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Experts on Monday gave a qualified welcome to the national dialysis programme and new drug stores proposed in budget 2016-17, but said the dual disease burden of communicable and non-communicable diseases remains unaddressed.
"Funding dialysis is an expensive affair and it should be done in a thoughtful manner. The focus should be on sustainability and monitoring quality because often markets tend to trump quality," Vivekanand Jha, professor of nephrology at the Postgraduate Institute of Medical Education and Research (PGIMER) at Chandigarh, told IANS.
He said audit of the dialysis programme becomes very important given the fact that public funds were going to be spent.
Finance Minister Arun Jaitley on Monday proposed to start a 'National Dialysis Services Programme' to make the expensive medical procedure available to the people in rural areas who cannot afford it.
Jha said the the programme should be implemented in consultation with professional organisations and specialists dealing with the issue.
D.S. Rana, a nephrologist and chairman of Sir Ganga Ram Hospital-Delhi, said tax relief for dialysis equipment and to start national dialysis programme on a public-private partnership (PPP) model in district hospitals will help reduce the financial suffering of lakhs of patients who cannot afford kidney transplants.
Sustainability expert Duke Ghosh questioned the infrastructure gap.
"I am not sure if district hospitals have the necessary infrastructure to carry out such a large scale plan," Ghosh, who is associated with the Global Change Research programme, told IANS.
"Creation of dialysis centres in the district hospitals will help in tackling the rising chronic cases of renal failures, but it has to be ensured that the facilities are well maintained and functional always," M.C. Misra, Director All India Institute of Medical Sciences (AIIMS), told IANS.
Misra said the government should not emphasise separately on primary and secondary healthcare but rather improve the healthcare system of the country as a whole.
In order to make quality generic medicines available at affordable prices, 3000 stores under the Prime Minister's Jan Aushadhi Yojana will be opened during 2016-17, Jaitley said.
"The steps taken by the government in health sector are welcome, but as far as the start of drug stores is concerned, it should be ensured that the generic medicines are tested and of the best quality," Mishra said.
Jaitley announced a new health protection scheme which will provide health cover up to Rs. one lakh per family for economically weak families.
For senior citizens of age 60 years and above belonging to this category, an additional top-up package of up to Rs.30,000 will be provided.
Health economist Kenneth E. Thorpe said the dialysis programme, generic drug stores and health protection scheme are positives of the budget, but wondered why there is no mention of the total public health expenditure.
"While the finance minister has outlined certain reforms in regard to new health protection and health cover schemes, there has been no mention of increase in the public health spend. The expenditure on public health still stands at 1.2 per cent of the GDP," Thorpe, Chairman, Partnership to Fight Chronic Disease (PFCD), told IANS.
"The dual disease burden that India bears - communicable and non-communicable diseases - has not been addressed in the Union Budget. NCDs - particularly cardiovascular diseases, cancer, chronic respiratory diseases and diabetes - account for 60 per cent of all deaths in India, making them the leading cause of mortality," said Thorpe.
He said the probability of death during the most productive years (ages 30-70) from one of the four main NCDs is a staggering 26 per cent, hampering not only health but also productivity.
Also, Thorpe said the government's initiatives like Digital India should be utilized by hospitals and healthcare professionals.
"India is going digital. However, the country is not utilizing the resources optimally," Thorpe said, adding the announcement of 10-15 percent increase in excise duty for all tobacco products, except beedi, is a positive development to tackle the rising number of deaths caused by tobacco consumption.