Lok Sabha Question No. 103 (STARRED), answered on 2018-02-09
Subject: Public Healthcare Infrastructure
Ministry: HEALTH AND FAMILY WELFARE
Asked by: PRATHAP SIMHA, SHOBHA KARANDLAJE

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

## LOK SABHA STARRED QUESTION NO. 103 TO BE ANSWERED ON THE 9 TH FEBRUARY , 2018 PUBLIC HEALTHCARE IN FRASTRUCTURE

## *103. SHRI PRATHAP SIMHA:

## KUMARI SHOBHA KARANDLAJE:

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

- (a) whether the neglect of investments in public healthcare infrastructure promotion of private hospitals to fill the gap have created a dependency th private sector and if so, the details thereof and the reaction of the Go thereto;
- (b) whether a large percentage of tertiary and primary healthcare services is to by the private sector and if so, the details thereof;
- (c) whether th e Government plans to set up a single National Authority to regu healthcare charges and if so, the details thereof;
- (d) whether the Concurrent List of the Constitution allows the Central Governm to enact laws to regulate healthcare charges and if so, the details thereof;
- (e) the steps being initiated by the Government to regulate healthcare cha imposing a ceiling o n the prices and ensure access to affordable healthcare?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE ( SHRI JAGAT PRAKASH NADDA )

- (a)to ( e) : A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 103* FOR 9 TH FEBRUARY , 2018

(a)  &  (b) Public  Health  and  hospitals  being  a  State  subject,  the  prim responsibility  to  invest  in  public  healthcare  infrastructure  and provide affordable  healthcare  services  lies  with  respective  State/UT  Governme However, technical and financial support under the National Health Miss (NHM)  is  being  provided  to  States/UTs  for  strengthening  their  healthc system.  According to the Nationa l Health Accounts Estimates for India, the Government  Health  Expenditure  (GHE)  has  increased  by  8  percent  from Rs  1,29,778  Crores  in  FY  2013 - 14  to  Rs  1,39,949  crores  in  FY  2014 - 15. The National Health Policy 2017 envisa ges raising public health expenditure progressively  to  2.5%  of  the  GDP  by  2025. It  also  envisages  that  States contribute  at  least  8%  of  their  Total  Government  Expenditure  to  Hea . The  share  of  utilization  of  healthcare  services  in  pub lic  sector  for  non -hospitalized, hospitalized and childbirth cases ,as reported by National Sample Survey Office (NSSO) ,is annexed.

(c) to (e)  Since public health and hospitals  is a State subject and not subject  on  concurrent  list,  it  is  the  responsib ility  of  the  respective State/Union  Territory  Government  to  regulate  healthcare  charges  in  th States/UTs.

The  Government  of  India  has,  however,  enacted  under  clause  (1)  o Article 252 of the Constitution ,the Clinical Establishments (Registration and Regulation)  Act,  2010 , for  registration  and  regulation  of  all  Clinic Establishments (both Government and Private) in the country. Currently, Act is applicable in 11 States and all Union Territories excep t Delhi. Other States may adopt the Act.

Under the Clinical Establishments (Central Government) Rules, 2012 , notified  under  this  Act,  the  clinical  establishments  (in  the  States  / Territories where the said Act is applicable) are required t o follow Standard

Treatment  Guidelines  as  may  be  issued  by  Central/State  Governments, display their rates at a conspicuous place and charge the rates for eac of procedures and services within the range of rates determined from tim time in cons ultation with the State Governments.  The National Council for Clinical Establishments has approved a standard list of medical procedures and a standard template for costing of medical procedures and the same has been shared with the States/UTs where the A ct is applicable for appropriate action.  The  enactment  and  implementation  of  the  said  Act  is  within  t purview of the State/UT Governments.

The  National  Pharmaceutical  Pricing  Authority (NPPA)  has  fixed the ceiling rates for essential drugs, including s tents and implants.

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## Percentage of ailments receiving treatment from government sources in two NSS rounds

Al

|                    | Rural           | Rural           | Urban           | Urban           |
|--------------------|-----------------|-----------------|-----------------|-----------------|
|                    | 2004 60th Round | 2014 71st Round | 2004 60th Round | 2014 71st Round |
| Non - hospitalized | 22              | 28              | 19              | 21              |
| Hospitalized       | 42              | 42              | 38              | 32              |
| Child Birth        | 18              | 56              | 31              | 42              |