BJP 2014 manifesto check: How has the Modi government performed on its healthcare promises?

In its 2014 manifesto, the BJP called for radical reforms in the healthcare system in relation to national healthcare programs and delivery, especially the National Rural Health Mission, which it declared had failed to meet its objectives. It also called for an overhaul of medical education and training and financing of healthcare to create a holistic care system that is universally accessible, affordable and effective.

The party said it accords high priority to health sector, which is crucial for securing the economy and that the overarching goal of healthcare would be to provide “Health Assurance to all Indians and to reduce the out of pocket spending on health care”, with the help of state governments.

Scroll.in takes a look at the how the Union government has performed vis-à-vis the promises made:

The last healthcare policy dates back to 2002. India now needs a comprehensive healthcare policy to address the complex healthcare challenges, keeping in view the developments in the healthcare sector and the changing demographics. BJP will initiate the New Health Policy.
Status: In March 2017, the government adopted the National Health Policy, 2017, that had taken a year and a half to draft. The new policy sets a very low bar for better public health outcomes. For example, it proposes that the government increase health expenditure from the existing 1.15% of the gross domestic product to to 2.5% of the gross domestic product by 2025. The draft policy released in 2015 had promised that this will be achieved by 2020. In other words, in 18 months, the government has already doubled the number of years it forecasts will be necessary to increase public spending on health to 2.5% of the gross domestic product. Even if this is achieved, it will be half of what the World Health Organisation recommends as optimum public spending on health.

Initiate the ‘National Health Assurance Mission’, with a clear mandate to provide universal healthcare that is not only accessible and affordable, but also effective, and reduces the OOP [out-of-pocket] spending for the common man.
Status: Launched the Pradhan Mantri Jan Aarogya Yojana, which is a scheme based on a health insurance model that offers Rs 5 lakh cover per year per family to 10 crore families. The National Health Authority says that more than 2.74 crore beneficiaries have been enrolled and more than 17 lakh people have received healthcare under the scheme since its launch in September 2018. However, it is too early to assess whether the scheme will achieve the goals of providing healthcare assurance and reducing out-of-pocket expenditure.

Will review the role of various professional regulatory bodies in healthcare and consider setting up an overarching lean body for healthcare. High priority will be given to address the shortfall of healthcare professionals.
Status: In December 2017, the Union health minister introduced National Medical Commission Bill ,2017, that aims to replace the Indian Medical Council Act of 1956 to oversee medical education and regulation. The Bill was sent to the standing committee, which recommended removing provisions related to a bridge course for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy or AYUSH practitioners to practice modern medicine and for a separate exit or licentiate examination for MBBS doctors. The National Medical Commission Bill, 2017, is yet to be passed by Parliament. Meanwhile, the government has promulgated the Indian Medical Council (Amendment) Ordinance to dissolve the Medical Council of India and to run it through a panel of board of governors made up of eminent professionals.

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Modernise government hospitals, upgrading infrastructure and latest technologies.
Status: The government has announced plans to make hospitals into an industry under the Pradhan Mantri Jan Aarogya Yojana by giving a range of sops to private hospitals in Tier 2 and Tier 3 cities, including allotting unencumbered land to private hospitals, providing viability gap funding and speeding up clearances. The move has added to apprehensions that the health insurance scheme transfers public money to the private health sector.

Reorganise Ministry of Health and Family Welfare in order to converge various departments dealing in healthcare, food and nutrition and pharmaceuticals, for effective delivery of healthcare services.
Status: No significant reorganisation.

Increase the number of medical and para-medical colleges to make India self sufficient in human resources, and set up an AIIMS-like institute in every state.
Status: Govt has announced creation of 16 new AIIMS since 2014, but many are stuck due to non-allocation of land and/or funds.

Yoga and Ayurveda are the gifts of ancient Indian civilisation to humanity and we will increase the public investment to promote Yoga and AYUSH [Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy]. We will start integrated courses for Indian System of Medicine (ISM) and modern science and Ayurgenomics. We will set up institutions and launch a vigorous program to standardise and validate the Ayurvedic medicine.
Status: The government set up the Ministry of AYUSH in November 2014 to replace the existing Department of AYUSH to focus on development of education and research in Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy.

School health program would be a major focus area, and health and hygiene will be made a part of the school curriculum.
Status: No significant change from existing school health interventions.

Focus on Rural Health care delivery.
Status: Under Ayushman Bharat, the government aims to create 1,50,000 new health and wellness centres by upgrading health sub-centres across the country. Although, the revamp is underway, the programme is severely underfunded to achieve its avowed targets.

Senior citizens healthcare would be a special focus area.
Status: The BJP government continues to implement the National Programme for Health Care of the Elderly launched by the Congress-led United Progressive Alliance government in 2010-’11.

Utilise the ubiquitous platform of mobile phones for healthcare delivery and set up the ‘National eHealth Authority’ to leverage telemedicine and mobile healthcare for expanding reach and coverage and to define the standards and legal framework for technology driven care.
Status: In March 2018, the government released the draft Digital Information Security in Healthcare Act or DISHA that will enable the digital sharing of personal health records with hospitals and clinics, and between hospitals and clinics. It will be the basis for the creation of digital health records in India. It allows the central government to set up Health Information Exchanges for sharing electronic health records, as well as the National Electronic Health Authority of India or NeHA and State Electronic Health Authorities or SeHAs. Meanwhile, the NITI Aayog released a consultation document on July 6 proposing the creation of a National Health Stack to make both personal health records and service provider records available on cloud-based services using the internet, which raised an alarm among digital rights activists.

Universalisation of emergency medical services – 108.
Status: In November, the government launched an Emergency Response Support System with a pan-India single emergency number – 112 – with funding from the Nirbhaya Fund. The 112 helpline integrates helpline number of the police (100), fire (101) and women safety (1090). The health helpline (108) is supposed to be integrated with it soon. The government says it has launched the 112 helpline in 16 states and union territories. Most states continue to operate emergency health services under the 108 helpline in partnership with private companies.

Re-orientation of herbal plants board to encourage farming of herbal plants.
Status: In 2015, the government set up the National Medicinal Plants Board under the Ministry of AYUSH to continue implementing the previous government’s schemes of conservation, development and sustainable management of Medicinal Plants and the centrally-sponsored National Mission on Medicinal Plants.

Move to pre-emptive care model where the focus and thrust will be on child health and prevention + Mission mode project to eradicate malnutrition.
Status: On International Women’s Day in 2018, Prime Minister Narendra Modi launched the National Nutrition Mission or POSHAN Abhiyan for all 640 districts of the country with the goal of making India malnutrition-free by 2022. The programme relies on already existing anganwadi centres, many of which still lack basic amenities, and overburdened anganwadi workers. It is too early to gauge the sustainability and success of the scheme.

Launch National Mosquito Control mission.
Status: Drafts being prepared but no progress.

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