Bhoomika Singh
After living with the pandemic for almost three years, India has finally begun to acknowledge and talk about the topic of mental health in a more comprehensive and inclusive manner. In our country, mental health-related issues have always been side-lined and tabooed but things are changing now.
As FM Nirmala Sitharaman presented the Union Budget 2022-23, she prioritised the mental health of the country and the digitalisation of the health sector. She announced the setting up of the National Tele Mental Health Program and the National Digital Health Ecosystem.
Allocation for the healthcare sector
As per the Budget Estimates (BE), Rs. 83,000 crores were allocated to the Department of Health and Family Welfare and Rs. 3,200 crores were allocated to the Department of Health Research, a total of Rs. 86,200 crores, which was Rs. 86,000 crores last year as per the Revised Estimates (RE).
The FM has also committed Rs 5,000 crores as a support to the states for their COVID-19 vaccinations this year, and this is Rs 34,000 crores less than the 2021-22 allocation. According to the Revised Estimates, the FM had allocated Rs 39,000 crores for COVID-19 vaccinations in the last fiscal year.
Central core schemes like the National Health Mission received Rs. 37,800 crores (BE) in 2022-23, and the amount was Rs. 34,947 crores (RE) last year.
The Pardhan Mantri Swasthya Suraksha Yojana was allocated Rs. 10,000 crores (BE), as opposed to Rs 7,400 crores (RE) last year.
The Pradhan Mantri Ayushman Bharat Health Infrastructure Mission was allocated Rs. 4,176 crores (BE), while it received Rs. 585 crores (RE) last year.
Saksham Anganwadi and Poshan 2.0 received Rs. 20,263 crores (BE), as opposed to the Rs. 19.999 crores (RE) that they received last year.
A marginal increase in funds
However, this year the allocations to the health sector have not increased significantly.
With COVID-19 still lurking, the healthcare sector expected a considerable increase in the expenditure budget allocations for itself. A total of Rs 86,200 crores of budget expenditure has been allocated to the health sector in the Union Budget 2022-23. The total budget expenditure allocated has negligibly increased by only 0.2 per cent from last year’s allocation, which was Rs. 86,000 crores as per the Revised Estimates (RE). In fact, for the fiscal year 2021-2022 the health budget received a 137 per cent increase in its allocation as compared to the amount that it had garnered the year before that.
Not satisfied with this increase, Dr. Azad Moopen, Founder Chairman and Managing Director, Aster DM Healthcare says that the allocation towards healthcare was not to the level that was being anticipated.
“Coming out of the shadows of the pandemic, it is most important to allocate at least 3 per cent of the budget to healthcare,” he says.
Rohit Jha, ED at Jain Multi-Specialty Hospital welcomes the budget but points out what the government has missed.
“We are not quite happy that healthcare spending as a percentage of GDP has remained unchanged. Finally, given the difficult times that the healthcare business has been through in the previous two years, some assistance in the form of concessions in creating compliance infrastructure connected to fire and other safety issues is needed,” he points out.
He further adds that the healthcare sector was expecting a push to make objective treatment packages covered by medical insurance in the field of mental health more accessible. The initiative on rapid vaccination is long overdue, and universal vaccine coverage for all segments of the population is required.
This year, the finance minister announced two main upcoming programs, i.e., the National Tele Mental Health Program (NTMHP) and an open platform for the National Digital Health Ecosystem (NDHE).
It’s a booster budget
On the other hand, a few stakeholders feel that the Union Budget has focused well on the healthcare sector. Among them is Puneet Aggarwal, Founder and CEO at Nirogam, who calls it a booster budget in terms of funds allocation.
According to him, an allocation of Rs 64,180 crores for the Atmanirbhar Swasth Bharat Yojana is commendable and will lead to the development of holistic healthcare. More evidence of the government’s seriousness for this sector in this budget is apparent in its plan of establishing 12 central institutions, while strengthening the National Center for Disease Control and expanding the health information portal to all states and UTs, thus connecting all health labs, he says.
“Now, healthcare facilities will be accessible to all in urban as well as rural India because the decision of setting up 17,000 rural and 11,000 urban health and wellness centres will be instrumental in overcoming healthcare disparities. Moreover, the establishment of a regional World Health Organisation office, nine bio-safety level 3 laboratories and four regional National Institutes of Virology will further reduce the disparity between the urban and rural healthcare infrastructure,” he adds.
Rs.1200 crores were also allocated for comprehensive medical support to pregnant and lactating mothers, childcare services, and for people suffering from non-communicable diseases. Free diagnosis and medical drugs have also been promised for each section. “If things are implemented on time, we will soon witness one of the world’s best healthcare sectors in India,” comments Aggarwal.
The National Tele Mental Health Program (NTMHP)
The NTMHP consists of a network of 23 telly mental health centres of excellence associated with the National Institute of Mental Health And Neurosciences (NIMHANS) for better access to quality mental health counselling and care services.
Speaking of which, Dr Satyender Goel, Founder & CEO of India Health Link (IHL) calls it a much-needed push.
“The proposed National Tele Mental Health Scheme involving Bengaluru-based NIMHANS shows the importance given by the government to a large segment of the population that was stressed out following the pandemic and is part of what the finance minister said about ‘empathy for the pandemic-hit population’,” he avers.
Dr Shravan Subramanyam, Managing Director, Wipro GE Healthcare and President & CEO, GE Healthcare – India and South Asia, also finds it a progressive step.
He says, “The NTMHP represents a progressive step towards recognizing and acting on mental health issues, especially considering the emotional toll that COVID-19 has taken on people. The government’s focus on holistic health encompassing physical as well as mental well-being, is the right step towards a strong health system.”
Calling the overall budget, a practical budget and a runway to long term growth, Founder and CEO of Soothe Healthcare, Sahil Dharia says, “Digitalisation of mental health under the Tele Mental Health program is a big thumbs up for the government and it should be commended for recognising this need.”
Similarly, Dr Moopen is also glad that mental health and the challenges put forward by the pandemic are being tackled at a national level with the launch of the Tele-Mental Health Programme.
Vijayaraghavan Venugopal, CEO & Co-Founder, Fast&Up calls the budget commendable.
“The FM highlighted the accentuation of mental health problems in people of all ages amidst the pandemic. The stress and lifestyle changes have definitely taken a toll on our mental as well as physical health. It is commendable on the part of our government to address it by providing access to quality mental health counselling and care services,” he says.
On the same note, another stakeholder G. Srinivasan, CEO of Athulya, Chennai, also finds the NTMHP beneficial for the elderly population,
“The budget is forward-looking with emphasis on mental healthcare. They have taken into consideration the increasing cases of mental health problems and have made provisions to offer quality counselling and care for people across all age groups,” he says.
Varun Khanna, Group CEO of Fullife Healthcare, calls the programme a holistic approach and says, “It is much-needed in a country like India which often considers the subject of mental health a taboo. The FM also said that as many as 95 per cent of the 112 aspirational districts have made significant progress in health and infrastructure which shows that we are on the right track and are taking health seriously through a holistic approach.”
The National Digital Health Ecosystem (NDHE)
The FM also announced the setting up of an open platform for the National Digital Health Ecosystem. It will consist of digital registries of the healthcare ecosystem which includes the providers, the health facilities, the unique health identities and the consent frameworks and will enable universal access to health facilities.
Experts from the sector are applauding this initiative.
Rajiv Mathur, Founder and Executive Chairman of Critical Care Unified (CCU) comments that this budget will establish the groundwork for India’s economic growth and progress.
“We commend the ‘Ayushman Bharat Digital Mission 51’ effort to create an open platform for the National Digital Health Ecosystem. This will aid in the development of a more inclusive and resilient medical society,” he conveys.
Khanna of Fullife Healthcare thinks that the budget has boosted the sector. “It’s a welcome change to see the digital emphasis on healthcare programmes and initiatives. Now Indians can have their own unique digital health identity and access to health facilities pan India. This attempt is a step forward to be at par with other countries,” he asserts.
Dr Subramanyam of Wipro GE Healthcare applauds the government’s efforts too. “We endeavour to scale technologies to aid safe, effective, and efficient care as the healthcare sector embraces the digital revolution. It will not only encourage people to buy health insurance but will also widen access to quality healthcare,” he points out.
Welcoming the announcements, Piyush Vishwakarma, Co-Founder & CEO of Jeevam Health says that launching the NDHE will help in transforming the medical infrastructure in our country. “We look forward to working closely with the government on this,” he says.
Similarly, Dr Ramesh Kancharla, Chairman and MD at Rainbow Children’s Hospital says that the NDHE will improve transparency,
“This will go a long way in providing a national registry of the healthcare infrastructure of the country. It will improve the transparency and information flow of the key healthcare parameters across the country. Given the challenges in mental health thrown up by the pandemic, the National Tele Mental Health Programme is another welcome step,” he elaborates.
Adding in his comments, Dr Goel of IHL says that the digital registries under the NDHE will provide access to healthcare digitally in the remotest of areas where even the Primary Health Centres (PHCs) are unavailable. “It will also help accelerate the regular screening for NCDs across the urban and rural PHCs being piloted through the National Health Mission and the National Urban Health Mission; allowing us to catch up on the time lost due to the COVID pandemic,” he adds.
DESH-Stack to fill the skill gap
Another progressive move by the government is the launch of the DESH-Stack e-portal for skilling and reskilling citizens.
Healthcare stakeholders opine that this step can mitigate the lack of skill and manpower in the sector. Speaking on the subject, Srinivasan of Athulya says,
“This step will address the current need to enhance the skills of the existing healthcare workers. The continuous development programs will be a game changer across all sectors, facilitating knowledge creation for people by grooming them to fit the industry requirements, eventually opening-up greater employment opportunities.”
Overall, the health sector has received a mixed bag from the Union Budget 2022. While it has brought in new age initiatives like the NTMHP and the NDHE, it still lacks on the increment in the overall budgetary allocation towards healthcare front. Also, the government has not increased the percentage of the expenditure on healthcare in the total GDP of the country, either.
