A positive Interim Union Budget 2024, say stakeholders

Finance Minister Nirmala Sitharaman presented the Union Budget 2024 on February 1, an interim budget, just ahead of the Lok Sabha elections. The full-fledged budget will be presented by the new government that comes to power after the elections.

Post Budget Reactions

“I am happy with the Interim Union Budget 2024, presented by the Finance Minister under the esteemed leadership of our Hon’ble Prime Minister.

Firstly, we must bear in mind that education and healthcare are fundamental rights and I am glad that these cornerstones of growth have been addressed. With the rise in the disease burden globally and the acute shortage of trained health manpower, India is well positioned to ‘Heal the World’, by harnessing its youth to become highly skilled manpower. Therefore, I welcome the strategy to augment medical education by capitalizing on existing hospital infrastructures. In doing so, we are not only paving the way for an increased number of medical and nursing colleges, but also enhancing the capacity for para-medical training. Further, with the emphasis on skilling, India will emerge as a beacon for global workforce development, bringing financial stability to families and attracting foreign exchange.

Secondly, unless India heightens its focus on innovation and research, as a nation, we will not be able to overcome the looming disease burden, e.g., the alarming increase in AMR, undetected heart disease and cancers. Innovative solutions to make healthcare accessible and affordable is truly the need of the hour. Hence, the creation of a corpus of ₹1 lakh crore to provide 50-year loans at low or nil interest rates to encourage the private sector to scale up research and innovate in sunrise sectors is commendable.

Finally, with women-led development as the way forward for India, as championed by the Hon’ble Prime Minister, the numerous initiatives including integration of maternal and child care programs, extending the cover of Ayushman Bharat scheme for ASHA and Anganwadi workers, the Saksham Anganwadi and Poshan 2.0′ initiative aimed at improving nutrition, and thrust to inoculate young girls against cervical cancer, demonstrate our unwavering commitment to the well-being of India’s daughters.

However, I remain concerned over the growing threat of non-communicable diseases (NCDs) and urge the government to consider increasing the tax exemption for preventive healthcare.

At large though, the Union Budget 2024 is clearly a clarion call to action, rallying India towards a radiant future.” Dr Prathap C. Reddy, Chairman of Apollo Hospitals.

“It is heartening to see that the Interim Union Budget focuses on the upliftment of the masses through a specific focus on the poor, farmers, youth, and women. The allocation of Rs. 1-lakh crore with 50-year interest-free loans will encourage the start-up culture that India is now thriving upon, encouraging the youth of today to become entrepreneurs and focus on their growth as well growth of the nation.

In healthcare we were hoping to see an increase in the GDP allocation of a minimum 5% for the sector, hopefully, this will be addressed in the complete Budget to be announced in July this year, under the new government. We are glad that the government is considering to add more hospitals in all districts in the country, which is essential to meet the rising demand. We would recommend focusing on public-private partnerships (PPP) to address this. With all maternal and child healthcare to be brought under one- scheme, this will be essential.

It is promising to hear that the government plans to open more medical colleges alongside existing hospital infrastructure. There is now an urgent need for comprehensive reform of medical education, to ensure that the medical professionals of tomorrow are trained in the latest medicine and techniques, like their Western counterparts.

The strong impetus on immunization of children under Mission Indradhanush and young girls for cervical cancer will go a long way in strengthening preventive care measures in the country and reduce the burden from communicable and non-communicable diseases”. Dr Azad Moopen, Founder and Chairman, Aster DM Healthcare.

“Recognizing the need for providing Universal Health Care, the interim Union Budget 2024-25 extended the Ayushman Bharat scheme to cover nearly over three million ASHAs and Anganwadi workers. In a noteworthy move, the budget also unveiled a roadmap for addressing long-term capacity building by investing in healthcare infrastructure, and converting existing hospitals into medical and nursing colleges. This will go a long way towards addressing the skill shortage in the healthcare industry and create millions of jobs. These initiatives align with our commitment to provide comprehensive health coverage across all our hospitals”. Viren Shetty, Executive Vice Chairman of Narayana Health.

“I appreciate the government’s push for a comprehensive health development for women in this budget. The emphasis on promoting cervical cancer vaccination for girls aged 9-14 is a pivotal step towards raising awareness and taking preventive measures to reduce cervical cancer burden in India. The budget announced other initiatives such as comprehensive programs for maternal and child healthcare schemes, mission to eliminate sickle cell anaemia by 2047, and setting up more medical colleges by utilizing existing hospitals. These steps will help in improving overall national health indicators in future. It is also important to recognize the significance of universal healthcare in ensuring equitable access to quality healthcare services for all citizens. However, I strongly recommend an increased allocation to the healthcare sector in the upcoming post-election budget”. Raj Gore, CEO, Healthcare Global Enterprises Ltd. (HCG).

“India is now the most populous country in the world with 66% of its population below the age of 35yrs. India is aiming at a GDP of $ 30 trillion in 2047, at the current rate of population growth that would translate to 1.65bn people and the country must grow at CAGR of 8% during this timeframe. This is a powerful vision for the country and is now being echoed at most events around the future growth of the Indian economy. As per Indian Union Budget estimates for financial year 2023, the health sector in India was allocated 2.26 percent of the total union budget expenditure. This was a decrease from 2022’s revised estimates of 2.35 percent. In Budget 2023 health sector was allocated ₹89,155 crore a hike of around 13 per cent as against ₹79,145 crore allocated in 2022.Since 2020 the share of the health sector as a percentage of total union budget expenditure has continuously decreased. While the interim budget may only be directional but the key question from the sector is whether the Govt considers healthcare as a priority sector which is a driver of GDP growth or a social enabler. A robust healthcare system drives GDP growth in the presence of adequate investments and a conducive environment by not only acting as a productivity and employment generator, but also as a sector that attracts FDI and provides opportunities for innovation and entrepreneurship. A better healthcare ecosystem is essential for achieving India’s vision of being a developed nation and it needs a paradigm shift and exponential change in budgetary outlay. Thus the finance minister should accord priority sector status to healthcare and increase public healthcare spending to 2.5% of GDP in budget 2024″. Vishal Bali, Executive Chairman, Asia Healthcare Holdings.

“We welcome the interim budget 2024 for the healthcare sector. These initiatives underscore the government’s commitment to promoting preventive healthcare measures, enhancing access to medical services, and strengthening the healthcare infrastructure across the nation.

The decision to encourage vaccination against cervical cancer among girls aged 9-14 years is a significant step towards combating the disease and safeguarding the health of our future generations. Furthermore, extending health cover under the Ayushman Bharat scheme to ASHA and Anganwadi workers recognizes their invaluable contribution to community healthcare and ensures their well-being.

The government’s plan to establish more medical colleges by utilizing existing hospital infrastructure is praiseworthy and will help address the shortage of healthcare professionals in the country. The consolidation of maternal and child healthcare schemes into a comprehensive programme will streamline service delivery and improve healthcare outcomes for women and children.

We are pleased to note the emphasis on upgrading Anganwadi centres under ‘Saksham Anganwadi’ and Poshan 2.0, which aligns with our commitment to promoting early childhood care and development. The introduction of the ‘U-Win’ platform for managing immunization reflects a concerted effort to strengthen vaccination programs and prevent the spread of infectious diseases.

The announcement regarding the establishment of new nursing colleges co-located with medical colleges is a positive development that will bolster the nursing workforce and enhance healthcare services across the country. Additionally, the mission to eliminate sickle cell anaemia by 2047 underscores the government’s proactive approach towards addressing prevalent health challenges and improving public health outcomes.

The MedTech sector is willing to collaborate with the government and healthcare stakeholders to support the implementation of these initiatives and contribute to building a healthier and more resilient India”. Himanshu Baid, Managing Director, Poly Medicure Ltd.

Rajiv Nath on behalf of the Indian Medical Devices Industry has praised the interim Union Budget 2024 as a comprehensive continuity of the earlier roadmap for India’s ‘Atmanirbhar Bharat’ during the Amrit Kaal but Nath also pointed out that we await the fine print to study if Department of Pharmaceuticals recommendations have been addressed as seemingly the budget has fallen short of expectations for addressing the rising import graph of medical devices and soaring import bills worth over Rs 63,200 crore ($8 billion).

Nath commended the government’s focus on ‘Nation First’, accelerated infrastructure development, research and development, skill development, sustainability, digitalization, innovation, low-interest rate financing for research and development in the pharma and tech sector, and youth and women empowerment. Specifically, Nath applauded the announcements regarding the establishment of medical colleges and the expansion of preventive vaccination and Ayushman Bharat to ASHA and Aganwadi workers.

Nath also welcomed the port connectivity corridors and high traffic density corridors through PM Gati Shakti and the focus on Northeastern states as it will improve supply chain management and infrastructure.

Nath’s comments suggest that the domestic medical technology industry may benefit from the budget’s focus on green growth, youth and women empowerment, and farmer centricity, which are aligned with Vision 2047, and the principle of reform, perform, and transform will ensure that India has a modular economic structure for all sections of business and society during the Kartavya Kal, enabling India to address global challenges and sustain development.

We do hope to see in the fine print action on the assurances from various government departments to implement the National Medical Devices Policy 2023 and make it attractive and profitable to make in India rather than import into India.

The Indian Medical Devices Industry’s expectations were:

1. Increase in Custom Duty to a nominal 10%-15% Duty and a predictable tariff policy
2. Correction of Inverted Duty by levying Health Cess of 5% custom duty on balance Medical Devices (this was not earlier applied to all HS Codes). Cess is used for Ayushman Bharat.
3. Trade Margin capping by monitoring MRP of Imports (if over 10 – 20 times of CIF)
4. Income Tax benefits for project investments in Medical Devices Manufacturing.

As per GTRI report of August 2023, the Indian medical devices industry can expand from $12 billion to $50 billion by 2030, reducing import reliance to 35% and boosting exports to $18 billion. Supporting policies are needed so that Indian Medical Devices Industry can make quality healthcare accessible and affordable for the common masses, aim to place India among the top five medical devices manufacturing hubs worldwide and help end the 80-85 per cent import dependence forced upon us and an ever-increasing import bill of over 63,200 Crore.

We can only be hopeful that the fine print of the Union Budget would possibly act upon our recommendations, said an ever optimistic Rajiv Nath who has been persevering to work with the Government in making India as leading manufacturing global hub. Rajiv Nath, Forum Coordinator, Association of Indian Medical Device Industry (AiMeD).

“It is imperative to strengthen healthcare infrastructure in India to manage the growing demand. In its journey of catering to the present and being prepared for future needs, the budget emphasizes on better access to healthcare.

In the fiscal year 2024-25 budget, the government revealed an ambitious plan for strengthening the healthcare sector in India. The emphasis on establishing medical colleges within existing hospital infrastructures is game-changing, resulting in a significant rise of healthcare professionals while expanding and enhancing healthcare accessibility across the country.

A notable step was taken towards cervical cancer awareness, encouraging vaccination for young girls, further augmenting our efforts in enhancing the cancer care continuum, and closing the care gap, thereby creating a future without fear of cancer. Extending healthcare coverage under Ayushman Bharat is an inclusive strategy that ensures quality healthcare for everyone, everywhere.

The budget also embraces new technology and promotes digital transformation, setting the path for economic potential and cost-effective, high-quality healthcare services across India. Fostering growth in the MedTech sector while emphasizing on achieving its vision of Atmanirbhar Bharat.

Overall, this budget aims to empower the healthcare sector for a healthier, stronger India.” Hariharan Subramanian, Managing Director, Siemens Healthcare Private Limited.

“Finance Minister, Nirmala Sitharaman presented the interim budget for 2024, outlining a strategic vision for healthy economic development. In her address, the Finance Minister emphasized India’s resilience in overcoming the challenges posed by the Covid-19 pandemic and highlighted the establishment of foundations for a self-reliant nation.

Notable initiatives for the healthcare sector include a significant focus on maternal and child healthcare through the introduction of Saksham Anganwadi and Poshan 2.0. Cutting-edge technologies like Newborn Screening, provided by Trivitron Healthcare, will play a crucial role in early health issue detection in newborns. Proposing the integration of newborn screening as a national program accessible in every hospital and maternity centre across the nation underscores the commitment to securing childhood and fostering holistic development. Additionally, the Finance Minister also announced a mission to eradicate sickle cell anemia by 2047, involving the screening of seven crore people, marking a transformative step in the diagnostic industry.

Addressing public health concerns, the government advocates for the vaccination of girls aged 9-14 against cervical cancer. This initiative, focusing on awareness, early HPV screening, and vaccination, aims to empower females to enhance their reproductive health and protect against the consequences of cervical cancer.

Recognizing the scarcity of medical professionals, the government plans to construct more medical hospitals and colleges, contributing to an improved healthcare landscape in India.

The 2024 budget reflects a strategic approach to healthcare, prioritizing maternal and child well-being, disease prevention, and the overall enhancement of the healthcare infrastructure. While specific measures for the MedTech industry were not detailed, Trivitron Healthcare remains committed to delivering best healthcare solutions and investing in research and development to transform and evolve the MedTech sector”.  Chandra Ganjoo, Group Chief Executive Officer, Trivitron Healthcare.

“Given the Government’s perspective of keeping the interim budget an on-account vote, the Finance Minister did not dwell into any specifics, leaving the changes for the full budget post elections. While she spoke of the past performance, as far as the Health Science Sector is concerned, there was some perspectives on things to come in future.

There was a commitment to focus on setting up medical colleges in existing hospitals, focus on women healthcare with encouragement of cervical cancer vaccination for young girls, maternal and childcare related schemes for improved nutrition delivery, early childhood care and development etc. The focus on research and innovation was given a further boost by announcing a one lakh crore corpus for providing interest free loan for a long duration for research and innovation for private sector. Also the cover under Ayushman Bharat Scheme has been extended to cover ASHA workers, Anganwadi workers and helpers.

On the tax front, the expectation of extension of concessional tax regime of 15% for manufacturing facilities beyond 31 March 2024 remained unmet.

While we will look at the full budget in July for more details, what is also positive is that there is increase in outlay on Health for FY 2024-25 versus the revised estimates for FY 2023-24. So overall the budget continues the path for growth of healthcare and access in India.” Hitesh Sharma, Partner, Life Sciences Leader – Tax, EY India.

“The Interim Budget 2024–25, with an allocation of Rs. 90,171 crore for health, aims to improve access to healthcare services and infrastructure in India. The government’s announcement to establish more medical colleges by utilizing existing hospital infrastructure will address manpower shortages while also increasing access to healthcare education. Implementation will be critical here and the financial and logistics issues which some of the private sector hospitals may face, needs to be looked into. More colleges will require more teachers, which needs to be managed and also set-up robust processes to ensure education quality. We look forward to working with the committee to form recommendations and guidelines for the implementation of this plan. However, the budget also has not addressed the issue of nursing shortage and migration of nurses from India. We also await action on our demands on tax enhancement for skill enhancement initiatives and DNB programs undertaken by private hospitals.

Encouraging preventive cervical cancer vaccination for young girls aged 9 to 14 is a positive step toward reducing cases of the third most common cancer in India. This move will also help to renew the focus on preventive healthcare in India, but its success will be dependent on effective implementation.

The announcement of extending health coverage under the Ayushman Bharat scheme to all ASHA and Anganwadi have been better if more families were covered under the scheme to achieve universal health coverage.

Bringing maternal and child healthcare schemes under one umbrella and upgrading anganwadi centers will result in efficient resource allocation and improve outcomes in maternal and child healthcare.

Allocating a substantial corpus, accompanied by a 50-year interest-free loan for private sector research and development, positions India as a global healthcare innovation leader. Offering attractive interest rates incentivizes the private sector to contribute meaningfully.

We look forward to the budget’s key announcements being implemented, as well as an increase in health expenditure as a percentage of GDP. It would have been desirable if the government had implemented our long standing demand of either zero-rating GST for the health care sector with input tax credit or brought the healthcare sector under 5% GST with input tax credit to help create an attractive environment for domestic production of medical equipment, devices, and consumables. Also, to ensure support to the Charitable Trust hospitals, to continue serving quality healthcare for all, the inconsistencies in tax exemption scheme should be resolved, and the approval-based category of exemption under Section 10(23C) be merged with the tax regime under Sections 11 to 13.3.

Synergy between government initiatives and operational objectives is paramount to fortify and enhance the Indian healthcare ecosystem, portraying a resilient and healthier India”. Gautam Khanna, CEO P.D. Hinduja Hospital and President Association of Hospitals, Mumbai.

“This year’s Union Budget is a testament to government’s dedication to improving public health in the country. The focus on establishing more medical colleges will help in utilising existing hospital infrastructure and creating quality professionals in healthcare. To enable wider access of preventive care and health cover, there is increased focus on vaccination for cervical cancer and extending health cover under the Ayushman Bharat scheme to ASHA and Anganwadi workers.

The consolidation of maternal and child healthcare schemes into a comprehensive program, alongside the expedited upgradation of Anganwadi centers and the rollout of the U-Win platform, reflects a holistic approach towards ensuring the well-being of women and children. These measures, coupled with the intensified efforts of Mission Indradhanush, signify a progressive leap towards a healthier and more resilient India. Mission Indradhanush is a critical health mission of the Government of India, aimed at achieving more than 90% full immunization coverage for children.

The mission’s goal complements the comprehensive healthcare approach outlined in Budget 2024, reflecting the government’s commitment to ensuring the well-being of all citizens through proactive healthcare measures.

The absence of specific allocations for AI in healthcare in this year’s budget, despite the previous focus on setting up a Center of Excellence in AI for health, overlooks the potential of AI in diagnostics and medical advancements”.  Abrarali Dalal, Director & CEO, Sahyadri Hospitals Pvt Ltd.

“We appreciate the government’s decision to extend healthcare benefits to ASHA and Anganwadi workers under the Ayushman Bharat scheme. This expansion will extend healthcare services not only to frontline healthcare workers but also to the underprivileged communities.

The initiative to establish additional medical colleges using existing infrastructure will address the shortage of healthcare professionals, promising better healthcare delivery and patient outcomes.

Furthermore, vaccinating girls aged 9-14 years against cervical cancer is commendable, prioritizing prevention over prevention to improve public health.

However, we are disappointed with the absence of GST reductions on essential medicines and tax concessions on generic pharmaceuticals in the budget. Affordable healthcare is vital, and these measures reduce the burden on patients while encouraging innovation.

We urge the government to rethink these aspects to ensure equitable access to essential medicines.

Overall, these budget initiatives underline the government’s commitment to healthcare. We look forward to collaborating to ensure their successful implementation to benefit all citizens”. Dr Gayatri Kamineni, COO, Kamineni Hospitals.

“Well-structured and a forward looking budget towards Health Infrastructure and focus on a holistic approach to health is seen as a witness of the commitment to building stronger health systems in the country. The allocation for the National Digital Health Mission allocation fund has increased from ₹140 crore to ₹341.02 crore is an admiring move but it requires a huge fund for health information technology (IT), telemedicine and telehealth. Telemedicine use is expanding across the vast array of neurologic disorders. Tele-neurology is no longer a vision, but a reality precipitated by the pandemic, the needs and aspirations of the Indian population. Follow-up- care of patients, epidemiological studies of various neurological chronic illnesses and their audit will become realities cutting down on costs and time to access quality neurological care using telemedicine has proven during the pandemic era, so the National Digital Health mission requires more funds. The pandemic has brought the subject of mental health to the forefront. For this, the National Tele Mental Health Programme, the budget allocation has been increased from ₹121 crore to ₹133.73 crore is a really appreciative push”. Dr Deepak Aiwale – Chairman & Director of Solaris Hospital.

“In India the doctor to patient ratio is below the recommended levels by international organisations such as World Health Organisation (WHO). The same is concentrated in metros and urban cities resulting in the lack of access to quality healthcare for the people of Tier 2/3 cities and villages requiring them to travel long distances to avail basic healthcare needs which in turn increases the overall healthcare expenditures.

Addressing this disparity is vital for enhancing the overall healthcare accessibility in India. The recent announcement in the budget today by our Finance Minister regarding strengthening of the medical colleges network by utilizing the existing hospital infrastructure is a strategic and welcoming decision.

This initiative promises to bridge the current gap in medical infrastructure by fostering a synergistic relationship between medical education and healthcare delivery. This approach, leveraging shared resources, is beneficial for both sectors and marks a significant step towards meeting the healthcare needs of the Indian population”. Dr Vishal Arora, Chief of Business Transformation & Operational Excellence, Artemis Hospitals.

“The decision to provide free HPV vaccines for girls between 9-14 years in the budget is a critical step in promoting the health and well-being of young girls in our community. By making these vaccines more accessible, we are taking a proactive approach to preventing HPV-related health issues in the future. This decision not only benefits the individuals receiving the vaccine but also serves to protect the broader population from the spread of HPV. Investing in the health of our young girls is an investment in the future of our society, as the budget focuses on poor, women and youth who are the pillars of our country”.  Behram Khodaiji, CEO of Ruby Hall Clinic.

“The paramount importance lies in capacity building within the realm of public health. A robust focus, particularly through the creation of more medical colleges in the country, is crucial. Assessing the practicality of integrating various healthcare programs and ensuring seamless implementation underscores the critical need for adequate resources. While acknowledging the positive aspects of the government’s initiatives, a cautious approach is urged to avoid disruptions in ongoing healthcare efforts. Integrating several schemes into one flagship program may create a gap in delivery systems. From a strategic perspective, the creation of additional medical colleges emerges as a key component in enhancing the overall capacity of the healthcare system, aligning with a future-oriented vision for a strengthened and resilient health infrastructure”. Sugandh Ahluwalia, Chief Strategy Officer, Indian Spinal Injuries Centre.

“The integration of nutrition delivery, early childhood care schemes, and other health programs into a comprehensive program is a holistic approach. We welcome such a move but stress the need for effective coordination among different departments to ensure seamless service delivery. Interdepartmental collaboration will be key to success. The government’s proactive approach to addressing the healthcare sector’s needs is commendable. Going forward, we need to have such innovative policies that not only strengthen the sector but also ensure affordable and quality healthcare for the 1.4 billion citizens”. Dr Anand Bansal, Medical Director, of Sri Balaji Action Medical Institute.

“Union Budget has given a boost to research and innovations with a corpus of Rs 1 lakh crore for long-term financing and refinancing. This is a welcome step. However, the government has not touched import duties in the interim provisions, we can expect this in the full budget by the next government. The tax rationalization would be necessary to gear up for an aspirational $50 billion MedTech economy. The heavy import duties on medical equipment affect operational costs. The Med Tech industry was expecting a reduction of import duties, creating a win-win situation for both manufacturers and large hospitals”. Prashant Arer, India Head, Enbio Group AG.

“Having worked across diverse healthcare systems, I can see that India is taking important steps towards building the next phase of its healthcare eco-system with a shift towards more affordable, data driven and accessible care. While there are still gaps in certain areas, the Union Budget’s dedicated focus on consolidating maternal and child health schemes reflects a wise approach to streamlining care delivery. Additionally, the announcement encouraging vaccination for girls to prevent cervical cancer is a proactive step towards prioritising preventive healthcare for women. Medix Global remains dedicated to collaborative efforts for a future defined by personalised care, inclusivity, and prevention, and we are confident that these initiatives will have a positive impact on healthcare delivery”. Sigal Atzmon, CEO & Founder, Medix Global.

Key takeaways for the healthcare sector – Interim Union Budget 2024.

MB Bureau