The state budget for Rajasthan for the fiscal year 2021-22 announced by the Chief Minister, Sh. Ashok Gehlot, on 24th February 2021 had a range of announcements related to health but fell short in allocating enough budgets to meet those promises. The Chief Minister mentioned about implementing ‘Rajasthan Model of Public Health’ but did not explain what it really entails leaving everyone clueless. He also mentioned of bringing about the much awaited ‘Right to Health Bill’ which is definitely a welcome announcement but again he neither made any budget provision for it nor did he suggest any timeline for its launch. He discussed how the public health insurance scheme (Mahatma Gandhi Rajasthan Swasthya Bima Yojana) will be expanded to cover the entire population of the state next year onwards which would require the govt. to spend about Rs. 3500 crores, but this is something for the next year and we will have to wait to see when this actually happens.
While there was a major push laid by the CM on expanding primary health infrastructure which is also reflected in the budget allocations for Sub health centre (increased from 105.90 last year to 157.08 crores this year), PHCs (increased from 309.84 crores last year to Rs. 437.11 crore this year) and CHCs (increased from 343.14 crores last year to 535.61 crores this year), yet what’s appalling is that the budget for some of the major health schemes and programs to be executed from these facilities have not been raised to the same extent.
The announcement to widen the scope of Mukhya Mantri Nishulk Janch Yojana (free diagnostic scheme) and to increase the number of free diagnostic services in the PHCs from 15 to 61, in CHCs from 37 to 95 and in District Hospitals from 66 to 133 is quite appreciable. However, this would mean that the supplies of diagnostic kits, reagents, equipments and their maintenance along with ensuring the availability of lab technicians especially at the primary level of care will have to be paid more attention to and robust systems will have to be put into place for delivery of seamless services. This would all call for additional finances. However, in the current budget there’s no extra allocation for the scheme in comparison to the last fiscal. The budget has on the contrary been slashed by Rs. 69.92 crores from Rs. 220.26 crores announced last year to Rs. 150.34 crores this year !! It is hence quite questionable as in how the govt. would be able to bring about the said expansion of the scheme with such meager resources.
The budget for National Health Mission (NHM) has seen a negligible increase from Rs. 1629.43 crores last financial year to Rs. 1882.00 allocated for this fiscal. If we break down the NHM budget further, this year the allocation for National Rural Health Mission (NRHM) is Rs. 1687 crores which is a meager rise from Rs. 1438.72 allocated last year. Similarly, the budget for National Urban Health Mission (NUHM) has seen a negligible increase from 61.71 crores last year to 65 crores this financial year. The budget for ambulance services under NHM has remained almost the same at Rs. 130 crores this year and Rs.129 crores which was allocated last fiscal. The allocation for Mukhya Mantri Nishulk Dawa Yojana (free medicines scheme) has seen an increase from Rs. 619.29 crores last year to Rs. 701.19 this year. The budget for public health insurance scheme, Mahatma Gandhi Rajasthan Swasthya Bima Yojana (MGRSBY), has been increased from 1241.51 last year to Rs. 1463.40 this fiscal.
The government this fiscal allocated a total of around Rs. 16269.35 crores for medical, health and family welfare, as compared to about Rs. 14700 crores last year, which is an increase of about Rs. 1569 crores. This is an almost negligible amount if we take inflation into account. If the Rajasthan Government really wants to bring about Right to Health Act and aims to implement it in its true spirit it should have strived for a more compelling health budget.