Lok Sabha Question No. 4177 (UNSTARRED), answered on 2019-12-13
Subject: Healthcare Facilities for the Poor
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Jyotsna Charandas Mahant

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTI ON NO. 4177 TO BE ANSWERED ON 13 TH DECEMBER, 2019

## HEALTHCARE FACILITIE S FOR THE POOR

## 4177. SHRIMATI JYOTSNA CHARANDAS MAHANT:

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

- (a) the initiatives/steps taken by the Government to provide and protect poor families to their healthcare;
- (b) the budget allotted for the same, State/UT -wise including State of Maharashtra during the current financial year;
- (c) whether it is a fact that there is acute shortage of nursing officers in various ho country; and
- (d) if so, details in this regard and steps being taken to increase and provide adequate nursing officers in hospitals?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

(a) & (b) : 'Public Health & Hospitals' being a State subject, the prima ry responsibility to provide  healthcare  to  all  the  citizens,  including  the  poor  families,  lies  with Governments. However, under National Health Mission, support is being provided to States for strengthening their healthcare services .

To  addressthe  healthcare  challenges,  particularly  in  rural  areas,  the  National Health  Mission  (NRHM)  was  launched  in  2005  to  supplement  the  efforts  of  the  State/U governments  to  provide  accessible,  affordable  and  quality  healthcare  to  all  those  who public health facilities. Currently, NRHM is a sub - mission of National Health Mission (NHM).

Under NHM, support is provided for host of free services including for maternal he child  health,  adolescent  health,  family  planning,  universal  immunisation  progr amme,  and  for major diseases such as Tuberculosis, HIV/ AIDS, vector borne diseases such as Malaria, De and Kala Azar, Leprosy etc. Other major initiatives include Janani Shishu Suraksha Karya (under  which  free  drugs,  free  diagnostics,  free  blood  a nd  diet,  free  transport  from  home  to institution, between facilities in case of a referral and drop back home is provided), Ras Swasthya Karyakram (which provides newborn and child health screening and early interventions  services  free  of  cost  fo r  birth  defects,  diseases,  deficiencies  and  developmenta delays to improve the quality of survival), implementation of Free Drugs and Free Diagn Service Initiatives, PM National Dialysis Programme and implementation of National Qual Assurance Fra mework.

As  per  the  budget  announcement  2017 - 18,  1.5  lakh  Sub  Health  Centres  and  Primary Health Centres across the country are to be transformed into Health and Wellness Centr December, 2022 under Ayushman Bharat (AB -HWCs) for provision of Compre hensive Primary Health Care that includes preventive healthcare and health promotion at the community with continuum of care approach for all. Services at AB - HWCs  are  free  and  universal  to  all individuals  residing  in  the  service  area.  The  AB - HWCs  wil l  provide  an  expanded  range  of services to include care for non -communicable diseases, palliative and rehabilitative care, Ora Eye  and  ENT  care,  mental  health  and  first  level  care  for  emergencies  and  trauma  as  we Health promotion and wellness acti vities like Yoga apart from services already being provided for Maternal and Child Health including immunization and communicable diseases.

The State wise Central Allocation under National Health Mission for the FY 2019 - 20 is at Annexure I.

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB - PMJAY)  was  launched  to provide cashless hospitalization facilities of up to Rs 5.00 Lakh per family per year t 10.74 crores families (approx. 50 crore individuals) belonging to poor and vulnerable sec the population. The salient features of the scheme are at Annexure II. The State/UT - wise details of funds released are at Annexure III .

The Umbrella Scheme of Rashtriya Arogya Nidhi and  Health  Minister's  Discretionary Grant (HMDG) provides financial assistance to poor patients belonging to families living threshold poverty line for treatment of major life threatening diseases such as Cancer, a kidney, liver, heart, Ra re Diseases at Government hospitals. Patients taking treatment in private hospitals are not eligible for assistance under the schemes and re - imbursement of expenditure already incurred on treatment is not permissible. While financial assistance upto a max imum of Rs.1,25,000/ - is  provided  under  HMDG  to  defray  a  part  of  the  treatment  cost,  the  maximum financial assistance provided under the Umbrella Scheme of RAN is Rs.15 lakh in each ca Assistance  under  both  the  schemes  is  provided  as  one - time grant  onl y. Financial  assistance under the schemes is released to the hospitals where eligible patients receive treatment and not to  States/UTs.    Funds  allocated  for  the  two  schemes  during  the  current  financial  year under:

|   S.No. | Name of Scheme                        | Budget Allocation in crore)   |
|---------|---------------------------------------|-------------------------------|
|       1 | Umbrella Scheme of Rashtriya Arogya   | Nidhi 200.00                  |
|       2 | Health Minister's Discretionary Grant | 6.00                          |

(c) & (d) : 'Public Health & Hospitals' being a State Subject, no data regarding nursing officers in various hospitals in the country is maintained centrally.

## State - wise Allocation under National Health Mission (NHM) for the FY 2019 -20

Rs. in crore

| Sl. No.   | States                    |   2019-20 |
|-----------|---------------------------|-----------|
| 1         | Andaman & Nicobar Islands |     39.41 |
| 2         | Andhra Pradesh            |   1037.27 |
| 3         | Arunachal Pradesh         |    197.23 |
| 4         | Assam                     |   1510.4  |
| 5         | Bihar                     |   1648.85 |
| 6         | Chandigarh                |     24.82 |
| 7         | Chattisgarh               |    802.75 |
| 8         | Dadra & Nagar Haveli      |     25.72 |
| 9         | Daman & Diu               |     17.36 |
| 10        | Delhi                     |    165.1  |
| 11        | Goa                       |     38.94 |
| 12        | Gujarat                   |   1052.83 |
| 13        | Haryana                   |    524.28 |
| 14        | Himachal Pradesh          |    396.86 |
| 15        | Jammu & Kashmir           |    718.22 |
| 16        | Jharkhand                 |    779.12 |
| 17        | Karnataka                 |   1174.37 |
| 18        | Kerala                    |    651.8  |
| 19        | Lakshadweep               |      6.97 |
| 20        | Madhya Pradesh            |   1611.15 |
| 21        | Maharashtra               |   2031.61 |
| 22        | Manipur                   |    163.2  |
| 23        | Meghalaya                 |    152.96 |
| 24        | Mizoram                   |    120.85 |
| 25        | Nagaland                  |    112.62 |
| 26        | Orissa                    |   1013.14 |
| 27        | Puducherry                |     34.1  |
| 28        | Punjab                    |    561.5  |
| 29        | Rajasthan                 |   1784.58 |
| 30        | Sikkim                    |     51.53 |
| 31        | Tamil Nadu                |   1315.57 |
| 32        | Tripura                   |    201.75 |
| 33        | Uttar Pradesh             |   3824.98 |
| 34        | Uttarakhand               |    505.83 |
| 35        | West Bengal               |   1758.6  |
| 36        | Telangana                 |    626.86 |
| Sub Total | Sub Total                 |  26683.1  |

Note:

1. Allocation is as per Regular Budgeted Estimate (B.E) and is provisional.

## Salient  features  of  Ayushman BharatPradhan Mantri Jan Arogya Yojana [ABPMJAY]

1. Government of India has launched Ayushman Bharat Pradhan Mantri Jan Arogya Yojana  (AB-PMJAY)  on  23.09.2018. AB-PMJAY is  centrally  sponsored  scheme.  It  is entirely  funded  by  Government  and  the  funding  is  shared  between  Centre  and  State governments as per prevailing guidelines of Ministry of Finance.
2. AB-PMJAY provides health  coverage  up  to  Rs.  5  lakh  per  family  per  year  for secondary  and  tertiary  hospitalization  to  around  10.74  crore  poor  and  vulnerable families (approx. 50 crore beneficiaries).
3. AB-PMJAY is  an  entitlement-based  scheme.  This  scheme  covers  poor  and vulnerable  families  based  on  deprivation  and  occupational  criteria  as  per  SECC database.
4. AB-PMJAY provides cashless and paperless access to services for the beneficiary at the point of service in any (both public and private) empaneled hospitals across India. In other words, a beneficiary from one State can avail benefits from an empaneled Hospital anywhere in the Country.
5. Under AB-PMJAY, the States are free to choose the modalities for implementation.  They  can  implement  the  scheme  through  insurance  company  or directly through the Trust/ Society or mixed model.
6. There  is  no  restriction  on  family  size,  ensuring  all  members  of  designated families specifically girl child and senior citizens get coverage.
7. A well-defined Complaint and Public Grievance Redressal Mechanism, has been put  in  place  through  which  complaints/  grievances  are  registered,  acknowledged, escalated for relevant action, resolved and monitored.
8. AB-PMJAY has created a robust IT system for implementation of scheme and manage the real time transaction data.
9. At  National  level,  National  Health  Authority  (NHA)  has  been  set  up  as  an attached office to Ministry of Health and Family Welfare to manage the implementation of the scheme.
10. The details of package, operational guidelines and key features are available at www.pmjay.gov.in

| Annexure-III                                           | Annexure-III                                           | Annexure-III                                           |
|--------------------------------------------------------|--------------------------------------------------------|--------------------------------------------------------|
| State/UT-wise details of funds released under AB-PMJAY | State/UT-wise details of funds released under AB-PMJAY | State/UT-wise details of funds released under AB-PMJAY |
| Sr. No.                                                | Name of States to whom Funds are released              | In 2019-20 Total Amount (Rs. In crore)                 |
| 1                                                      | Andaman Nicobar Islands                                | 0.41                                                   |
| 2                                                      | Andhra Pradesh                                         | 107.12                                                 |
| 3                                                      | Arunachal Pradesh                                      | -                                                      |
| 4                                                      | Assam                                                  | 82.21                                                  |
| 5                                                      | Bihar                                                  | -                                                      |
| 6                                                      | Chandigarh                                             | 1.5                                                    |
| 7                                                      | Chhattisgarh                                           | 23.54                                                  |
| 8                                                      | Dadra & Nagar Haveli                                   | -                                                      |
| 9                                                      | Daman and Diu                                          | -                                                      |
| 10                                                     | Goa                                                    | 0.04                                                   |
| 11                                                     | Gujarat                                                | 212.33                                                 |
| 12                                                     | Haryana                                                | 50.36                                                  |
| 13                                                     | Himachal Pradesh                                       | 13.61                                                  |
| 14                                                     | Jammu and Kashmir                                      | 19.26                                                  |
| 15                                                     | Jharkhand                                              | -                                                      |
| 16                                                     | Karnataka                                              | 85.9                                                   |
| 17                                                     | Kerala                                                 | 36.28                                                  |
| 18                                                     | Lakshadweep                                            | -                                                      |
| 19                                                     | Madhya Pradesh                                         | 84.6                                                   |
| 20                                                     | Maharashtra                                            | 162.03                                                 |
| 21                                                     | Manipur                                                | 7.18                                                   |
| 22                                                     | Meghalaya                                              | 14.78                                                  |
| 23                                                     | Mizoram                                                | 2.58                                                   |
| 24                                                     | Nagaland                                               | -                                                      |
| 25                                                     | Puducherry                                             | -                                                      |
| 26                                                     | Punjab                                                 | 23.95                                                  |
| 27                                                     | Rajasthan                                              | -                                                      |
| 28                                                     | Sikkim                                                 | -                                                      |
| 29                                                     | Tamil Nadu                                             | -                                                      |
| 30                                                     | Tripura                                                | 5.6                                                    |
| 31                                                     | Uttar Pradesh                                          | 72.49                                                  |
| 32                                                     | Uttarakhand                                            | 7.96                                                   |
| Grand Total                                            |                                                        | 1013.8                                                 |