Introduction

The article talks about how the money set aside for healthcare Programmes in India’s Union Budget depends a lot on how well the states manage their part of the work. Even though the central government gives funds to help, the states have to chip in and make sure they use the money properly. So, even if the government allocates a lot of money for healthcare, it won’t have much impact unless the states can handle it effectively.

Two Major Healthcare Programs

The government has introduced two important programs to boost healthcare:

Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM):

• This program focuses on creating new healthcare facilities, such as:
  • Health and Wellness Centers, where people can get regular checkups.
  • Block-level public health units in smaller areas.
  • District-level labs for important health tests.
  • Critical care hospital units to handle emergencies, like pandemics.
• The main aim is to make India better prepared for future health crises like COVID-19.

Human Resources for Health and Medical Education (HRHME):

• This program is about increasing the number of healthcare professionals by:
  • Opening new medical, nursing, and paramedical colleges.
  • Expanding the number of seats in these institutions.
  • Connecting district hospitals to medical colleges to train students.

Challenges in Spending the Money

Even though money was allocated for these programs, very little of it has been used. For example, in 2022-23, only 29% of the budget for PM-ABHIM was spent. Similarly, only a quarter of the funds for HRHME were used in the last two years. Because the funds weren’t fully utilized, the government reduced the budget for these programs moving forward.

Reasons for Low Spending

There are several reasons why the funds weren’t used properly:

Health Grants:

• PM-ABHIM was supposed to get much of its money from health grants decided by the 15th Finance Commission. But only 45% of these grants were used from 2021 to 2024. The reason? The process of using the grants is too complicated, and states are struggling to manage them.

Reorganizing Health Labs:

• States were asked to combine their health labs into one system to avoid duplication, but this required a lot of planning and effort, causing delays.

Delays in Construction:

• Much of the work involves building new health centres and hospitals. Construction often faces delays due to complicated approval processes.

Confusion Over Multiple Funding Sources:

• Sometimes, different funds are allocated for similar projects, leading to confusion and more delays in getting the work done.

Shortage of Faculty

Even if the states build new hospitals and colleges, there’s another problem: not enough teachers and healthcare professionals to staff them.

• In many of the new AIIMS, 40% of teaching positions are vacant.
• In some state-run medical colleges, such as those in Uttar Pradesh, 30% of teaching jobs were empty in 2022.
• Without enough specialists and staff, it will be tough to run these new facilities and upgrade existing hospitals.

This shortage of specialists could also affect other parts of PM-ABHIM, like critical care hospitals, which need experts to function well.

Financial Strain on States

The article also highlights that states will need to take on the ongoing costs of running the hospitals, colleges, and health centres built under these programs. The central government’s help with staffing is only temporary, until 2025-26. After that, states will need to come up with the money to keep everything going. This could be a big financial burden for many states that are already short on funds.

Conclusion

In short, although the government is trying to improve healthcare by allocating funds for new hospitals, colleges, and healthcare workers, there are many obstacles. States need to manage the money better, address the shortage of healthcare professionals, and ensure smoother execution of these projects. Without this, the money set aside in the budget won’t be as effective as intended.

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