Experts and health rights activists called upon the government to increase health budget, improve skills and governance and change financial rules to ensure better medical services with limited resources.
They noted with concern that despite an increase in the health budget in terms of the outlay, the lion's share of the funds would go for non-development expenditure like salary as the pay scale of government employees is being raised. It will definitely affect the expected improvement in health-service delivery.
But the health ministry could not say for sure about any qualitative change in their budget proposal for the upcoming fiscal year-although the domestic health sector is deemed far behind the modern-day standards.
Despite communicating with health officials to know about any major changes in the budgeting dimensions, this reporter failed to receive any satisfactory answer except for confirmation of the amount of fund allocation the finance ministry has set as the ceiling.
Deputy Secretary of the health ministry Abeda Khatun told the FE Wednesday that the finance ministry has fixed for them a ceiling of more than Tk 127.25 billion for the fiscal year (FY) 2015-16. The health outlay is up from Tk 115.68 billion in the FY2014-15.
She said the allocation usually increases in the revised budget.
Health Rights Movement Bangladesh president Dr Rashid-e-Mahbub said the health-budget allocation might increase in terms of the amount of money. Health budget in Bangladesh is not exceeding 1.0 per cent of the GDP (gross domestic product). It should be at least 3.0 per cent according to the global standards.
"If the amount increases in this year's budget, it will go for salary payment to the government officials. This salary hike will create inflation and the quality of present medicare will fall," said Dr Mahbub.
He also noted that the present fiscal-management system in the health sector was very outmoded and needed to be changed for better service delivery in the lifesaving sector.
"The hospitals cannot spend their earnings from lab charge, seat rent, ticket fee and procedural charge. As per our estimate, the government earns more than Tk 5.0 billion from various hospitals," said Mr Mahbub, adding: if the hospitals could spend these funds, they could have provided better services.
The health specialist recommends that the institutions should have the authority to spend funds, change financial rules, and make needs-based allocation.
Decentralisation of management, institutional empowerment, separation of preventive and curative line of action and reform in health sector are also prescribed for a healthy healthcare system.
He pointed out that it is not determined who to receive free treatment in government hospitals, but individuals with social face value enjoy most of the facilities.
"These are related with management and budget. It's not the allotment only," said Dr Mahbub to underpin his pleas for a comprehensive change through a holistic approach to the sector.
Health Economics Unit (HEU) director-general Ashadul Islam said health- budget allocation has been doubled since 1993-94. But it has decreased in proportion to the national budget.
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