Public health has been a neglected area in India for a long time with health infrastructure in most of the states remaining underdeveloped mainly because of poor planning and inadequate fund allocation for healthcare. Even after 68 years of independence, country’s spending on public health remains as low as 1.04 per cent of GDP. This is deplorably low when compared to spending on health by several other developing countries. The net result of this government failure is reflected in the current disease profile of the country showing a dangerous spurt in infectious and lifestyle diseases. A draft National Health Policy 2015 has been notified last February to address this serious issue by the Central government and is put up for public discussion. The new policy is being introduced almost 13 years after the implementation of last health policy. The main focus of the new Health policy is to step up government spending on public health services by building health facilities in rural and urban areas. The Policy has rightly proposed to raise the target of public health expenditure to 2.5 per cent from the present 1.04 per cent of GDP. It also notes that 40 per cent of this would need to come from central expenditure. As per the Policy, 70 per cent of the funds would be spent on primary health care, 20 per cent on secondary health care and 10 per cent on tertiary health care. States would also be encouraged through performance based incentives to ensure that at least 8 per cent of their annual budgets are spent to providing health services. And for meeting strategic gaps in the supply that public health infrastructure cannot provide, the government may procure specific services from the private healthcare sector for the secondary and tertiary health sectors under a regulatory network.

The responsibility for the failure to attain minimum levels of public health expenditure remains largely on the state governments. Many northern states have failed miserably in establishing adequate number of primary health centres and district hospitals and running them effectively all these years. The state governments have neither utilized allocated funds for setting up adequate number of PHCs nor effectively run the established health centres. Now, a detailed road map has been provided in the new policy for the implementation of its objectives on a phase-wise basis. Specific quantified targets too have been proposed under the policy to measure achievements. The parameters have been set for countrywide health status, performance of public health facilities, the financial plans and other deliverables under the policy. A significant proposal in the draft policy is the provision for providing essential generic drugs and diagnostics free of cost at all PHCs. At the tertiary care level too, patients in geriatric and chronic care segments are expected to get most drugs and diagnostics either free or subsidised rates with fair price selling mechanisms. This policy thrusts and targets sound appealing but what is important is the constant monitoring of nationwide implementation of the new policy. For achieving this, Union health ministry should have a coordinated approach involving key officials of health ministries of all the state governments.