A lacklustre budget, rue stakeholders

September 7, 2019 0 By S Harachand

While there is a sharp spike in spending on sectors like agriculture, the Union Budget 2019-20 has grossly overlooked healthcare as a priority, say experts.

Terming the Rs. 62,659 crore budgetary allocation for the health sector as inadequate, Indian Medical Association said health remained the only subject the union finance minister preferred to underplay.

The only silver lining in the budget proposals is the earmarking of Rs 2,000 crore for converting district hospitals into medical colleges, and Rs 1,361 crore for strengthening government medical colleges (MBBS).

“Even this allocation is highly inadequate, considering that the number of district hospitals in the country is at least 763. Giving Rs 2 to 3 crore per district hospital will be inadequate for any meaningful change,” the medical body said in a statement.

As for the government’s flagship programme, Pradhan Mantri Jan Arogya Yojana – Ayushman Bharat, there is no clarity on an enhancement of investment.

“Had the government extended the insurance coverage under Ayushman Bharat to primary care, thousands of clinics and small hospitals situated in rural and semi-urban areas would have participated. This would have made both Ayushman Bharat and small hospitals viable and sustainable,” IMA said.

Instead of fostering healthcare from the grassroots level, some of the proposals look to challenge their very existence, it alleged.

“The IMA is concerned that small and medium hospitals will be decimated with the current design of healthcare. IMA demands a review of the concept and operational aspects of Ayushman Bharat while demanding more allocation for health,” said Dr R V Asokan, general secretary, IMA.

The statement also urged people to exert pressure on their MPs to increase public spending on health.

The private sector feels that even as emphasis is given on cleanliness and sanitation, important areas like medical emergency services are left out of the budget. Overall, the private sector does not find the proposals of the budget encouraging, especially due to a lack of impetus to the Ayushman Bharat.

“There have been no significant announcements pertaining to healthcare in the Union Budget. While there was hope that the allocation for the health sector [would be increased] in view of the requirement for funding Ayushman Bharat, this has not been done,” Aster DM Healthcare Founder Chairman and Managing Director Azad Moopen said.

He appreciated the focus on education. “I hope that there will be more funding for starting and upgrading medical colleges,” he added.

Though there has been no direct mention for the healthcare industry, the proposed Rs 100 lakh crore investment in infrastructure in the next 5 years could result in a boost for the healthcare segment, P D Hinduja Hospital & MRC CEO Gautam Khanna commented.

The government’s decision to set up a National Research Foundation to boost research in all areas is one of the most notable announcements in the budget, said Shankar Narang, COO, Paras Healthcare.

“While the healthcare allocation had been covered in the Interim Budget earlier this year, it is still a little disappointing that there was no new commitment to healthcare in finance minister Nirmala Sitharaman’s maiden budget,” stated Narang.

The pharmaceuticals and medical devices makers too looked disappointed as their oft-repeated pleas for incentives for promoting the growth of the sector fell on deaf ears once again.

“The expectations from the Union Budget 2019 were that from a bold, reformist budget. However, it turned out to be an incremental budget at best,” according to Satish Reddy, Chairman, Dr Reddy’s Laboratories.

“The emphasis on start-ups and on the education sector is a good move. However, there was nothing to fuel growth in the healthcare and pharma sectors, which is disappointing. I was particularly keen on seeing a change in the weighted deduction for R&D, which did not happen. A positive policy move of this kind would have spurred R&D and innovation in pharma and other sectors,” Reddy said.

Industry body All India Medical Devices (AiMeD) expressed deep anguish over what it called the continued neglect of domestic medical device manufacturers.

“It is appalling to note that for the past 3 years, this is the first Budget with zero mention of healthcare.. not even a higher allocation for Ayushman Bharat,” AiMeD Forum Coordinator Rajiv Nath said.

Despite umpteen reminders, the Union Budget 2019-20 has not heeded AiMeD’s suggestions on extending tax and non-tax protection to the domestic medical devices industry, he added.

Meanwhile, some of those engaged in online pharmacy trade see the promise of healthy growth for the sector.

They point out that it is high time healthcare was accorded ‘priority sector’ status to ensure smooth credit flow, mandatory universal health insurance, tax incentives for capacity building, creation of a dedicated infrastructure and innovation fund.