What do health experts think of India’s interim budget? How can govt improve it?

Indian Finance Minister Nirmala Sitharaman presented the Interim Budget for the fiscal year 2024, which included the announcement of the health outlay. It was an interim budget and it aims to take care of the fiscal needs of the intervening period until a government is formed after the general elections, hence, it didn't include major announcements.

When it comes to the health sector, the finance minister made only a slight increase in fund allocations for the ministries of health and family welfare and women and child development.

The Indian government announced the extension of the flagship Ayushman Bharat health insurance scheme to all ASHA and Anganwadi workers and helpers. It also upgraded and strengthened the POSHAN scheme, which aims to provide nutritious meals to children at government schools.

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Sitharaman announced ₹90,658 crore to the health ministry, which is an increase of only 1.68 per cent over the previous year. The Ministry for Women and Child Development (WCD) has been allocated ₹26,092 crore, a 2.53 per cent increase over last year.

In a release, Dr Vijayabhaskaran, Executive Director, Kauvery Hospital, Bengaluru & Hosur weighed in on the interim budget 2024. He said, "The Indian Government's 2024 interim union budget for the healthcare sector underscores a multi-faceted approach towards enhancing healthcare education, broadening coverage, and emphasising preventive measures."

"The initiative to establish more medical colleges by leveraging existing hospital infrastructures aligns with global best practices, similar to the integration seen in teaching hospitals in the US, where clinical settings offer robust training grounds for medical students. This model fosters a blend of academic knowledge and practical experience, crucial for producing well-rounded healthcare professionals," Dr Vijayabhaskaran added.

He added that in order to "effectively manage the primary healthcare needs and address the shortage at the speciality level, it's essential to consider strategies beyond just increasing the number of medical colleges".

Explaining with an example, Dr Vijayabhaskaran mentioned that India faces a nearly 80 per cent shortage of surgeons, physicians, gynaecologists, and paediatricians in rural community health centres. "Specialist doctors often prefer urban settings or overseas opportunities due to better infrastructure, resources, and professional growth prospects," he said.

Sitharaman's budget included the health of young girls as she said that the government will actively promote the vaccination of girls aged 9-14 for the prevention of cervical cancer.

Dr Sanjeev Kumar, who is Surgical Oncologist, at Manipal Hospital, Dwarka, told WION: "It's a welcome move by the government of India. Cervical cancer is one of the preventable cancers. HPV vaccination in the age group 9-14 years hasbeen shown to be safe and effective in preventing HPV infection and cervical cancer. Routine HPV vaccination should be included in the National Immunisation Programme.

Sombrata Roy, Unit head of CMRI-CK Birla Hospitals, Kolkata, said in a release: "In the 2024 interim budget, our healthcare mission is firm. We commend the government's dedication to combat cervical cancer. The plan to establish additional medical colleges resonates with our commitment to advancing medical education. We eagerly anticipate contributing to these national initiatives, ensuring comprehensive and inclusive healthcare for all."

How govt can improve it?

After the Lok Sabha polls, a full budget will be presented probably in July by the new government. Experts expect that new policies and major policies will be announced then.

Dr Vijayabhaskaran said in the release that the government should explore adopting some of these strategies to address this imbalance.

1. Incentivising Rural Service: Offering financial incentives, housing, and opportunities for professional development for doctors serving in rural and underserved areas could help attract more specialists to these regions.

2. Enhanced Telemedicine Services: Leveraging telemedicine can help bridge the gap in specialist care in remote areas. This could involve setting up teleconsultation services that connect specialists in urban centres with patients in rural areas and can also help create younger entrepreneurs in tier twoand rural areas.

3. Focused Training Programmes: Developing training programmes specifically designed for rural healthcare needs could help prepare specialists willing to work in these settings. This might include training in a broader range of skills to manage a variety of conditions in resource-limited settings.

4. Public-Private Partnerships: Encouraging partnerships between the government and private sector can lead to the development of healthcare infrastructure in underserved areas, making them more attractive places for specialists to work.

5. Regulatory Reforms: Simplifying the process for medical professionals trained abroad to practice in India could help alleviate the shortage of specialists.

Ayushman Bharat Expansion

Dr Vijayabhaskaran said, "The expansion of Ayushman Bharat to include all ASHA workers, Anganwadi Workers, and Helpers under its healthcare cover is a commendable move towards ensuring a healthier workforce at the grassroots level of healthcare delivery. Ayushman Bharat has already made significant strides by operationalising over 1.5 lakh Health and Wellness Centres (HWCs) across India, providing comprehensive primary healthcare services."

"This initiative has seen remarkable progress, with millions benefiting from screenings for non-communicable diseases and teleconsultations. With a proven and well-established system Ayushman Bharat can further strengthen its primary healthcare framework, ensuring early detection and management of diseases at the community level," he added.