The allocation for health in the 12th Five Year Plan at Rs 3 lakh crore may appear better than the previous Plan, but it falls far short of requirements and expectations. The allocation amounts to 1.95 per cent of the national GDP. At present it is only about 1 per cent.
There were promises that it would be raised to 2.5 per cent. The draft Plan document had mentioned only 1.58 per cent, but it was marginally raised after pressure from various quarters, including the National Development Council. A comparison with the public spending on health by many other countries puts the problem in perspective. A global report prepared by an NGO, Save the Children, reveals that India shares last rank with Congo and Yemen in nutritional barometer and comes out as one of the worst countries in policy commitment as well as outcomes on health. The demographic advantage the country is supposed to have will prove to be unreal if care is not taken of public health and education. Economic and social development goals are dependent on performance in these areas. India is behind most other countries in all the critical indicators of health like child mortality rate, maternal health care and control of common diseases.
The higher, though inadequate, spending on health is aimed at supporting new programmes like providing universal health care, supply of free medicines and setting up of a national urban health mission. But plans for formulation of new programmes and strengthening of old ones are not enough. The national rural health mission is mired in corruption in most places. Basic health infrastructure is absent in most areas, especially villages. Trained medical personnel are not available at all levels. Since public health services are inadequate and inefficient, people have to depend on the private sector. Poverty, lack of access to private health care in villages and its high costs make this an impossible option for most.
More resources need to be found to increase the allocation for health. The commission has suggested a tax on vices like tobacco and alcohol to raise funds for health care. The proposal may sound good, because it is aimed at curbing habits which pose a risk to health, while raising funds to promote common good. But higher costs are often no deterrents against consumption of substances which are deleterious to health. In any case, proper utilisation of funds and strict monitoring are necessary to ensure better public health facilities for the people.
