Dr Sanjay Agrawal
Leading Pharmaceutical Consultant and Editor-in Chief of IJMToday
The allocation of Rs 69,000 crores for healthcare sector in Budget 2020, it includes Rs. 6,400 crores for Prime Minister Jan Arogya Yojana, and opening of hospitals in tier 2 and tier 3 cities are certainly positive steps in ensuring better healthcare for achieving to holistic vision of healthcare sector that translate wellness of all citizens in the country.
It perceptibly moderates with a vision of some good opportunities for the medical fraternities. The public-private-partnership model to deal with the shortage of doctors as proposed in the budget is going to be substantially beneficial to healthcare sector. The tie-up of medical colleges with district hospitals for increasing the number of doctors that provide care to the patients will enhance the overall quality of the healthcare ecosystem as this will lead to a greater number of skilled doctors in the medical fraternity. In order to expand outreach of healthcare one lakh gram panchayats in the country will be provided with optical fibre technology for accessible healthcare and telemedicine.
The Budget is more focussed on healthcare to improve the country’s human development index. The government’s move to use the proceeds from the taxes levied on medical devices to boost the health infrastructure in tier 2 and tier 3 cities is a smart move. It will help hike the access to quality healthcare in underserved areas and in turn increase the sales of medical devices. Since most of the medical devices are replaced by a newer model once in every two years or so, the major medical device manufacturing companies spend more money on R&D compared to other industrial firms. Since the payback period is shorter, central incentive will more than help foster innovation in the sector and increase the quality of healthcare service delivery, according to experts.
Emphasising on nutrition as a critical component on healthcare, the finance minister proposed to provide Rs 35,600 crores for nutrition-related programmes for the year 2020-21. With an allocation of Rs 35,600 crores for nutrition-related programmes both health and wellness received due attention in the budget and also drew attention to the Poshan Abhiyan which was launched in the year 2017-18 to improve the nutritional status of children, adolescent girls, pregnant women and lactating mothers. Over six lakh anganwadi workers have been equipped with smart phones to upload the nutritional status of more than ten crore households, which is an unprecedented development.
In the budget the finance minister also announced that a task force will be appointed to recommend regarding lowering MMR and improving nutrition levels. The finance minister added that with India’s progress, opportunities were opening up for women to pursue higher education and careers, and the entire issue about age of a girl entering motherhood, therefore, needed to be seen in a new light.
Apart from the healthcare, promoting entrepreneurship and facilitating easy tax structures for business, strengthening the infrastructure and cold chain logistics as well as focus on skill development, are all areas that will hugely benefit the nutraceutical sector in India, according to analysts.
Highlighting the government’s continued commitment to the welfare of women, the finance minister allocated Rs 28,600 crore for programmes specific to women. The minister introduced key proposals with a focus on women, child and social welfare in the Union budget 2020-21. The minister informed that Beti Bachao Beti Padhao has yielded positive results. Gross enrollment ratio of girls across all levels of education is now higher than boys. At elementary level, it is 94.32 per cent as against 89.28 per cent for boys. Similar trends in gross enrollment ratio were also observed at secondary and higher secondary levels, the minister said.
For accelerating and enhancing the public health facilities, the positive outlook from the budget see the growth of Ayushman Bharat, besides allocating Rs 6,400 crore for the scheme. The AB-PMJAY scheme would be expanded by setting up more hospitals in the tier-II and III cities under the public-private-partnership model. This will be reaching out to villages and mass audiences. The plan of proceeds from medical devices would be used for the development of hospitals, the minister said.
‘Presently, under PM Jan Arogya Yojana, there are more than 20,000 empanelled hospitals. We need more in tier-2 and tier-3 cities for poorer people under this scheme. It is proposed to set up Viability Gap funding window for setting up hospitals in the public-private-partnership model. In the first phase, those aspirational districts will be covered, where presently there are no Ayushman empanelled hospitals. This would also provide large scale employment opportunities to youth. Proceeds from taxes on medical devices would be used to support this vital health infrastructure’, the minister said.
The government has also proposed to attach medical colleges with district hospitals on public-private-partnership model to deal with shortage of doctors. The health authorities and the medical fraternity can target disease with an appropriately designed preventive regime using machine learning and AI in the Ayushman Bharat scheme.
As the finance minister said, by 2030, India will have the largest working age population in the world and therefore, more than ever before, addressing non communicable diseases (NCDs) must be India’s immediate imperative as the prevalence of these diseases is being witnessed increasingly in the younger segment of our population. NCDs are responsible for two-thirds of the total morbidity burden and according to the World Economic Forum, by 2030, the world could lose over 30 trillion dollars and about 36 million people could die every year due to NCDs if rapid remedial action is not taken up. Hence, in addition to initiatives announced to improve access to medical care across the nation and boost human health resources, it was encouraging that vital determinants of good health which include wellness, nutrition, clean drinking water and sanitation were at the forefront of this Budget. Likewise, the ‘Fit India’ programme championed by Prime Minister personally, will certainly motivate a greater focus on fitness amongst Indian citizens. The allocation of Rs 69,000 crore to healthcare, inclusive of Rs 6,400 crore for Jan Arogya Yojana, this marks an increase from last year when the minister allocated Rs 62,659 crore for the healthcare sector. The expansion of the government’s flagship scheme-Ayushman Bharat scheme, billed as the world’s largest government funded health insurance scheme. The expansion of Ayushman Bharat scheme will be done in more hospitals and will open hospitals in tier 2 and tier 3 cities under the public-private-partnership model covered under aspirational districts scheme which still do not have an Ayushman-empanelled hospital.
In budget an allocation of said Rs 99,300 crore has been provided for education sector and Rs 3,000 crore for skill development for the next fiscal. The Govt of India will immediately announce a new education policy and the government has received too much suggestions on it.
According to reports India’s public school areas facing an acute shortage of five lakh teachers cross just the six states of Uttar Pradesh, Bihar, West Bengal, Chhattisgarh, Maharashtra and Tamil Nadu, with Bihar and Uttar Pradesh accounting for 84 per cent of that shortage, or 4.2 lakh teachers. At a nation-wide level, India is short of over 1 million teachers with 17.52 per cent posts at the elementary level and 14.78 per cent posts at the secondary level in government schools lying vacant. At the college and university level, almost 3.45 lakh posts, accounting for 24.5 per cent of total posts, are lying vacant.
The importance of more women entrepreneurs and employees in workplace cannot be stated enough as it contributes to the growth of the economy as well as helps lend a positive atmosphere in office. In budget finance minister praised the positive effect of Beti Bachao Beti Padhao that has led to higher gross enrollment ratio for girls than boys. Rs 28,600 crores have been set for women centric programmes to encourage women to do business and become entrepreneurs.
According to experts the Union Budget covers the societal arc across healthcare, nutrition, education, environment, agriculture sectors despite considerable fiscal constraint.
It is learnt that the Budget had been below par considering investors had extremely high expectations from the government to revive the economy.