137% Increase In Health And Sanitation Spending But With Caveats

The budget focuses more on water and sanitation facilities over solely improving health infrastructure

Finance Minister Nirmala Sitharaman allocated over ₹35,000 crore rupees for supporting COVID-19 vaccination across the country for FY 2021-2022 but the grant is not a part of the allocations budgeted for the health ministry as seen in the budget documents uploaded on the budget website. This allocation is budgeted under the demand of grants by the Ministry of Finance.

This is the only COVID-19 provision in the Budget estimates for 2021-22 as the government has not allocated any money for COVID -19 Emergency Response and Health System Preparedness Package - EAC in FY 2022.

Along with announcing the support for vaccines, the Union Budget 2021 focused on improving the health and sanitation infrastructure, an oft- ignored sector in the budgets. The country's low spending on health, particularly, has been criticised by several economists and health experts domestically and internationally.

Sitharaman highlighted that the government has increased its expenditure by 137% in the health and sanitation programs wherein the major focus is on universal access to drinking water under the Jal Jeevan Mission and universal access to safe toilets and cleanliness through the Swachh Bharat Abhiyaan. The departments handled by the Ministry of Health and Family Welfare- Department of Health and Family Welfare and Department of Health Research received a push in the form of a new act as well as more focused immunisation.

Pradhan Mantri Atma Nirbhar Swasth Yojana, a newly introduced health scheme for strengthening health systems across the country has been budgeted for ₹64,180 crore with an outlay of over six years. This scheme, running along with the National Health Mission- the flagship health program of the country, however, is not mentioned in the detailed budget document.

In the 2020 Budget, the health and sanitation programs were only allotted ₹94,452 crores while in the current Budget the schemes have received an estimated ₹2,23,846 crore. The budget estimates for 2020-2021 for the departments of the Health Ministry was ₹67,111 crore and the Revised due to the unforeseen pandemic were at ₹82,728 crore. In spite of the pandemic showing that the health sector needs special attention, the budget estimates for 2021-2022 stands at ₹73,901 crore.

The government also plans to introduce two new bills for medical workers in the Parliament. The bills intend to create a National Commission for Allied Healthcare Professionals that will be an umbrella institution for 56 different healthcare professionals as well as a National Nursing and Midwifery Commission in the country. The pneumococcal vaccine for children is also now going to be rolled out to all the states in the country. It is currently available only in 5 states.

The Breakdown of the 137% Increase

The ₹2,23,846 crore health and well-being package is spread across the Ministry of Health and Family Welfare, Ministry of Women and Child Development, Ministry of Water and Sanitation, and Ministry of Environment, Forests, and Climate Change.

Under the MOHFW, the government introduced the Pradhan Mantri Swasth Abhiyaan with an outlay of ₹64,180 crore for a period of six years. This scheme intends to develop 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.

The program will support over 17,788 rural and 11,024 urban Health and Wellness Centers and also set up integrated public health labs down to the block level in 11 states. To further augment the improvement of health infrastructure, critical care hospitals will be established in 602 districts and 12 central institutions along with 17 new Public Health Units and strengthening of 33 existing Public Health Units at Points of Entry, that is at 32 Airports, 11 Seaports and 7 land crossings, and 15 Health Emergency Operation Centers and 2 mobile hospitals. While the National Centres for Disease Control will be strengthened, One Health, a Regional Research Platform for WHO South East Asia Region, 9 Bio-Safety Level III laboratories and 4 regional National Institutes for Virology will also be set up across the country.

Through the Ministry of Women and Child Development, the government will enhance the Poshan Abhiyaan by incorporating it with the existing Supplementary Nutrition Programme for pregnant and lactating mothers and young children to reach over 112 aspirational districts.

The Ministry of Water and Sanitation will receive close to ₹2,87,000 crores across five years to achieve the goals of the Jal Jeevan Mission (urban). It aims to achieve universal water supply in all 4,378 Urban Local Bodies with 2.86 crores household tap connections, as well as liquid waste management in 500 AMRUT cities. It will also receive ₹1,41,678 crores Urban Swachh Bharat Mission 2.0 over a period of 5 years.

Finally, the Ministry of Environment, Forests, and Climate Change received ₹2,217 crores for setting up 42 urban centres to tackle air pollution in cities with a million-plus population

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