Budget 2023-24: Is the GDP allocation for healthcare sufficient? How do doctors react?

The most lauded initiative this year is the decision to set up 157 nursing colleges, in addition to the existing medical colleges
What experts think of the healthcare budget this year | (Pic: EdexLive)
What experts think of the healthcare budget this year | (Pic: EdexLive)

Finance Minister Nirmala Sitharam, while presenting the Union Budget today, February 1, emphasised that healthcare was one of the priorities for the financial year 2023-24, and mentioned some of the proposed initiatives. Healthcare experts from across India opine that it is a "good" budget.

The most lauded initiative this year is the decision to set up 157 nursing colleges, in addition to the existing medical colleges. Dr Raj Shekhar Yadav, State Convenor of UPCHAR (United Private Clinics and Hospitals Association of Rajasthan), stated the nursing care sector has been suffering for long, and the Centre's move was in the right direction.

"Education in the existing nursing colleges is not systematic or proper. I know for a fact that many students don't attend classes but receive their degrees from home," he said, adding that nursing was an equally important aspect, which hadn't been much focussed on till date. "The start of 157 nursing colleges will help in shortening the gap in the availability of students for nursing care," said Dr Ajay Swaroop, Chairman, Sir Ganga Ram Hospital, a private hospital in New Delhi.

Pointing out the crucial role which nurses play, Dr Aviral Mathur, President of FORDA (Federation of Resident Doctors' Association), explained, "Paramedical staff is very important for the healthcare sector. Most healthcare facilities are unable to run to their full capacity due to the scarcity of such staff."

"I work in ICUs, and I can tell that ICUs are not able to function to their maximum capacity, as it is mandated that there should be one nurse for each bed, but the staff isn't available," he explained further. Thus, he added that the government's move would boost the healthcare infrastructure. Dr Lakshya Mittal, Vice-President of UDFA (United Doctors' Front Association) also supporting this statement, adds, "Nurses are the backbone of any healthcare facility, be it primary, secondary or tertiary."

Another significant announcement made by Minister Sitharaman was that ICMR (Indian Council of Medical Research) labs would now be made available for research by public and private medical college faculty and private sector Research and Development (R&D) teams. Speaking about it, Dr Manish Jangra, Founder of FAIMA (Federation of Indian Medical Association), says, "A public-private partnership part is a very good move, which will give a chance to entrepreneurship in the health sector."

"Augmenting the research facilities will go a long way," says Dr Mathur. He speaks of two immediate benefits. "The research process will be fast-tracked. Next, it will open new avenues, in terms of extensive lab accessibilities and hassle-free clearance for trials" he states. The expert explains that private labs have many great facilities, which will now be available to the public sector, and since their reach is better, the research works will obtain a better scope.

He reiterated that the clearances required for trials will now be obtained quicker and more easily. "For Phase III and human trials, the government has enough resources and infrastructure, but it lacks them when it comes to the initial trial phases. A good example is the Cyrus Poonawallah-owned Serum Institute, which quickly brought out a COVID-19 vaccine," Dr Mathur said, adding that the government's move will enable faster and better redressal of health threats.

"A new programme for research and innovation in pharmaceuticals will be taken up through Centres of Excellence," the FM stated. This move too is being praised by the experts. "In India, there is no significant research in Pharma, and it was much needed. Most medicines in the market today are made elsewhere. As such, they are expensive. India-produced drugs will potentially make Pharma accessible to all," said Dr Yadav.

The downside?
Dr Mathur points out a public-private partnership may result in stiff competition among drug controllers to reduce prices, and this needs to be kept in check. Meanwhile, "Besides opening nursing colleges, the government must strengthen the peripheral healthcare system, as so much load is there on tertiary care hospitals," states Dr Jangra.

"This load can be reduced by making healthcare delivery better at the periphery. More funds should be allocated to these places. Moreover, some places are overstaffed, while periphery staff don't work at all. A balance needs to be there," he added. 

On the other hand, Dr Rohan Krishnan, Chairman of FAIMA, opines that improving the existing medical and nursing colleges would be a better move than opening new colleges. He stated that not hiring good faculty and not spending on the suffering infrastructures of the existing colleges was disadvantageous, and in absence of these, new colleges would be "wasteful".

Additionally, doctors working in the private healthcare sector point out that no schemes have been announced for the sector. Dr Yadav says, "Private healthcare sector has been ignored in every budget for years. No incentive has ever been given by any government to boost this sector, which is the backbone of the Indian healthcare delivery system."

And Dr Swaroop states, "It would have been nice if some incentive would have been given to charitable hospitals like us who have been doing charity work for the last five decades. Also, focus on funding and incentives for telemedicine and research works in remote areas would have been a welcome step."

Dr Mittal highlights that mental health has become a key issue, especially in the post-pandemic times. "Not only the public, but mental health hold great importance for medicos as well," he says, and is disappointed that the government has not allocated any extra funds in this regard. "Recently we heard of many medicos taking extreme steps. The government should implement some measures for mental health-related problems," he added.

As to the overall budget allocation to the healthcare sector, it is Rs 88,956 crore this year, denoting a 2.71 per cent hike from FY 2021-22. Though doctors are happy that the 2 per cent mark in the previous healthcare budgets has been breached, more funds were required to improve the sector further.

"New challenges surface with time. The GDP thus needs to be stepped up," says Dr Mathur. He opines, no major healthcare scheme had been announced in the budget, as far as he knew. "Only the old ones are being modified," he added.

All in all, the experts opine that this year's budget is better than that of FY 2021-22.

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