State Budget and Health Sector

Prof. (Dr.) Dharmakanta Kumbhakar

(The writer can be reached at drkdharmakanta@yahoo.com)

Finance Minister Ajanta Neog presented the State Budget 2024–25 in the Legislative Assembly on February 12, allocating 2.76 percent of the total Budget of Rs 2,90,155.65 crore to the health sector. The allocation to the health sector is Rs 8001.96 crore, which is Rs 871.77 crore more (or an increase of 12.23 percent) than the Rs 7,130.19 crore for the 2023–24 fiscal. Of the total health sector outlay in 2024–25, Rs 5354.68 crore has been allocated to the Health and Family Welfare Department and Rs 2647.28 crore to the Medical Education and Research Department.

The Finance Minister did not announce any new major health schemes in this budget. Instead, she focused more on the continuation and fruitful implementation of previously announced health schemes. This is one of the best aspects of this budget. It is better to implement previously announced schemes fruitfully than to announce any new major scheme.

The Minister assured that the government’s ongoing flagship insurance scheme, Ayushman Asom-Mukhya Mantri Jan Arogya Yojana (AA-MMJAY), will continue enrolling more beneficiaries in 2024–25. The State Government launched the AA-MMJAY on October 2, 2023, to provide health insurance coverage to the entire family to beneficiaries of the National Food Security Act of Rs 5 lakh and cashless treatment to supplement the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). The scheme will provide affordable and quality-free healthcare to more families in FY 2024–25. Moreover, it will reduce out-of-pocket private expenditure on health, which has been pushing several people into poverty.

The Minister also assured that the scheme Ayushman Asom-Mukhya Mantri Lok Sevak Arogya Yojana (AA-MMLSAY) for medical reimbursement of government employees, pensioners, and their dependents through an online IT portal will continue in FY 2024–25. The scheme will decrease the processing time for medical reimbursement, ensuring a smooth and seamless reimbursement process.

The Minister also announced that all medical colleges in Assam will implement the Village and Community Outreach Programme under the AA-MMJAY for MBBS students to learn communication skills along with various cultural factors affecting community health. Under this programme, each MBBS student will adopt a family, delving into the intricacies of community health and gaining insights into diverse cultural aspects impacting well-being. If implemented properly with a hands-on approach, the scheme will enrich the education of MBBS students, and they will develop a profound understanding of the health needs specific to the local community.

A school health programme was proposed in the budget under the AA-MMJAY to ensure good health, nutrition, and a high standard of living for schoolchildren. The programme has been designed to provide health cards to schoolchildren to record their health reports and correct health problems if noted. However, schoolchildren will be provided with social, behavioural, and reproductive knowledge. The programme is excellent if implemented properly. Children are the supreme asset of our state. The future of our state rests on healthy, protected, educated, and well-developed children. Hence, proper implementation of this programme is necessary.

An announcement to include families with members suffering from cerebral palsy, thalassemia, haemophilia, leprosy, or autism spectrum disorders in the government’s expanded welfare programme, Orunodoi 2.0, will definitely improve the health status of these new beneficiaries. They will receive Rs 1,250 each on the 10th day of every month directly in their bank accounts. The proposed mission will effectively reduce out-of-pocket expenditures for these families and prevent them from entering debt traps due to treatment expenditures.

The Budget announcement to continue the schemes such as Chief Minister’s Free Diagnostics Programme, Free Essential Drugs Services in Government Hospitals, Swasthya Sewa Utsav, Universal Immunisation Programme, Polio eradication programme,  Intensified Mission Indradhanush 5.0 (IMI5.0) Campaign, Tele Mental Health Assistance and Networking Across States (Tele-MANAS) initiative, Pradhan Mantri National Dialysis Programme (PMNDP), free treatment for children having congenital heart diseases, providing Rs 15,000 under the Wage Compensation Scheme for pregnant women of tea gardens and piped drinking water connection to every household in the tea garden colonies under Jal Jeevan Mission in FY 2024-25 are definitely good moves by the Government. The schemes will continue to improve the health status of the beneficiaries. The Wage Compensation Scheme for pregnant women in tea gardens will help them look after themselves and their unborn babies better without compromising the livelihood of their families. This incentive will not just ensure nutritional support for the tea community’s pregnant mothers and infants but also help in reducing maternal mortality and infant mortality in the community.

The Finance Minister did not make any announcements to establish more new medical colleges this time, like in previous years’ budgets. Instead, she has given priority to the early completion of the ongoing construction of already announced new medical colleges and the upgrading of existing state medical colleges in terms of infrastructure development, recruitment of expert manpower, and installation of high-end equipment. The Minister proposed a scheme within ‘Amrit Kalor Amrit Pidi Prakalpa’ for the infrastructure development of Gauhati Medical College and Hospital (GMCH) with a total outlay of Rs 3,250 crore over a period of three years under the Astadash Mukutar Unnoyonee Mala. It will upgrade and strengthen the healthcare services at GMCH. The Minister announced the setting up of in-vitro fertilisation (IVF) centres in Assam Medical College, Dibrugarh (AMC), and Silchar Medical College (SMC). It will definitely help lots of infertile couples in the upper Assam and Barak valleys. Also, the proposed graduate courses in Allied Health Sciences in Guwahati and B Pharm courses in SMC and GMC will reduce the skill gap by producing more skilled paramedics and pharmacy graduates.

The budget is a promising one in the health sector and is expected to provide enhanced coverage of preventive, promotional, curative, and quality healthcare services to the people of Assam. The proposals announced will be of tremendous help to the people if they are implemented in letter and spirit. I hope the budget will reduce out-of-pocket health expenditures for the common people. However, there was a dire need to increase the health allocation. This amount of allocation doesn’t seem enough to tide over the current challenges of upgrading infrastructure and providing accessibility and affordability to quality healthcare in the state. The government should focus more on primary healthcare investment and increase public spending in the health sector to make quality health services affordable for all.