Public expenditure on health should be hiked from 0.15 to 0.5% of GDP: IIM-A faculty

If healthcare services in India has to be made ubiquitous, hike in public expenditure as well as specific taxes should be taken up by the government, opined Dileep Mavalankar, faculty member of Indian Institute of Management, Ahmedabad (IIM-A).

Offering his critique to the recommendations made by the High Level Expert Group (HLEG) for the implementation of Universal Healthcare Coverage (UHC) in India by 2022, Mavalankar said that even if public expenditure is increased from current 0.1 per cent to 0.5 per cent of GDP, medicines can be made available for free in the country. "This way the UHC recommendation of increasing public expenditure to three per cent of GDP by 2022 can also be achieved," added Mavalankar, who is also the director of Indian Institute of Public Health (IIPH) Gandhinagar. In his critical analysis of HLEG's recommendations which was released on Monday by India Health Progress, an independent forum, Mavalankar stated that specific taxes on tobacco, alcohol, petrol and junk foods could also be levied to fund public healthcare. "The recommendations seek to develop a new cadre of 'Bachelor of Rural Health Care (BRHC). However, this will take a long time to develop. Instead the 'Bachelor of Surgery' (BS) in MBBS should be done away with. Instead the focus should be on the 'Bachelor of Medicine' (MB) which can produce qualified general practitioners in three years," said Mavalankar.

According to Mavalankar, as against 25,000 public health centres (PHCs) in India, the country produces 35,000 MBBS doctors per annum. "If all MBBS graduates are attracted to PHCs through proper incentives and better living conditions, we can put three medical officers (MOs) per PHC in next two years," While the recommendations also emphasise on more use of technology in public health care, the IIM-A faculty member is of the view that instead of technology, the country should focus more on learning birth and death statistics. "HLEG has paid too much emphasis on technology.

However, we need to learn from countries like England and Germany who since centuries have been able to analyse basic health statistics without much use of technology. Information technology is just a tool; the real need is to record, analyse, monitor and take action based on health data where India currently lags behind," he added.

Meanwhile, further critiquing the recommendations, Mavalankar added that given the faculty shortage in backward areas, opening of too many colleges for nurses and doctors will dilute the standards.