The government’s public health expenditure has not crossed 4 percent of the total budget outlayeven once in the last five years, contrary to experts’ opinion that it should be a minimum of 5 percent. Last week’s budget by chief minister HD Kumaraswamy too restricted its health outlay to 4 percent, which, according to experts, betrays lack of focus on scaling up public health infrastructure. The last time Karnataka earmarked 5 percent of the budget outlay for health was in 2014 when the allocation stood at Rs 3141 crore. It was 4 percent during the next two years and plummeted to 3 percent in 2017 when the outlay was Rs 7122 crore. The allocation was back to 4 percent over the next two years. “Moneywise there is a hike compared to the last five years. But health expenses too have gone up. The budget over the years has ignored key aspects of creating fully equipped trauma-care centers across the state. That’s why accident cases from far- off Belagavi and Ballari end up coming to Nimhans. There is a need to set up Nimhans- like institutions in every district and make right allocation in the budget for the same,” a top official in the government said on condition of anonymity. The budget lacks comprehensive planning for public health delivery, said Dr NK Venkataramana, founder chairman and chief neurosurgeon, Brains Hospital.
“Earmarking merely 4 percent of the state’s total expenditure for health is too low and this only shows the lack of right focus. The budget should focus on creating a basic platform inclusive of all specialties. This year, the health budget is focused more on cancer and cardiology, while other major disease burdens like neuro have not been given due attention. The budget allocation for health does not seem to be balanced, with lack of uniform allocation for different specialties,” he adds. Dr Venkataramana also thought that the need of the hour is to call for a pre-budget meeting with leading health professionals from both private and government sectors. Dr Alexander Thomas, president, Association of Healthcare Providers in India (AHPI), said there is much scope for improvement at the primary healthcare level. “Karnataka is better compared to some other states, but there is lot more to improve. This budget has focused on establishment of Diplomate in National Board (DNB) centers at 11 district and taluk hospitals at a cost of Rs 2 crore with a view to tackle shortage of specialists. This is a good move to increase the number of specialists in government sector and to retain talent,” he said. According to Dr Thomas, state budgets are yet to incorporate sustainable development goals which mandate public health sector plans. – TOI