Allocation for national healthcare is two dimensional. If a nation is generally healthy with the majority of the population living an active, regular and quality life supported by matching income, the need for overall medical care gets significantly curtailed. But if poverty, unhealthy and unhygienic practices mark the national life, the need for an extensive healthcare system becomes overriding. With rare exception like Cuba, nations with resource constraints can hardly do justice to develop an adequate and advanced medical service system for their populations. Bangladesh is no exception to this rule. The reported preliminary allocation of Tk434.83 billion, for the country's health budget for the next fiscal, up from the current year's Tk414.80 billion is just a modest increase by Tk20.75 billion. Although this marks a 5.0 per cent increase in health allocation on the current year's, it is 1.0 percentage point less than the overall growth of the budget size. Clearly, health budget has failed to get the priority it deserves even under the interim government.
Reading between the lines, there is enough reason to be highly concerned. The slashing of development budget in the health sector, as proposed, is likely to have serious implications on patients seeking medical intervention. While development outlay is going to decrease by 13.30 per cent, the operating expenditures such as salaries, procurement and other non-development expenses are likely to rise by 22.44 per cent. Like the education budget, health allocation also loses any substantial gain because of the major expenditure on salaries and other non-development heads. Experts in health economics have duly expressed concern over the massive reduction in the sector's development expenditure. The country has been spending only 0.7-0.8 per cent of the gross domestic product and the result is that the per capita expenditure here wallows at $58 as against the minimum $88 per person per year the World Health Organisation (WHO) recommends.
Then there is a wide gap between medical services in government hospitals and private facilities. The majority of private health clinics and diagnostic centres, moreover, run shabbily without required medical equipment, emergency devices and even qualified manpower. Many of the upazila health complexes run poorly with the physicians remaining absent most of the time. Thus health service available in many cases is more a misnomer than a reality. No wonder, therefore, patients in Bangladesh are compelled to spend the highest out-of-pocket proportion of money at 74 per cent under the current health budget, a rise by 5.53 per cent from the 68.5 per cent in 2020---far higher than the global average of 17.05 per cent. The proposed budget allocation may raise the out-of-pocket expenditure even further.
However, there is a silver lining amid this gloomy picture. It concerns the 'human resource development' as Planning Adviser Dr Wahiduddin Mahmud revealed. That priority will be given to employment of the much-needed medical staff such as doctors, nurses and technicians is appreciable. Indeed, this move is pragmatic. It will address, to some extent, the growing problem of unemployment and at the same time the shortage of required manpower at health complexes and hospitals. Costly medical equipment and machines lie idle or get rusted because of no recruitment of expert technicians for the purpose. However, employment of physicians is no guarantee of their stay at the duty stations. A sure recipe has to be developed for this problem.
Proposed health budget falls short of expectation
FE Team | Published: February 10, 2025 20:22:33
Proposed health budget falls short of expectation
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