significantly assist those in need.

The FM didn’t announce any new major health scheme in this budget. He focused on the continuation and effective implementation of previously announced health schemes. The government’s ongoing flagship insurance scheme, Ayushman Asom–Mukhya Mantri Jan Arogya Yojana (AA-MMJAY), will continue enrolling more beneficiaries in 2026-27. 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 offer cashless medical treatment to its members at prices set by the central government health scheme by partnering with well-known hospitals, in addition to the existing reimbursement option. Free treatment for children with congenital heart diseases will continue under Mission Hridoy.

The budget is expressed to provide enhanced coverage of preventive, promotive, curative and quality health care 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.