The Union Budget for fiscal year 2022-23 announced on February 1 focused on integrating technology in healthcare to improve the delivery of healthcare services across the country. This is seen in the announcement on the roll-out of an open platform for strengthening the digital health ecosystem in India to improve access to and the quality of healthcare services. It is also witnessed in the announcement of the launch of a tele-mental health platform to provide mental healthcare.
The Union Budget 2022-23 emphasised on the use of digital technologies in healthcare, in line with the Government of India’s recent initiatives such as the Ayushman Bharat Digital Mission. With digital technology emerging to be the backbone of healthcare, the Centre raised its allocation to the National Digital Health Mission to Rs.200 crore as compared with Rs.30 crores allocated in the previous fiscal year.
This year, the health sector has been allocated Rs 86200.65 crore in the Union Budget, a hike of 16 percent over Rs 73,931 crore in 2021-22. In the previous year’s budget, the Government had announced that it would spend Rs 64,180 crore over the next six years to improve healthcare services in the country under the Pradhan Mantri Aatmanirbhar Swasth Bharat Yojana. The Government had also projected a broader vision of health beyond healthcare by merging allocations to water, sanitation, nutrition and air pollution control with the health budget. This had resulted in a 137 per cent increase in the allocation to health, though the increase to the health ministry itself was 11 per cent.
Healthcare Budget 2022-23 in numbers:
- Out of Rs 86200.65 crore, Rs 83,000 crore have been allocated to the Department of Health and Family Welfare, while Rs 3200 crore have been allocated to the Department of Health Research.
- The budget allocation for central sector schemes and projects has been increased from Rs 10,566 crore to Rs 15,163 crore. Among these, the budget allocation for the Pradhan Mantri Swasthya Suraksha Yojana has been increased from Rs 70,000 crore to Rs 10,000 crore.
- The allocation for National Digital Health Mission – NHM has been increased from Rs 30 crore to Rs 200 crore.
- For the National Health Mission, the budget allocation increased from Rs 36576 crore in 2021-22 to Rs 37,000 crore in 2022-23.
- Outlay for new medical colleges, seats increased by Rs 2,700 crore. Major institutions of medical education, including the All India Institutes of Medical Sciences (AIIMS), Post Graduate Institute of Medical Education and Research (PGIMER) and Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER) saw their budgets increase by a few hundred crore.
Key announcements for healthcare sector
National Digital Health Ecosystem: An open platform for the National Digital Health Ecosystem will be rolled out. It will consist of digital registries of health providers and health facilities, consent framework, unique health identity and universal access to health facilities. Health experts highlighted that the implementation of these initiatives will make it easier to provide affordable healthcare.
The Digital Health Mission has the potential to enhance efficiency of the health systems through better data collection and analysis, improved medical and health records, efficient supply chain management, tele-health services, support for health workforce training, implementation of health insurance programmes, real time monitoring and sharper evaluation of health programme performance along with effective multi-sectoral coordination.
Currently, the government is creating Ayushman Bharat Health Account (ABHA), a randomly generated 14 digit number that can be used for the purposes of uniquely identifying persons, authenticating them, and reading their health records, only with informed consent across multiple systems and stakeholders.
National Tele Mental Health Program: The announcement of the National Tele Mental Health Program is seen as an important step towards recognising the mental health burdens that face our country in the wake of the pandemic. Union Finance Minister Nirmala Sitharaman said while presenting the Budget that the pandemic had accentuated mental health problems in people of all ages.
Under the program, 23 centres of excellence will be set up with NIMHANS at the centre and the International Institute of Information Technology-Bangalore (IIITB) giving tech support.
The use of telemedicine to diagnose and treat such patients had proved to be highly effective given the unobtrusive nature of the interaction which also ensured patient privacy. Given the shortage of mental health professionals, especially in rural areas, telemedicine would greatly enhance accessibility for patients requiring psychiatric help.
Increased Allocation to AYUSH
AYUSH services under the National AYUSH Mission (NAM) received a major boost in the budget. The allocation has gone up to Rs. 800 crores from the earlier Rs. 500 crores. The total allocation of budget to the AYUSH Ministry in the last 7 years has increased over four times from Rs. 691 crore to Rs 3050 crore. Increasing the budget amount under NAM will help in the upgradation of its hospitals and dispensaries, support cultivation of medicinal plants and in many other areas including increasing the export of value added items of medicinal plants.
Despite some pointed announcements towards improving healthcare services, some experts believe that we have not heard as much on healthcare in this budget as one would expect in the aftermath of an ongoing pandemic. Experts also point to the fact that the budget is silent on the increase in public expenditure on healthcare and the path to achieve 2.5 per cent spending of GDP on healthcare which is the much-needed reform path for this sector to improve access.
Dr. Krishna Reddy Nallamalla, President, InOrder said, “A ten percent increase in allocation to health is not in line with the health policy aspiration of public spending of 2.5 percent of GDP. Increased allocation to other social sectors that have a bearing on health status of people is a saving grace.”
The Economic Survey 2022 suggested that an increase in public spending from 1 per cent to 2.5 to 3 per cent of GDP can decrease out of pocket expenditures from 65 per cent to 30 per cent of overall healthcare spend. The report highlighted that the government expenditure on public healthcare in 2021-22 increased by 73 percent to ₹4.72 lakh crore, from ₹2.73 lakh crore in 2019-20. The Economic Survey, also said that the government’s spending on social services increased significantly during the pandemic.
Allocations to other social sectors that impact health:
- Rs 60,000 crore allocated for providing access to tap water to 3.8 crore households. Current coverage is 8.7 crores households.
- For women and child development, 2 lakh Anganwadis will be upgraded with better facilities.
- For the fight against climate change, 4 pilot projects for conversion of coal to energy through gasification will be launched.
- To facilitate domestic manufacturing of 280 gigawatt of installed solar capacity by 2030, additional allocation of Rs 19,500 crore for production linked incentive (PLI) for manufacturing of high-efficiency modules with priority to fully integrate manufacturing units to solar PV modules has been made.
While mental and digital health are priorities in the budget as they should be, the other important areas should not be overlooked. Priority should be laid on the upgradation of skills of health workers, more investment in research and innovation, upgradation of district hospitals and strengthening of medical college hospitals. There is a need to develop multi-layered, integrated, and efficient health system in the country.