National Health Policy is high on ambition, but sketchy on achieving targets

The health policy does not address key issues such as human resources gaps, especially in the

rural areas, underutilisation of resources, poor quality control and poor track record in scaling up

experiments in public-private partnerships to meet challenges (Representative Photo)(AFP)

India’s ambitious National Health Policy, which plans to increase public spending on health from

1.15% to 2.5% by 2025 and offer “assured healthcare to all”, is a step down from the policy’s

original draft in 2015 that had proposed health be considered a fundamental right and set the

deadline for raising spending on health to 2.5% by 2020.

The policy outlines an ambitious plan to optimise primary care delivery in the public sector and

fill critical gaps by strategically purchasing secondary-care hospitalisation and tertiary care

services from the public sector and NGOs. It also wants to reinforce trust in the public 
healthcare system by providing treatment for infections and chronic diseases, eliminating 
leprosy, kala-azar and lymphatic filariasis, lowering under-five deaths, stabilising population 
growth and increasing longevity.

It acknowledges the need to prioritise the prevention, diagnosis and management of 
noncommunicable diseases (NCDs), which account for 39.1% of India’s disease burden 
and have replaced communicable diseases as the leading cause of death, and halve premature 
deaths from heart diseases, cancer, diabetes or chronic respiratory diseases by 25% by 2025.

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Deadlines have been set for each deliverable, but what’s missing is the path India needs to take

to meet these targets.

Union health and family welfare minister JP Nadda has reiterated that since public health, along

with hospitals, dispensaries and sanitation is on the state list, the onus of implementing is with

the states. The Centre will help, but each state will have to find more money to give their state’s

health indices a boost.

The policy has scrapped the initial proposal to use taxation, including a special health cess, to

finance the increased budget, and has instead suggested the state sector health spending to be

increased to more than 8% of the state budget by 2020. Currently, the average annual health

spending of most states is less than 5%, with only a handful — Delhi, Goa, Kerala and Rajasthan

— spending more than 5% on their citizens’ health.

The health policy does not address key issues such as human resources gaps, especially in the

rural areas, under-utilisation of resources, poor quality control and a patchy track record in

scaling up experiments in public-private partnerships to meet challenges. With the poor

implementation of existing legislation, such as the Clinical Establishment (Registration and

Regulation Act), accountability and quality standards vary widely across India.

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Close to one in three persons calling themselves allopathic doctors are educated to Class 12,

while 57% practitioners had no medical qualification. India needs to fill gaps in healthcare

delivery and meet infrastructure and human resource shortfalls in public centres to lower 
out-of pocket spending and save people from catastrophic spending on health.

Source: Hindustan Times