budget 2020

Implementation in right direction and run it with “Accountability”

Says, Professor Gautam Sen, Ex Member First Board of Governors, Medical Council of India (2010-2011) Chairman, Health spring Community Medical Centers, Wellspring Healthcare Ltd to the Finance Minister

I was surprised that in all the leading Channels they had all the expertise representing finance, economy and corporate houses expressing their desire for dream budget allocation for infrastructure development and ease to do business with India- with singular exception of leading educationist/academicians and health care delivery thought leaders who should have been in the forefront of nation’s development goals and hence in the panel.

It was also reflected in FM’s budget speech where a passing comment made in a hurry to state that 5 more AIIMS like super specialty hospitals will be built in States of J and K, Punjab, Bihar, West Bengal, Assam and Tamil Nadu- which will not really solve the poor health outcomes of the nation. These 6 are in addition of 6 such super specialty hospitals declared in earlier budget during UPA 2. Clearly it is a populist demand for vote catching exercise.

Perhaps FM was not advised sufficiently about the importance of investing in building a high quality Primary Care System where Preventive measures and 80 % of routine care can be effectively handled. This combined with integrated referral service to District hospitals will solve90% of health care needs of the District  and the rest 10% in Tertiary Care Hospital. Any country which has invested in health care in this segment has reaped huge benefits- as the examples of developed world show as in UK, Canada, Australia and EU Countries, and developing economies like Brazil, Thailand and nearer home Sri Lanka.

Having said that, there is enough money allocation on health sector (3,31,500 Crores) which should be utilized in an efficient manner with principle of “Accountability”. FM mentioned that MNERGA was not functioning well and hence he has increased the investment. He should now make sure that the principles of “Accountability” are applied- lest again the funds are mismanaged, misused or even abused.

The funds allocated for “Swtchha Bharat” is in right direction of making our Public Sanitation come to modern standard. Emphasis on providing safe and clean drinking water is again a great bold step to strengthen our Public Health system. Both are foundation for Prevention of ill health. FM has taken PM’s direction seriously and this single action or a vision can strengthen our health care delivery system.

If we consider Health Infrastructure as any other important infrastructure like Roads and Electricity, then the positive indication given for infrastructure development and inviting Public Private Partnership to fill in the gaps, is in right direction.

A beginning on National Social Security has been made. We can build a National Health Scheme with participation from both Private and Public Insurance organizations and pooling of funds even from various Pension Funds declared.

All in all, a great Budget. Implementation in right direction and run it with “Accountability” principles are the key.

So my take on present Budget is:

  • Spend the money on health making Primary care and Secondary care Robust and of High Quality, where 90% of health care needs of the population can be well taken care of.
  • Develop Metrics to measure health care outcomes and reward the District Health care System which provides better health outcomes- the principle of “Accountable Care”
  • Allow Private Public Partnership in all aspects of Health Care Delivery wherever there is resource constraint and gap.
  • National Social Security to gradually give rise to and be combined with National Health Scheme with the help of Public Private Insurance Organizations. (Example Australia Brazil UK)


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