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NAC meeting tomorrow to discuss National Health Mission-Aarti Dhar
-The Hindu

Government plans to roll out 12th Plan

The National Advisory Council (NAC) is meeting here on Friday to sort out differences between the Planning Commission and the Union Ministry of Health & Family Welfare over the proposed National Health Mission.

The Government plans to roll out the 12th Plan. The implementation of the Universal Health Coverage, as recommended by the High Level Expert Group, will also be discussed.

The Planning Commission wants the scope of the existing National Rural Health Mission (NRHM) to be expanded to towns and rename it as the National Health Mission, whereas the Health Ministry has been pitching for a separate National Urban Health Mission (NUHM) for the urban poor. The two could be subsequently merged into a National Health Mission, it has maintained.

Chaired by United Progressive Alliance chairperson Sonia Gandhi, the task of the National Advisory Council is to provide inputs in the formulation of policy by the government and to provide support to the government in its legislative business.

The NAC has special focus on social policy and the rights of the disadvantaged groups. It comprises professionals from diverse fields of development activities who serve in their individual capacities.

The Health Ministry has made it clear to the Planning Commission that the draft of the chapter on health in the 12th Plan document proposes an omnibus National Health Mission and the way it has been articulated was fraught with the danger of neglect of rural areas, which require more attention.

“The health set-ups in rural areas, more or less, conform to a uniform pattern while in the urban areas the health set up varies widely not only from State to State but also for different categories of local bodies within a State such as mega cities, metropolitan cities or municipal town. Hence, there cannot be a uniform approach for both rural and urban areas,” the Health Ministry said in a formal communication to the Planning Commission. It will stick to the same stand in the NAC meeting also.

The Cabinet has already approved the continuation of the NRHM during the 12th Plan and a separate proposal for the NUHM is under formulation.

‘Report used selectively’

The Health Ministry has also pointed out that the HLEG report on Universal Health Coverage seems to have been used rather selectively and focus has been on a managed care approach with an enhanced role for the private sector. The suggested pilot models heavily promote corporatisation of health.

“The Ministry has been advocating developing a strong public health system to be supplemented by private sector participation. This has also been highlighted by HLEG, which advocates strengthening on primary care as well as district hospitals,” it said.

On the issue of UHC, the Ministry strongly feels that it can become a reality only if requisite investment is made in the public sector, which now suffers from serious shortages in terms of infrastructure, machinery and equipment and human resources on account of historical underinvestment. “Therefore, we must strengthen the public health systems at all levels while focussing on primary and secondary care. Though this could be supplemented through private sector participation, there is no denying that private hospitals are concentrated as well as interested only in urban centres. A vast majority of the population living in remote rural areas have no access to such facilities and cannot afford them. We need to build on the gains of the Eleventh Plan and guard against weakening of programmes that have yielded positive results, like the NRHM,” the official note said.

The Approach Paper to the 12th Plan has clearly indicated that the government should aim at raising total health expenditure to 2.5 per cent of the gross domestic product by the end of the Plan. This fact has also been reiterated in different forum. However, the draft chapter on health indicates a total public investment on health in the 12th Plan to be only 1.58 per cent of GDP as against the suggested 2.5 per cent.