Peanuts for UPA’s urban health plan

NEW DELHI: UPA’s quiver for the 2014 battle may end up with one blunt arrow with the long-promised National Urban Health Mission (NUHM) for urban poor being backed by a mere Rs 1 crore budget for the entire fiscal.
Attempts by the health ministry to use the rural health mission funds to push the new venture along — as promised by the ministry — is likely to impose a high cost to the rural programme itself as it is already strapped for funds this year.
The sharing of allocations could also end up diminishing the freshly launched flexible pool of funds to fight specific diseases.
The urban mission has been clubbed with the rural one under an over-arching National Health Mission and called a sub-mission. But the re-christening of schemes has not taken away from the fact that the urban mission will remain only on paper unless resources are mobilized for it.
The 12th Five Year Plan provided Rs 16,955 crore as the Centre’s share for the urban health mission. That means an annual spend of roughly Rs 3,300 crore every year, but in the second year of the plan there would be only Rs 1 crore available – what one official quipped as “ribbon cutting money”. The health ministry had initially asked for Rs 3,200 crore for a full-blown launch of the mission this fiscal.
Sources in the health ministry said the unified mission was cleared by the Cabinet earlier on the assurance that funds for the urban component would be cobbled together from other sources too.
The urban mission is expected to cover approximately 7.75 crore poor urban people in 779 cities but this is expected to be postponed well into the next fiscal, too late for UPA to claim any potential political dividend from the scheme it had promised since 2005.
If the health ministry does use the rural health mission infrastructure and finances for the new mission it is bound to hit the former badly, which got a mere 2.5% increase in the budget this year.
Some of the most ambitious targets for the health missions are likely to miss targets under the circumstances. The mission was to provide free essential drugs and diagnostics through government hospitals – a provision that required roughly Rs 2,000 crore annually and could have provided political benefits to UPA. This will now get pushed to the next year.
Strengthening of district hospitals was also on the anvil and requires upwards of Rs 1,000 crore. The test pilot of universal healthcare system too requires funds, and is now likely to be put off.
Experts within the government remain wary that while stiff targets have been set for the health missions, the missing funds will invite criticism later about non-delivery by public sector health systems.
While the government had promised large sums of money for public health and education controversy raged when the 12th Plan health chapter was being finalized with the health ministry upset that the Planning Commission had favoured a route that would help the private sector monopolize the health sector. Planning commission officials denied the allegations.
Though differences were ultimately resolved with the formulation of a national health mission and health ministry prevailing in most cases, when it came to the current year’s budget it was clear that urban health impetus had been put off for later.