Representational use only.
New Delhi: In 2021, India saw its healthcare system collapse as the second wave of the COVID-19 hit the country. Hence, it was expected that the Union Budget for the fiscal year 2022-2023 would see an increased allocation for the Ministry of Health and Family Welfare (MoHFW), and the government will try to strengthen the skeletal public healthcare system in the country.
However, a glance at the budget estimates shows that the Union government has failed to learn its lesson. In the Union Budget for FY 2022-2023, which Finance Minister Nirmala Sitharaman presented on Tuesday, February 1, MoHFW was allocated a total of Rs 86,200.65 crore, which is to be shared between two departments – the Department of Health and Family Welfare and the Department of Health Research. In the budget estimate for FY 2021-2022, the allocation for MoHFW was Rs 73,931.77 crore; the amount has seen an increase of 16.6%. Rs 83,000 crore has been allocated to the Department of Health and Family Welfare for the upcoming year, a rise of 16.46% from the budget estimate for the current fiscal year. In comparison, the Department of Health Research has been allocated Rs 3,200.65 crore.
While these numbers look good, and an increase of 16.46% in allocation for the Department of Health and Family Welfare seems significant, the actual picture is much grimmer. The revised estimate for the department for FY 2021-2022 is Rs 82,920.65, which is to say that the allocation for FY 2022-2023 only saw an increase of 0.09% compared to the revised estimate for the current year, which can barely be called an increase.
The Economic Survey 2021-2022, which was released on Monday, January 31, showered PM Modi's flagship AB-PMJAY scheme with praises, much like the Economic Survey 2020-2021. It said, “As of January 19 2022, a total of 17.5 crore Ayushman Cards have been issued under AB PM-JAY. A total of 2.73 crore authorised hospital admissions worth Rs 30,673 crore have been provided through a network of approximately 25,000 hospitals (approximately 10,800 Private and 14,300 Public hospitals).” It added, “A massive information, education and communication drive, Aapke Dwar Ayushman was carried out in 2021 with the support of grassroots resources such as frontline workers, healthcare workers and Panchayati Raj Institutions. This led to the identification and verification of more than four crore people under the scheme.”
And much like FY 2020-21, and FY 2019-2020 before that, the Union government failed to spend even 50% of the allocation. The budget estimate for FY 2021-2022 saw an allocation of Rs 6,400 for AB-PMJAY. In the revised estimate, the amount was Rs 3,199. And yet, the scheme was allocated Rs 6,412 crore, despite the Union government's continuous failure to spend the large amount allocated to the scheme.
The National Digital Health Mission (NDHM), or the Ayushman Bharat Digital Mission (ABDM), increased over 500%. The scheme had seen an allocation of Rs 30 crore in FY 2021-2022, which was increased to Rs 200 crore for FY 2022-2023. ABDM is an ambitious plan to build a digital health ecosystem that connects different stakeholders in the healthcare sector, both public and private. Experts have criticised it for potentially putting citizens' personal data at risk and leading to exclusion.
The allocation for National Health Mission (NHM) – which comprises National Rural Health Mission and National Urban Health Mission, is supposed to ensure that primary, secondary, and tertiary healthcare programmes are available and accessible for all country citizens – saw an increase of only 1.15%. The allocation was increased from Rs 36,576 crore in FY 2021-2022 to Rs 37,000 crore in FY 2022-2023.
While the Economic Surveys and budget speeches every year make it seem like the Union Government has realised the importance of strengthening the structure of the healthcare system, the health budget says otherwise. The government continues to expand the insurance model of the Ayushman Bharat Scheme while the primary and secondary healthcare and hospital infrastructure barely get any importance.