A draft National Health policy was notified in February 2015 to address the country’s deplorable state of public health by the Central government and was put up for public discussion. The main focus of the draft was to step up government spending on healthcare infrastructure and public health services in rural and urban areas of the country. It was proposed in the draft to raise the target of public health expenditure to 2.5 per cent from the present 1.04 per cent of GDP. It also noted that 40 per cent of this would need to come from Central government and the rest from the state governments. As per the draft Policy, 70 per cent of the funds would be spent for primary health care, 20 per cent on secondary health care and 10 per cent on tertiary health care. States would be encouraged through performance based incentives to ensure that at least 8 per cent of their annual budgets are spent to providing health services. And for meeting strategic gaps in the supply that public health infrastructure cannot provide, the Central government may initiate measures to procure specific services from the private healthcare providers under a regulatory network. This new initiative on the health front comes from the government after 15 years when the last health policy was notified.
Public health has been a neglected area in India for a long time with health infrastructure in most of the states remaining underdeveloped because of poor planning and inadequate fund allocation. Even after 69 years of independence, country’s spending on public health remains very low compared to spending on health by several other developing countries. The net result of this government failure is reflected in the current disease profile of the country showing a dangerous spurt in lifestyle diseases and re emergence of two of the deadly infectious diseases like TB and malaria. Such a trend needs to be arrested considering millions of poor people becoming victims of these diseases. Responsibility for the failure to attain even minimum levels of public health expenditure remains largely on the state governments. Allocation of funds for healthcare by the state governments and poor utilization of the allocated funds is the prime reason for this state of affairs. Records show that many northern states have failed miserably in establishing adequate number of primary health centers, district hospitals and running them effectively all these years. What is surprising is the fact that state governments have not given adequate attention in running at least the PHCs with qualified medical staff and essential medicines. Now, a detailed road map has been provided in the new policy for the implementation of its objectives on a phased manner. Specific quantified targets too have been proposed under the policy to measure achievements. The parameters have been set for countrywide health status, performance of public health facilities, the financial plans and other deliverables under the policy. A key proposal in the draft policy is the provision for providing essential generic drugs and diagnostics free of cost at all PHCs. At the tertiary care level too, patients in geriatric and chronic care segments are expected to get most drugs and diagnostics either free or subsidised rates. Now to bring this badly needed reform in the healthcare sector, the Centre has to speed up and implement policy with active support of the all the state governments. The nation already lost a lot of time deliberating the draft policy with the stakeholders.