If ever an impetus was needed by this country to prioritise healthcare, it is now with the pandemic having exposed several shortcomings.
There is no denying that the healthcare sector was stretched to the limit during the ferocious second wave with various challenges coming to the forefront such as shortage of hospital beds, lack of specialised equipment like ventilators/ECMO, and perhaps most tellingly, adequate medical personnel.
A valiant effort enabled a pull back from the brink, and laudable steps have been taken such as initiating action to put up PSA oxygen plants in all districts of the country, adding critical care beds, fast tracking licenses for certain medicines, and roping in final year medical and nursing students.
However, there is a need to aim for time bound outcomes which will improve overall standards of healthcare.
For example, five hospital beds per 10,000 people is a far cry from the more than 100 beds countries like Japan and South Korea provide for their population or even China’s 43. When it comes to trained physicians, India has 8.6 doctors for every 10,000 whereas it is 28.1 in the United Kingdom.
In this context, the Finance Minister’s announcement of a Rs 23,220 crore outlay over one year for short-term emergency preparedness with emphasis on children/paediatric care and Rs 50,000 crore specifically earmarked for under-served areas is laudatory.
Prior to this, India’s expenditure on health sector had grown at a CAGR of 14.9 per cent (pc) but mostly on account of salary hikes. While per capita spending has increased by 93 pc from Rs 1,008 in FY15 to Rs 1,944 in FY20, it is woefully inadequate as compared to BRICS peers, let alone OECD nations, given the historical under-investment.
Tellingly, total health sector allocation as a percentage of GDP has remained around 1.4 pc although FY20 Budget Estimate stood at 1.8 pc due to higher provision on account of the pandemic.
While the Central Government has a pivotal role in terms of setting policy and stepping in when necessary such as the current vaccination drive against COVID, it only spends 25 pc of the country’s total outlay on health.
Hence, it is incumbent on the states to also do their part if the overall standard of healthcare is to improve along with better coverage, especially in far flung areas. Odisha has kept pace with a health sector outlay of Rs 8,776 crore in FY21 amounting to 1.7 per cent of GSDP which has been further stepped up to Rs 9,164 crore for the current fiscal.
Some notable interventions in the FY22 budget are Rs 1,353 crore for free medical treatment under 'Biju Swasthya Kalyan Yojana', converting SCB Medical College to an 'AIIMS Plus Institute' with an outlay of Rs 3,500 crore over three years, Rs 1,572 crore for augmenting health infrastructure and services, Rs 1,755 crore provision for National Health Mission (NHM), and Rs 829 crore allocation for free medicines and diagnostics.
Moreover, the Chief Minister has also announced an exceptional allocation of Rs 8,500 crore for the health sector which is very welcome though more details are awaited.
The State’s performance in terms of reducing prevalence of malaria by over 90 pc in three years shows that it has the willpower and capability to bring about change. Similarly, improvement on other fronts such as TB, measles, rubella, etc., saw a leading weekly publication rank Odisha number one in 2020 in terms of health sector improvement.
Even as far as Covid specific intervention is concerned, Odisha did well to add 8,000 oxygen beds and 1,600 ICU beds to cater to an expected surge in cases. With a low fatality rate of 0.4 pc and more than one crore people as on date having received at least one dose of the vaccine, the State is well poised to tackle a third wave although there is no room for complacency.
The last 18 months have shown as never before that health is all important - lives come before livelihoods or, for that matter, anything else. Successfully augmenting the State’s health infrastructure will be one of the most important legacies of India’s current longest serving Chief Minister.
(The writer is Vice President, FICCI and Managing Director, IMFA)