Health spending cuts in India will lead to continued inadequate services: Experts

Washington: A new study has suggested that spending cuts in India will hurt already inadequate health services.

Experts argued that Deep cuts in health spending by the Indian government will lead to continued inadequate health services and delays in achieving universal access to healthcare.

The Bharatiya Janata Party, elected to power in 2014, promised to increase access to health, improve quality and lower costs, but in 2014-2015, the central government spent much less than it had budgeted for 20 percent less in current spending and as much as 50 percent less in capital spending.

Jayati Ghosh from Jawaharlal Nehru University wrote that as a result the government has not just belied these promises; it has done precisely the opposite of them. For example, the National Health Mission (NHM), which supports a network of accredited social health activists (ASHAs) to provide basic services, is in a mess following a 20 percent cut in funding.

The Integrated Child Development Services (ICDS) scheme, which provides nutrition and other services to pregnant and lactating mothers and infants, received around 10 percent less than expected. In 2016, both programmes will face even sharper cuts: the ICDS will have funding cut by more than half and the NHM by a further 17 percent.

The government explained that the cuts were required to meet the fiscal deficit target since tax collections were lower than expected, adding that individual states should take more responsibility for health spending because they will now receive a larger share of tax revenues upon the award of the latest Finance Commission.

Total health spending of the central government will be almost at the same level as two years ago, which is "indefensible" and will likely "throw the entire government health sector into disarray," she argues, adding private hospitals will continue to flourish for India's wealthy customers and medical tourists from abroad, but in what is still a largely poor country, most of the population will continue to experience inadequate public health.

Massive cuts imply the persistence of huge shortfalls including of healthcare staff, such as doctors, surgeons, and nurses, and insufficient physical infrastructure to support health services. Ghosh notes that India has among the worst ratio of clinics and hospital beds per head of population in the world.

In a linked article, Leena Menghaney, a lawyer working on public health law and policy in New Delhi, writes that she has seen huge insufficiencies in India's HIV programme following the cutbacks.

The study appears in The BMJ.