Experts emphasise the need to shore up urban health infrastructure
Mumbai: As India reels under the onslaught of the deadly ‘second wave’ of the Covid-19 pandemic, touching new peaks in cases and fatalities daily, the country’s urban health infrastructure lies in a shambolic state. Decades of neglect at both the Central and State government levels and a niggardliness to spend on boosting healthcare has resulted in a severe shortage of critical healthcare facilities today as the crisis shows no signs of abating.
With a lack of ventilator beds and oxygen supply virtually endemic in the most-afflicted cities across the country, the soaring fatality toll has tragically resulted in the dead having to wait their turn in packed crematoriums. Hospitals, heaving with ever-rising patients, are forced to deny them admission leading to a collapse of health systems in cities like Pune, Mumbai and other places.
TheNews21 investigated the amount spent on the improvement of the health system in Maharashtra during the last 21 years. This period witnessed both the Congress-Nationalist Congress Party (NCP) as well as the Bharatiya Janata Party (BJP) – Shiv Sena regimes.
Our investigation revealed some startling facts: As per figures from the official accounts of the Maharashtra state expenditure, the Congress-NCP alliance which ruled the state during 2009-2014 never allotted more than three per cent in the annual budget for the public health department.
The budget size of the state was Rs 1,22,963 crore in the fiscal year 2009-10. It ballooned to Rs 4,34,085 crores by 2020-21. This year, current finance minister Ajit Pawar has presented a budget to the tune of Rs 4,84,091 crores.
In 2009-10, there was a provision of Rs 2,093 crores for public health in the fiscal year 2009-10 (a mere 1.70 per cent) the total budget. In 2020-21, the provision for public health against the total expenditure was Rs 10,323 crore ( 2.18 per cent) which incidentally came down to 2.23 per cent (Rs 10,826 crores) for the fiscal year 2021-22.
While speaking with TheNews21, Prithviraj Chavan, former Chief Minister emphasised providing accommodation facilities to doctors whose service wanted to be in rural areas. He also stressed the poor educational facilities in the rural area which, according to Chavan, is the reason doctors who are more sensitive about the quality education of their wards – refused to stay in PHCs or rural hospitals.
Sudhir Mungantiwar, the BJP leader and former Minister for Finance and Planning praised the schemes launched by Prime Minister Narendra Modi in terms of health facilities and promotion of fitness. Mungantiwar recalls the scheme like Ayush, Yoga days, Fitness scheme, set of AIIMS (All India Institute of Medical Sciences) and many more. He said that research in health-related issues should be given priority.
A senior bureaucrat who spent always a decade in the health and finance ministry in Maharashtra said that there might be some lacunae in the system, but Maharashtra has achieved a lot in the health and medical education system during the last 10 years. These are the combined efforts of political leaders, administration and doctors who work in the field.
# In the 21 years from, 2009-10 to 2019-20, out of the state budget, Rs 6763 (3%) was spent on the public health department in 2015-16 & Rs 8770 crores (3.06%) in 2017-18. This is the highest amount ever spent on public health.
# In the 21 years, the average expenditure on the state budget was Rs 2 lakh 20 thousand 932 crores (Rs 2,20,932 crores), while the average expenditure on the public health department was Rs 5,949 crores (2.69%).
# During the 21 years, Rs 24,30,255 crores (Rs 24 lakh 30 thousand 255 crores) were spent on schemes various departments including salaries, pensions and interest on loan taken by the state. Of which, Rs 65,434 crores were spent on the Public health department. In terms of per cent to the total expenditure, it comes to 2.69 per cent.