Question : Public Health Expenditure

(a) whether as per the Global Health expenditure data base, 2016 of World Health Organisation, India is placed at 170th position out of 188 countries in terms of expenditure on health and if so, the reaction of the Government thereto;

(b) whether inadequate health infrastructure and less expenditure on health in the country during last three decades has led to difficulty in combating the COVID-19 pandemic;

(c) if so, the efforts being made to increase the public health expenditure in the country in cooperation with the State Governments;

(d) the steps taken/being taken by the Government to strengthen public health, expand medical infrastructure, and ensure efficient delivery of health services; and

(e) the efforts made/to be made by the Government to expand primary care substantially and ensure secondary care to all, at little or no cost?

THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

(DR. BHARATI PRAVIN PAWAR)

(a) to (d): As per the data available on Global Health expenditure data base (GHED) of World Health Organisation, the rank of India in terms of Domestic General Government Health Expenditure (GGHE-D) per Capita in purchasing power parity International Dollar(PPP Int$) has improved from 150 in the year 2016 to 147 in the year 2019.
Public Health & Hospitals is a State subject and the primary responsibility to provide healthcare services to all the citizens of the country lies with the State Government. With a view to strengthen the Public Health Infrastructure effectively, PM-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) was launched by Hon’ble Prime Minister of India with a mission to develop the capacities of primary, secondary, and tertiary care health systems, strengthen existing national institutions, and create new institutions, to cater to detection and cure of new and emerging diseases. Ayushman Bharat Digital Mission (ABDM) has also been launched by Government with aim to make healthcare more accessible for citizens and enable greater efficiencies for healthcare quality and continuity of treatment.

In addition, some of the major initiatives include National Health Mission (NHM), Ayushman Bharat – Health and Wellness Centres (AB-HWCs), Ayushman Bharat - Pradhan Mantri Jan ArogyaYojana(AB-PMJAY),Pradhan MantriSwasthya Suraksha Yojana (PMSSY) and upgradation of medical colleges. With the objective of delivering comprehensive primary health care, closer to the homes of people 1.5 lakh Health and Wellness Centres (HWCs) are approved to be set up. More than 80,143, HWCs are functional as on 21.11.2021. AB-PMJAY is the largest health insurance scheme providing a health cover of Rs 5 lakhs per year for secondary and tertiary care to approximately 50 cr beneficiaries from poor and vulnerable families.
Essential medicines and diagnostics are provided to beneficiaries under Free Essential Diagnostics Service Initiative under NHM. Under Pradhan Mantri National Dialysis Programme, dialysis services are provided free to patients below the poverty line (BPL). Further, under Pradhan MantriJanaushadiPariyojana (PMBJP) quality medicines at affordable price are provided to the masses through dedicated outlets called Pradhan MantriBhartiyaJanaushadi Kendra (PMBJK) across the country.
(e) According to the National Health Accounts Estimates-2017-18, the Government health expenditure on primary and secondary care has increased from 74.4% in the year 2013-14 to 86.2% in the year 2017-18. The implementation strategy under NHM has been to provide financial and technical support to States / Union Territories (UTs) enabling them to provide accessible, affordable, accountable, and effective healthcare upto District Hospitals (DHs). The National Health Policy 2017 has also advocated the provision of comprehensive primary health care in the country and recommended that allocation on primary care upto two-third or more. Consequently, the existing Sub and Primary Health Centres are transformed into Health and Wellness centres to deliver Comprehensive Primary Health Care. On the basis of the health infrastructure available in the States, 15th Finance Commission identified interventions that will directly lead to strengthening the primary health infrastructure and facilities both in the rural and urban areas.


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