New Delhi: The planning commission on Friday said expansion of healthcare will be one of its top priorities during the 12th five-year plan (2012-17) and it aims to increase spending in the sector to 2.5% of the GDP from around 1% at present by the end of the period.
“In the 12th plan, we hope that we will be able to increase the percentage of both central and state government spending (on health) as a percentage of GDP somewhere up to 2.5% from a little over 1%,” planning commission deputy chairman Montek Singh Ahluwalia told reporters on the sidelines of a Ficci seminar.
The healthcare sector, he said, was a focus area in the ongoing 11th plan as well and the effort will continue in the 12th plan.
“We tried to make a start in the 11th plan, but it has to continue in the 12th plan. India spends too little on the public sector in health,” Ahluwalia said.
In its approach paper to the 12th plan, which was approved by the full planning commission headed by Prime Minister Manmohan Singh last month, the plan panel had emphasised on increased spending in social sectors, including health and education.
It had also called for greater public-private partnership in the sector.
Ahluwalia, while addressing the seminar, said the Srinath Reddy Committee on Healthcare will submit its report by the end of this month.
The high-level expert group was set up by the planning commission in 2010 to examine the prospects for a universal health cover and to develop a blueprint and investment plan for meeting the human resource requirement to achieve the objective of health insurance for all by 2020.
Ahluwalia termed current spending on healthcare as “skewed”, with the government contributing only a small portion.
He also said that though the private sector is present in a big way in the health segment, there is a big difference in the quality of service provided by non-state actors.
“In the private sector, there is incredible variety. On the one end, we have some very high-end hospitals and treatment facilities of global standards, which, however, only a fraction of the population can afford and on the other hand, we have hospitals, which are of poor standard,” Ahluwalia said.
“We have some of the best doctors in the world and also quacks,” the planning commission deputy chairman added.
He also expressed concern over the low rate of health insurance penetration, even among organised sector employees, and said employers need to make efforts for bringing their staff under appropriate covers.
“Many people can afford health insurance but they don’t go for it. There is a belief on risk-pooling by family and friends in case of any emergency. But, like other social norms, this is also breaking up in India along with the rest of the world,“ Ahluwalia said.
He said besides the lack of money, the scarcity of qualified healthcare specialists is also a worry in India.
“If you want to do as well as China -- and healthcare in China has deteriorated in last 5-10 years as they more or less dismantled their public health system -- then India needs twice the personnel it has got... We have a huge human resource shortage,” Ahluwalia said.
He cited a study done by the planning commission in collaboration with the Registrar General of Census.
“50% of the people who in the Census (2001) declared themselves as doctors and who are included in the per capita doctor calculation did not have an educational degree beyond secondary school. So a lot of people who are calling themselves doctors are actually not medical graduates,” he said.
According to Ahluwalia, programmes like the National Rural Health Mission have achieved success, but there is a need to replicate the model in urban areas.
He said the Rashtriya Swasthya Bima Yojana (RSBY), which provides totally subsidised health insurance to BPL category families, has been a major success and efforts are on to make rope in all the 370 million people living below the official poverty line under it.
“We are looking at what we can do. A controversial area is the PPP model... There is a lot of resistance to that in healthcare, including from states,” he said.
Ahluwalia also said that in many cases of PPP, the venture fails because of the disparate objectives of the public players and private firms.