Lok Sabha Question No. 1871 (UNSTARRED), answered on 2017-12-29
Subject: Healthcare of Elderly People
Ministry: HEALTH AND FAMILY WELFARE
Asked by: R. PARTHIPAN

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

LOK SABHA UNSTARRED QUESTION NO. 1871 TO BE ANSWERED ON   29 TH DECEMBER, 2017

## HEALTHCARE OF ELDERL Y PEOPLE

## 1871. SHRI R. PARTHIPAN:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) the details of healthcare programmes for the elderly in the country; and
- (b) the details of Government expenditure incurred on healthcare of elderly during the l years?

## ANS WER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE ( SMT. ANUPRIYA PATEL )

- (a) : The Government of India had launched National Programme for Health Care of the Elderly (NPHCE) during 2010 - 11 with a view to provide separate and specialized comprehensive  health  care  facilities  to  senior  citizens  at  various  levels  of  state  h delivery system including outreach services. The health ca re f cilities, being provided under this programme, are either free or highly subsidised.

The major activities of the NPHCE are: -

- i)  Setting up of Geriatric department in identified Regional Geriatric Centres (RGCs OPD care services and 30 bedded Geriatric ward for providing indoor services. RGCs will als undertake PG Courses in Geriatric for developing Human Resource
2. ii) Setting up of 10 bedded Geriatric units at all District Hospitals that will prov services for elderly during hospitalisation.
3. ii) Establishment of Rehabilitation unit at all Community Health Centres (CHCs) and Ger clinic twice/week.
4. iv)  Setting up weekly Geriatric clinic by trained medical Officer at Primary Health (PHCs).

Contd………

In addition, th e Government of India is supporting the development of two National Centres of Ageing (NCAs) -one in AIIMS, New Delhi and another in Madras Medical College, Chennai.The  NCA s  are supposed  to  function  as  a  National  Centre s of  Excellence  wit h  200 bedded facility and aimed to be teaching, research & referral institute for geriatric country.

Apart  from  this, the Government  of  India  is  implementing  Senior  Citizen  Health Insurance Scheme (SCHIS) for Senior Citizens of age 60 year s and above, belonging to Below Poverty Line (BPL) and 11 other defined categories such as MGNREGA Workers, Construction Workers, Mine Workers, Licensed Railway Porters, Street Vendors, Beedi Workers, Rickshaw Pullers, Rag Pickers and Auto/ Taxi drivers wi th effect from 01.04.2016, as a top up scheme of Rashtriya Swasthya Bima Yojna (RSBY). The health coverage is upto Rs. 30,000/ -- per annum per senior citizen for treatment packages, over and above RSBY entitlement.

At present ,SCHIS is being implemented in 8 States namely Assam, Gujarat, Karnataka, Kerala, Meghalaya, Nagaland, Tripura and West Bengal. 211 treatment packages (Cardiolog -17, Cardio Thoracic Surgery -18, Cardio Vascular Surgery -18, Neuro Surgery - 5, Polytrauma & R epair -7, Burns - 8, Surgical Oncology - 89, and Medical Oncology - 49) are covered under SCHIS.

(b) : The details of the funds released and expenditure incurred under NPHCE are given Annexure -A, B & C.

The funds for SCHIS will be released throu gh Senior Citizens Welfare Fund administered by  Ministry  of  Social  Justice  &  Empowerment.  No  funds  have  been  released  to  Sta Governments implementing SCHIS till now.

…………….

## Annexure-A

## NATIONAL PROGRAMME FOR HEALTH CARE OF THE ELDLERY (NPHCE) (Amount Rs. in Lakhs)

|        |                    | 2014-15             | 2014-15                            |
|--------|--------------------|---------------------|------------------------------------|
| Sl. No | Name of the States | GIA Released by GOI | Expenditure Reported by the States |
| 1      | Andhra Pradesh     | 0.00                | 0                                  |
| 2      | Assam              | 142.27              | 53.55                              |
| 3      | Bihar              | 150.00              | 84.22                              |
| 4      | Chattisgarh        | 99.00               | 126.71                             |
| 5      | Gujarat            | 215.66              | 230.87                             |
| 6      | Haryana            | 77.62               | 48.81                              |
| 7      | Himachal Pradesh   | 11.85               | 68.04                              |
| 8      | Jammu &Kashmir     | 0.00                | 84.94                              |
| 9      | Jharkhand          | 111.00              | 56.00                              |
| 10     | Karnataka          | 170.95              | 16.33                              |
| 11     | Kerala             | 150.00              | 749.74                             |
| 12     | Madya Pradesh      | 215.34              | 81.54                              |
| 13     | Maharashtra        | 203.64              | 239.44                             |
| 14     | Odisha             | 116.00              | 140.71                             |
| 15     | Punjab             | 111.36              | 48.14                              |
| 16     | Rajasthan          | 87.05               | 86.03                              |
| 17     | Sikkim             | 44.00               | 0                                  |
| 18     | Tamil Nadu         | 0.42                | 0                                  |
| 19     | Uttarakhand        | 0.00                | 11.24                              |
| 20     | Uttar Pradesh      | 0.00                | 0                                  |
| 21     | West Bengal        | 150.00              | 18.58                              |
| 22     | Daman &Diu         | 24.34               | 0                                  |
| 23     | Lakshdweep         | 95.66               | 10.90                              |
| 24     | Mizoram            | 119.06              | 0                                  |
|        | Total              | 2295.22             | 2155.79                            |

## Annexure- B

## *National Programme for Health Care of the Elderly (NPHCE)- Funds Allocation/released/Expenditure under NonCommunicable Diseases (NCD) flexible pool

|         |                          |                                     | 2015-16   | 2015-16     | 2016-17    | 2016-17   | 2016-17     | 2017-18**   | 2017-18**   | 2017-18**    |
|---------|--------------------------|-------------------------------------|-----------|-------------|------------|-----------|-------------|-------------|-------------|--------------|
| Sl. No. | Name of State            | Allocatio n under NCD flexible pool | Release   | Expenditure | Allocation | Release   | Expenditure | Allocation  | Release     | Expendi ture |
| 1       | Andaman & Nicobar Island | 0.73                                | 0.55      | 0.00        | 1.21       | 1.21      | 0.00        | 1.06        | 0.79        | 0.00         |
| 2       | Andhra Pradesh           | 17.66                               | 14.78     | 0.00        | 17.49      | 30.82     | 0.00        | 30.23       | 22.67       | 0.94         |
| 3       | Arunachal Pradesh        | 7.81                                | 5.7       | 0.00        | 7.81       | 8.41      | 0.69        | 14.17       | 0.00        | 0.00         |
| 4       | Assam                    | 44.44                               | 35.78     | 1.18        | 44.44      | 55.33     | 3.02        | 80.61       | 0.00        | 0.12         |
| 5       | Bihar                    | 36.43                               | 22.34     | 0.18        | 36.08      | 18.04     | 0.28        | 63.01       | 47.26       | 0.04         |
| 6       | Chandigarh               | 0.25                                | 0.69      | 0.00        | 0.42       | 0.46      | 0.00        | 0.9         | 0.61        | 0.00         |
| 7       | Chhattisgarh             | 14.99                               | 8.47      | 0.26        | 14.85      | 14.85     | 1.59        | 25.93       | 19.45       | 7.92         |
| 8       | Dadra & Nagar Haveli     | 0.66                                | 0.63      | 0.15        | 1.09       | 0.82      | 0.35        | 0.96        | 0.48        | 0.00         |
| 9       | Daman &Diu               | 0.47                                | 0.35      | 0.00        | 0.78       | 0.39      | 0.00        | 0.68        | 0.00        | 0.00         |
| 10      | Delhi                    | 4.05                                | 2.23      | 0.00        | 6.72       | 5.64      | 0.00        | 14.31       | 0.00        | 0.00         |
| 11      | Goa                      | 0.47                                | 0.23      | 0.00        | 0.46       | 0.00      | 0.00        | 0.8         | 0.00        | 0.00         |
| 12      | Gujarat                  | 21.53                               | 20.98     | 1.91        | 21.32      | 21.32     | 1.83        | 36.85       | 27.64       | 0.06         |
| 13      | Haryana                  | 7.67                                | 4.93      | 0.68        | 7.6        | 3.80      | 1.01        | 13.18       | 9.89        | 0.01         |
| 14      | Himachal Pradesh         | 6.55                                | 4.78      | 0.47        | 6.48       | 3.24      | 0.35        | 11.32       | 5.66        | 0.00         |
| 15      | Jammu& Kashmir           | 14.73                               | 8.16      | 0.91        | 14.59      | 14.59     | 0.72        | 25.48       | 19.11       | 0.04         |
| 16      | Jharkhand                | 15.26                               | 10.57     | 0.00        | 15.11      | 15.11     | 0.52        | 26.4        | 0.00        | 0.00         |
| 17      | Karnataka                | 21.56                               | 14.29     | 0.92        | 21.34      | 21.34     | 2.38        | 36.9        | 27.68       | 0.01         |
| 18      | Kerala                   | 9.33                                | 5.18      | 0.76        | 9.24       | 6.93      | 1.28        | 16.07       | 12.05       | 1.40         |
| 19      | Lakshadweep              | 0.12                                | 0.07      | 0.25        | 0.21       | 0.00      | 0.024       | 0.18        | 0.000       | 0.03         |
| 20      | Madhya Pradesh           | 35.75                               | 26.82     | 1.05        | 35.4       | 35.40     | 0.81        | 61.83       | 46.37       | 0.00         |
| 21      | Maharashtra              | 38.05                               | 27.54     | 1.86        | 37.68      | 37.68     | 0.79        | 65.2        | 48.90       | 0.19         |
| 22      | Manipur                  | 5.00                                | 3.08      | 0.60        | 5.00       | 2.50      | 0.00        | 9.07        | 0.00        | 0.00         |
| 23      | Meghalaya                | 5.31                                | 2.46      | 0.00        | 5.31       | 5.31      | 0.00        | 9.62        | 4.33        | 0.00         |
| 24      | Mizoram                  | 2.85                                | 1.42      | 0.07        | 2.85       | 2.14      | 0.64        | 5.17        | 3.49        | 0.06         |

## Rs. in Crore

| 25   | Nagaland      |   3.66 |   2.63 |   0.00 |   3.66 |   1.83 |    0.00 |   6.64 | 4.48    |   0.00 |
|------|---------------|--------|--------|--------|--------|--------|---------|--------|---------|--------|
| 26   | Orissa        |  19.74 |  16.19 |   0.81 |  19.55 |  19.55 |  0.7    |  34.14 | 17.07   |   0.14 |
| 27   | Pudducherry   |   0.31 |   0.29 |   0    |   0.52 |   0.39 |  0.182  |   2.5  | 1.250   |   0.22 |
| 28   | Punjab        |   8.43 |   6.71 |   0.82 |   8.35 |   8.35 |  0.69   |  14.49 | 0.00    |   0    |
| 29   | Rajasthan     |  36.05 |  27.04 |   8.26 |  35.7  |  26.78 |  6.38   |  62.35 | 46.76   |   0.1  |
| 30   | Sikkim        |   1.27 |   0.95 |   0.51 |   1.27 |   1.58 |  0.31   |   2.31 | 0.00    |   0    |
| 31   | Tamil Nadu    |  21.66 |  17.16 |   0    |  21.45 |  21.45 |  1.26   |  37.22 | 27.91   |   0    |
| 32   | Tripura       |   5.32 |   2.55 |   0    |   5.32 |   2.66 |  0      |   9.65 | 4.34    |   0    |
| 33   | Uttar Pradesh |  72.51 |  54.39 |   6.28 |  71.81 |  71.81 |  9.15   | 125.4  | 94.00   |   2.08 |
| 34   | Uttarakhand   |   8.99 |   6.62 |   0    |   8.9  |   8.9  |  0.0044 |  15.54 | 0.000 0 |   0.01 |
| 35   | West Bengal   |  25.09 |  13.03 |   0.24 |  24.85 |  24.85 |  0.51   |  43.22 | 21.61   |   0    |
| 36   | Telangana     |  12.63 |   9.41 |   0    |  12.5  |  11.23 |  0      |  21.61 | 16.20   |   0    |
|      | Total         | 527.33 | 379    |  28.16 | 527.36 | 504.71 | 35.47   | 925    | 530.00  |  13.38 |

## National Programme for Health Care of Elderly Funds released to Regional Geriatric Centre (RGC) and National Centres of Ageing (NCAs)

| Sl. No   | Name of the States                                          | 2014-15                                          | 2014-15                                          | 2015-16                                          | 2015-16                                          | 2016-17                                          | 2016-17                                          | 2017- 18                                         | 2017- 18                                         |
|----------|-------------------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|
| Sl. No   | Name of the States                                          | GIA Released by GOI                              | Expenditure Reported By the Institutes           | GIA Released by GOI                              | Expenditure Reported By the Institutes           | GIA Released by GOI                              | Expenditur e Reported By the Institutes          | GIA Release d by GOI                             | Expendi ture Reporte d By the Institute s*       |
|          | RGCs covered during 11th Five Year Plan                     | RGCs covered during 11th Five Year Plan          | RGCs covered during 11th Five Year Plan          | RGCs covered during 11th Five Year Plan          | RGCs covered during 11th Five Year Plan          | RGCs covered during 11th Five Year Plan          | RGCs covered during 11th Five Year Plan          | RGCs covered during 11th Five Year Plan          | RGCs covered during 11th Five Year Plan          |
| 1        | Govt. Medical College, Tiruvananthapuram, Kerala            | 0.00                                             | 14.78                                            | 0.00                                             | 8.55                                             | 0.00                                             | 0.00                                             | 0.00                                             | 0.00                                             |
| 2        | Intt. Of Medical Sciences, BHU, UP                          | 0.00                                             | 52.01                                            | 0.00                                             | 36.97                                            | 224.98                                           | 34.64                                            | 0.00                                             | 21.35                                            |
| 3        | Guwahati Medical College, Guwahati, Assam                   | 0.00                                             | 71.26                                            | 0.00                                             | 31.87                                            | 88.44                                            | 18.05                                            | 238.4 4                                          | 11.73                                            |
| 4        | S.N Medical College Jodhpur, Rajasthan (Insttitute)         | 0.00                                             | 0.00                                             | 50.00                                            | 0.00                                             | 0.00                                             | 0.00                                             | 0.00                                             | 11.45                                            |
| 5        | Madras Medical College , Chennai,Tamil Nadu                 | 0.00                                             | 5.41                                             | 50.00                                            | 26.26                                            | 50.00                                            | 0.00                                             | 0.00                                             | 1.39                                             |
| 6        | Grants Medical College &JJ Hospital, Mumbai, Maharashtra    | 0.00                                             | 54.54                                            | 50.00                                            | 27.82                                            | 0.00                                             | 80.51                                            | 238.4 4                                          | 7.34                                             |
| 7        | Sher-e-Kashmir Institute of Medical Science, Srinagar, J &K | 0.00                                             | 30.34                                            | 50.00                                            | 0.00                                             | 0.00                                             | 0.00                                             | 0.00                                             | 0.00                                             |
| 8        | All India Institute of Medical Science, New Delhi           | 0.00                                             | 31.73                                            | 0.00                                             | 10.26                                            | 163.00                                           | 7.50                                             | 0.00                                             | 5.00                                             |
|          | Sub Total (A)                                               | 0.00                                             | 260.07                                           | 200.00                                           | 141.73                                           | 526.42                                           | 140.69                                           | 476. 88                                          | 58.26                                            |
|          | RGCs and NCAs covered during 12th Five Year Plan            | RGCs and NCAs covered during 12th Five Year Plan | RGCs and NCAs covered during 12th Five Year Plan | RGCs and NCAs covered during 12th Five Year Plan | RGCs and NCAs covered during 12th Five Year Plan | RGCs and NCAs covered during 12th Five Year Plan | RGCs and NCAs covered during 12th Five Year Plan | RGCs and NCAs covered during 12th Five Year Plan | RGCs and NCAs covered during 12th Five Year Plan |
| 1        | Gandhi Medical College, Bhopal                              |                                                  |                                                  | 100.00                                           | 0.00                                             | 247.11                                           | 0.00                                             | 0.00                                             | 0.00                                             |
| 2        | Kolkata Medical College, Kolkata                            |                                                  |                                                  | 100.00                                           | 0.00                                             | 247.11                                           | 0.00                                             | 0.00                                             | 0.00                                             |
| 3        | Nizam's Institute of Medical Sciences, Hyderabad            |                                                  |                                                  | 100.00                                           | 0.00                                             | 247.11                                           | 0.00                                             | 0.00                                             | 0.00                                             |
| 4        | S.C.B. Medical College, Cuttack                             |                                                  |                                                  | 100.00                                           | 0.00                                             | 247.11                                           | 0.00                                             | 0.00                                             | 0.00                                             |
| 5        | King George's Medical University, Lucknow                   |                                                  |                                                  | 100.00                                           | 0.00                                             | 247.11                                           | 0.00                                             | 0.00                                             | 0.00                                             |
| 6        | Rajendra Institute of Medical Sciences, Ranchi              |                                                  |                                                  |                                                  |                                                  | 347.11                                           | 0.00                                             | 238.4 4                                          | 0.00                                             |
| 7        | Bangalore Medical College& Research Institute, Bengaluru    |                                                  |                                                  |                                                  |                                                  | 347.11                                           | 0.00                                             | 238.4 4                                          | 0.00                                             |

Rs. in Lakhs

| 8                                  | B.J. Medical College, Ahmadabad                              |                                    |                                    |                                    | 347.11                             | 0.00                               | 238.4 4                            | 0.00                               |                                    |
|------------------------------------|--------------------------------------------------------------|------------------------------------|------------------------------------|------------------------------------|------------------------------------|------------------------------------|------------------------------------|------------------------------------|------------------------------------|
| 9                                  | Government Medical College, Nagpur                           |                                    |                                    |                                    | 0.00                               | 0.00                               | 0.00                               | 0.00                               |                                    |
| 10                                 | Agartala Medical College, Agartala                           |                                    |                                    |                                    | 347.11                             | 0.00                               | 238.4 4                            | 0.00                               |                                    |
| 11                                 | Patna Medical College, Patna                                 |                                    |                                    |                                    | 0.00                               | 0.00                               | 413.4 4                            | 0.00                               |                                    |
| 12                                 | Rajendra Prasad Government Medical College, Himachal Pradesh |                                    |                                    |                                    | 347.11                             | 0.00                               | 238.4 4                            | 0.00                               |                                    |
|                                    | Sub Total (B)                                                |                                    | 500.00                             | 0.00                               | 2971.10                            | 0.00                               | 1605 .64                           | 0.00                               |                                    |
| National Centres for Ageing (NCAs) | National Centres for Ageing (NCAs)                           | National Centres for Ageing (NCAs) | National Centres for Ageing (NCAs) | National Centres for Ageing (NCAs) | National Centres for Ageing (NCAs) | National Centres for Ageing (NCAs) | National Centres for Ageing (NCAs) | National Centres for Ageing (NCAs) | National Centres for Ageing (NCAs) |
| 1                                  | Madras Medical College, Chennai                              |                                    | 1000.0 0                           | 0.00                               | 2400.00                            | 3400.00                            | 4400. 00                           |                                    |                                    |
| 2                                  | All India Istitute of Medical Science, New Delhi             |                                    | 900.00                             | 0.00                               | 2490.00                            | 0.00                               | 0.00                               | 0.00                               |                                    |
|                                    | Sub Total (C)                                                |                                    | 1900.0 0                           | 0.00                               | 4890.00                            | 3400.00                            | 4400 .00                           | 0.00                               |                                    |
|                                    | Grand Total (A+B+C)                                          | 0.00                               | 2600.0 0                           | 141.73                             | 8387.52                            | 3540.69                            | 6482 .52                           | 58.26                              |                                    |

* As on date.