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The Union Budget plays a crucial role in shaping healthcare infrastructure in India. However, the realization of these budgetary promises depends significantly on how state governments implement them. Although many health sector initiatives are centrally funded, the responsibility of execution lies with the states. Two key schemes, the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) and the Human Resources for Health and Medical Education (HRHME), have recently taken the spotlight. These schemes focus on improving India's healthcare infrastructure and addressing the shortage of trained medical personnel.
Challenges in Utilization
The issue of low fund utilization is evident across both initiatives. A significant amount of funds allocated for PM-ABHIM remain underutilized, with actual expenditure lagging behind the budget estimates. This underutilization is driven by several factors, including the reliance on state governments for implementation and the complex approval processes that slow down execution.
For instance, states were required to reorganize public health laboratories, often leading to delays. The process involved integrating existing public health infrastructure and avoiding overlap between state and central funding schemes. Another issue is the rigidity of procedural frameworks, which hampers swift decision-making and execution.
Shortage of Faculty in Medical Colleges
One of the biggest hurdles faced under HRHME is the shortage of teaching faculty for medical colleges. A study by the Centre for Social and Economic Progress (CSEP) pointed to a 40% vacancy in faculty positions in newly established medical colleges. This shortage has made it difficult to operationalize new institutions and upgrade existing facilities, severely affecting the quality of medical education and the overall healthcare system.
Fiscal Space in States
State governments are under considerable pressure to bear the recurring costs of maintaining newly created healthcare infrastructure. The financial assistance from the central government only covers part of the costs and is available for a limited period (until 2025-26). As a result, states need to find ways to finance these initiatives while also managing their existing health schemes. A sustainable solution requires states to reform their financial management and streamline processes to avoid fund duplication.
Conclusion
The success of PM-ABHIM and HRHME hinges on addressing the underlying challenges that impede their execution. States must take active steps to resolve procedural inefficiencies and ensure proper fund utilization to achieve tangible health outcomes. Streamlining state-level operational frameworks and addressing the shortage of medical professionals will be critical for transforming the budget allocations into effective healthcare improvements.
[SOURCE: THE HINDU EDITORIAL}
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