Health Infrastructure and inadequate spending 


The 15th Finance Commission has mooted a greater role for public private partnerships to ramp up health infrastructure and scale up public spending on health from 0.95% of the GDP to 2.5% by 2024.



  • While public outlays should focus on primary health care at the panchayat and municipality levels, private players should be relied on for specialty healthcare. 
  • Fix the skewed availability of healthcare across India as poorer States have the worst facilities. 
  • Substantial improvements in the working conditions for doctors in government hospitals, many of whom are hired on a contract basis by the States, and the creation of an Indian Medical Service cadre as envisaged in the Civil Services Act, 1951. 
  • The total spending of around 0.95% of GDP is not adequate both in relation to our peer groups, and in relation to the commitments under the National Health Policy of 2017. 
  • There is no doubt that public spending, both by the Centre and the States, needs to go up very significantly. The endeavour must be to raise public spending from 0.95% of GDP to 2.5% of GDP by 2024. 
  • While India does not have adequate health infrastructure, the picture is “exceedingly skewed” among the States with the poorest of them having the worst health infrastructure. 
  • Seeking greater attention on the role of paramedics and frontline health workers in countering the pandemic. 
  • On the proposal to constitute an All India Medical Service, no action had been taken on the issue till date. 
  • To achieve better healthcare parameters, public private partnerships must be considered “in a holistic way” instead of the current situation where the government only turned to the private sector in times of emergency. 



  • Trust deficit :​ For that, a working relationship is needed and this relationship can be built only if, first and foremost, the trust deficit that exists [between industry and government] now is bridged. 
  • Private sector investment in health has an exceedingly important role to play, needs tobe encouraged. 
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