Lok Sabha Question No. 3741 (UNSTARRED), answered on 2023-08-11
Subject: Expensive Health Services
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Ajay Kumar Mandal, Locket Chatterjee, Navneet Ravi Rana

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

## LOK SABHA UNSTARRED QUESTION NO. 3741 TO BE ANSWERED ON 11 TH AUGUST, 2023

## 'EXPENSIVE HEALTH SERVICES'

## †3741. SHRI AJAY KUMAR MANDAL: MS. LOCKET CHATTERJEE: SHRIMATI NAVNEET RAVI RANA:

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to state:

- (a) the assistance being provided by the Union Government to the State Governments under various heads to make the health services available to the last person of the country;
- (b) whether the State Governments are not able to provide many important testing facilities 24x7 due to financial constraints;
- (c) if so, the assistance proposed to be provided by the Union Government to the State Governments in this regard;
- (d) whether the burden of inflation is increasing on the general public due to expensive health services in the country and if so, whether the Government proposes to provide free health services to all the citizens in the country; and
- (e) whether the Government proposes to provide free and uniform health services to all the citizens of the country in the future and if so, the details thereof and the steps taken in this regard?

## ANSWER

## THE MINISTER OFSTATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a): National Health Mission (NHM) envisages achievement of universal access to equitable, affordable & quality health care services that are accountable and responsive to people's needs. The Ministry of Health and Family Welfare provides technical and financial support to the States/UTs to strengthen the public healthcare system, based on the proposals received in the form of Programme Implementation Plans (PIPs) under National Health Mission. Government of India provides approval for the proposals in the form of Record of Proceedings (RoPs) as per norms & available resources.

The support provided under NHM includes engaging of health human resource on contractual basis, National Ambulance Services, Mobile Medical Units, ASHAs, Infrastructure strengthening, operationalisation of Ayushman Bharat-Health and Wellness Centres (AB-HWCs) by transforming the existing Sub Centres and Primary Health Centres, 24 x 7 Services and First Referral facilities, Mera Aspataal, Kayakalp Award Scheme, Prime Minister's National Dialysis Programme, National Quality Assurance Standards implementation and related Activities, LaQshya Certification, Biomedical Equipment Maintenance and Management Programme, Free Diagnostics Service Initiative and Free Drugs Service Initiative. Further, initiatives such as Mission Parivar Vikas, Adolescent Friendly Health Clinics (AFHCs),

Weekly Iron Folic Acid Supplementation (WIFS), Menstrual Hygiene Scheme, Facility Based Newborn Care (FBNC), Home Based Newborn Care Program, Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS), Home Based Care for Young Child (HBYC), Rashtriya Bal Swasthya Karyakram (RBSK), Rashtriya Kishor Swasthya Karyakram (RKSK), Early Childhood Development (ECD), Comprehensive Abortion Care (CAC), Anemia Mukt Bharat (AMB) strategy, Pradhan Mantri TB Mukt Bharat Abhiyaan (PMTBMBA), Nutrition Rehabilitation Centre (NRC) program and Universal Immunization programme.

(b) and (c): The Ministry of Health and Family Welfare, Government of India supports 'Free Diagnostics Service Initiative' (FDSI) programme under National Health Mission. The programme was launched with the aim to provide accessible and affordable pathological and radiological diagnostics services closer to the community which in turn reduces the Out-of-Pocket Expenditure (OOPE). Diagnostics services are provided free of cost at all levels of public health facilities (14 tests at Sub Centers, 63 at Primary Health Centers, 97 at Community Health Centres, 111 test at Sub District Hospitals and 134 tests at District Hospitals).

Under PM-ABHIM, 730 Integrated Public Health Laboratory (IPHL) are allocated to be established at district level across the country till FY 2025-26.

(d) & (e): National Health Policy (NHP), 2017 envisages raising Government Health Expenditure to 2.5% of GDP. Further, as per the National Health Account Estimates, Out-of-Pocket Expenditure (OOPE) has decreased from 64.2% to 47.1% of Total Health Expenditure (THE) during the last 7 years.

Government of India implements various schemes/initiatives to provide free and uniform health services to all citizens of the country.These schemes/initiatives include:

 In February 2018, the Government of India announced 1,50,000 Ayushman BharatHealth and Wellness Centres (AB-HWCs) to be established across the country by December 2022. The existing SubHealth Centres (SHC), Primary Health Centres (PHC) and Urban Primary Health Centres (UPHC) are transformed into AB-HWCs to deliver Comprehensive Primary Health Care (CPHC) that includes preventive, promotive, curative, palliative and rehabilitative services which are universal, free, and closer to the community. As on 31.07.2023 a total of 1,60,816 AB-HWCs have been operationalized across the country.

 Teleconsultation services, through eSanjevani, are available at functional AB-HWC to ensure specialist services closer to the people. As on 31st July 2023, more than 14.35 crore Teleconsultations have been provided via eSanjeevani portal. Screening of women is also done at AB-HWCs for breast cancer and cervical cancer.

 Under National Free Drugs Initiative, States/UTs are supported to provide essential drugs based on the level of public health facilities free of cost to all who access these facilities.

-  Under the NHM, technical and financial support is provided for emergency medical services in States/UTs through a functional National Ambulance Service (NAS) network linked with a centralised tollfree number 108/102.

 National Mobile Medical Units (NMMU) are supported to facilitate access to public health care at the doorstep particularly to people living in remote, difficult, under-served and unreached areas to provide primary care services.