New Delhi, Sep 14 (IANS) Admitting that the government expenditure on healthcare has been less than desired, Health Minister Ghulam Nabi Azad Monday said underfunding by the public sector over the years has made it expensive and less accessible.
“Years of prolonged underfunding of the public health system and dependence on the private sector has pushed the cost of healthcare and also affected access,” Azad said while addressing a conference organised by the industry lobby Federation of Indian Chambers of Commerce and Industry (FICCI) here.

“The issues of inaccessibility, inadequate infrastructure and need for far more human resource for health in the rural areas, however, remain huge challenges. It is this area that the private sector can play a crucial role in augmenting and supplementing the efforts of the government,” he added.

To buttress his argument, the minister said the National Sample Survey data has revealed that the annual hospitalisation cost by a person is much more in private hospitals than in government hospitals.

“In rural areas the (average) hospitalisation cost is Rs.7,408, which is higher than the hospitalisation cost in government hospitals (which is Rs.3,238). In urban areas it is Rs.11,553 in private hospital and Rs.3,877 in government hospitals as hospitalisation cost,” the minister said.

Azad said that between 1986 and 1996, the number of people who did not seek health care due to poverty increased from 15 to 24 percent in rural areas and from 10 to 21 percent in the urban areas.

The minister said his government was trying to increase the health care expenditure.

“We have increased the health care expenditure to 1.4 percent of GDP in 2008-09 as against a dismal 0.97 percent in 1999-2000.”

The minister said the central government supports the states in reforming the state supported public health delivery system in order to achieve the Millennium Development Goals (MDGs) and combat communicable as well as non-communicable diseases effectively.

“However still, expenditure in health must go up considerably. The UPA government has tried to do so over the last five years, though much more remains to be done. Health is a state subject and state governments also need to raise public expenditure on health. It is only through a partnership of the central and the state governments that the objective of 2-3 percent GDP public expenditure can be achieved,” he said.

He said the reduction in maternal mortality ratio from 301 to 254, in infant mortality rate from 58 to 55 and reduction in TB and malaria cases in recent years are “all indicators that we are on the right track of achieving better health outcome through strengthened primary care”.

“Institutional deliveries have increased from 40.9 percent (2002-04) to 47 percent (2007-08) and full immunization coverage of children up to 2 years has gone up from 45.9 percent (2002-04) to 54.1 percent (2007-08),” he revealed.

While urging the private sector to play a more constructive role, Azad said: “Potential areas where private players can play a crucial role are provision of health services, disease control and surveillance, diagnostics and medicines, health manpower, capacity building including training and systems development, managerial service and auxiliary activities of the health sector.”