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A budget built on a foundation of Health and Wellbeing

Elias George, Partner and Head, Infrastructure, Government and Healthcare, KPMG in India analyses the government's focus, which has been seen in the Union Budget, mainly due to coronavirus, and going forward what measures need to be taken on a constant basis for improving the country's healthcare system

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One of the central pillars of this year’s budget has been its unprecedented focus and substantially enhanced investment around improving health outcomes for all Indians. What is new is that the budget has focused not just on its curative and preventive aspects, but has also tried to address causative factors that affect health outcomes, like urban air pollution and deficiencies in urban sanitation.

An enduring critique about India’s public policy approaches to healthcare has been its inadequate levels of public spending, traditionally accounting for only around one percent of the GDP. This gap has been now substantially overcome in the budget with an outlay Rs 2.2 trillion, which is an enhancement of 137 per cent over preceding budgetary allocation.

In response to the compelling need for augmenting healthcare infrastructure, the budget has earmarked Rs 64,180 crore over six years to develop capacities of primary, secondary and tertiary healthcare systems and to improve existing institutions under the PM AtmaNirbhar Swasth Bharat Yojana.

To mitigate the causative factors that adversely affect people’s health status and wellbeing, the budget has announced Rs 2,217 crore for setting up 42 urban centers to tackle air pollution as well as Rs 1.4 trillion for launching Urban Swachh Bharat Mission 2.0 over five years.

The challenge of providing vaccination coverage against the pandemic for those in need has been squarely met by earmarking Rs 35,000 crores which will be further augmented, if required.

Further, the introduction of the National Commission for Allied Healthcare Professionals Bill, along with the soon-to-be-introduced National Nursing and Midwifery Commission Bill, is expected to bring in transparency, efficiency and governance regulation to the 56 allied healthcare professions.

Operationalisation of Public Health Units and strengthening them at Points of Entry by setting up Health Emergency Operation Centers and mobile hospitals will not only ensure robust surveillance and containment strategies, but will also help in screening passengers, especially when tourism and travel resume in the coming months.

The pandemic has brought into stark focus the need for efforts to focus not just on healthcare – improving individual health outcomes; but also, on health security for communities by involving digital surveillance, early healthcare warning systems, pandemic surveillance and protection, etc. The initiative of setting up an inter-connected network of public health labs in all districts, along with expansion of the health information portal to all States, lends itself to India’s digital health agenda.

This is also expected to encourage technology startups to develop solutions especially focused on healthcare.

The enhanced resourcing for healthcare and allied sectors, along with the regulatory improvements and institutional restructuring that have been proposed, will all hopefully contribute to improving health outcomes and enhancing economic growth.

Going forward, however, it will be important to shift the focus towards the quality of implementation of the new programmes and schemes, as well as on fostering convergence between publicly funded health programmes and private sector healthcare providers to work together in quest of desirable outcomes.

In sum, the fundamental, the unprecedented focus and attention in the budget to improving health outcomes is borne from the realisation that it is not only a primary public good that has to be one of the cardinal objectives of public policy in India, but also that improving healthcare outcomes and community healthcare status is vital for the Indian economy to transit into a higher growth path.

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