JOIN USBudgeting is a tricky affair in Central government departments. Bureaucrats need to factor in national priorities, political realities and institutional capabilities to prepare a realistic annual plan. Miss any one of these factors and the plans are almost certain to remain on paper for years. This is exactly what happened with as many as 10 schemes of the Union health ministry, as pointed out by the department related Parliamentary Standing Committee on Health and Family Welfare in its report tabled in the winter session. Some of these stalled projects relate to strengthening of government medical colleges, providing better health insurance for the common man and improving the supply of good quality medicine at an affordable cost – schemes that are essential to reduce out of pocket expenditure, which is one of the world’s highest in India and pushes lakhs of Indians below the poverty line every year.
One of the schemes that didn’t take off was setting up an integrated vaccine complex in Chengalpattu in Tamil Nadu and a Medi Park. This was conceived in UPA-I period when PMK leader Anbumani Ramadoss was the Union health minister. In subsequent months, three public sector vaccine producing units were shut down and reopened; and health ministry purchased large quantities of vaccines from the private sector for its routine immunisation programme at higher cost. With little domestic manufacturing, India continues to import bulk of the medical devices. But there is little movement on the Chengalpattu front, where it was planned to establish a vaccine production and medical device manufacturing complex. Other important policy decisions that needed to be taken to realise this goal were not taken. One such pending decision is on the modification of tax structure because existing duties make import of medical devices more lucrative rather than local manufacturing. This is known to governments for many years with barely any action. Another sloppy piece of planning is on the purchase of equipment for the six new AIIMS on which Rs 979 crore is locked due to slow progress in capital works.
On several schemes, the health ministry conveniently shifted the blame either to the
state governments – health being a state subject, they have to be on board – or other Central departments. The ministry, however, maintained a stoic silence on a simple question – why those factors were not taken into account in the planning stage itself. All these factors are known for years, yet the ministry commits the same mistake repeatedly. The House panel has asked the department to “realistically assess” the fund requirements so that scare resources are not blocked and can be used in other projects. The ministry must act on this recommendation.