Parliamentary panel stresses better rural medical infrastructure; exposes budget discrepancies

New Delhi: Noting that there is a “yawning gap” between approved outlays and sanctioned budget, a parliamentary panel has recomended higher budgetary allocation for National Health Mission (NHM) to boost public health standards.

The Parliamentary Standing Committee on Health and Family Welfare in its 93rd report on Demands for Grants 2016-17 said that it seems the priority towards NHM and the health sector as a whole has been a “soft” target whenever the government faces a resource crunch.

“The committee recommends that given the need to augment rural health infrastructure and fill the vacancies of various categories of health professionals, this trend of the yawning gap between the approved outlays and sanctioned budget should be reversed and a much higher magnitude of the union budget allocation for NHM than what is prevailing should be made so that the central health spending could be ramped up to boost Indian public health standards. Only then will NHM be able to guarantee universal access to equitable, affordable and quality healthcare,” the committee chaired by Ram Gopal Yadav said in the report tabled in Parliament.

The committee also observed that if the government wants to enhance access to quality healthcare for the people, it will have to alter the health financing landscape of NHM by allocating adequate financial resources.

The committee said it was “revealing” after it scrutinised the total 12th Plan approved outlays for NHM and the entire Health Department.

“The committee notes that the Planning Commission had approved a total outlay of Rs 1,93,405.71 crore for NHM and Rs 2,68,551.00 crore for the whole department for the 12th Plan.

“However, the total budget allocation made by the union government in the five years (2012-13 to 2016-17) is Rs 90,000.82 crore for NHM and Rs 1,25,117.00 crore for the department of Health and Family Welfare which works out to measly 46.50 percent of the funding originally envisaged for NHM as well as the department under 12th Plan,” it said.

It further said the overall NHM releases made are as high as 98.13 percent, implying that the allocated amounts are utilised effectively.

“The committee observes that the avowed vision of NHM is the attainment of universal access to equitable, affordable and quality healthcare services accountable and responsive to people’s needs with effective inter-sectoral convergent action to address the wider social determinants of health and the Mission has huge potential to transform healthcare delivery in the country,” the committee said.

It also observed that had the government allocated the entire 12th Plan approved outlays, the country would have seen much improved primary healthcare services, fulfillment of the free medicines and diagnostic policy, reduced out of pocket expenditure and probably 1.5 percent of GDP as public health expenditure reached by 2015.

The committee also said that as against the projected demands of Rs 31,492.95 crore for NHM for 2016-17, the allocation made in Budget Estimate 2016-17 is only Rs 19,000.00 crore, leaving a shortfall of more than Rs 12,000 crore.

“In comparison to the Revised Estimate allocation 2015-16 of Rs 18,295 crore, the increase in the Budget Estimate 2016-17 is of Rs 705 crore, which is grossly inadequate and will be eaten up by inflation.

“Taking note of the submissions of the representatives of department of health that in order to undertake new initiatives like free drugs, diagnostics and dialysis, the minimum required increase in allocation for 2016-17 would be Rs 5,000 crore, the committee lends its support to the allocation of Rs 5,000 crore if not full projected amount for NHM which may be raised in the Revised Estimate stage,” the committee said.

It observed that given the projection of a promising economic growth which is pegged at 7.5 percent, the government should have the fiscal space to provide this amount of Rs 5,000 crore in 2016-17.