The alacrity with which India responded to the pandemic in close partnership between the Centre and the States, between public and private institutions, took the world by surprise, said N K Singh, Chairman of the 15th Finance Commission of India.

Speaking at the industry body CII’s 19th Health Summit on Tuesday, Singh said despite having done many things there is no getting away from the fact that public outlays in the health sector need to be “substantially augmented”. “We need to enhance public outlays to 2.5 per cent GDP by 2025. This will mean a substantial rise in the budgetary figures for 2022-23. 70 per cent of this expenditure came from States and 30 per cent from the Central government,” Singh said in his address at the Summit.

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“But in respect of State spending, the target of 8 per cent of their budget going for the health sector and a very substantial part of that towards primary health still remains a daunting challenge.”

Further, he said we must recognize the large inter-State variations in health spending and outcomes.

He said states except Meghalaya are spending less than 8 per cent of their budget on the health sector, with the average being at 5.18 per cent in 2018-19.

“Furthermore, the per capita health spending of Bihar, Uttar Pradesh, and Jharkhand is about half that of Kerala and Tamil Nadu. Equally, the ratio of doctors and nurses to the total population reflected in variations on life expectancy remains on a broad spectrum,” Singh mentioned.

He further suggested health be listed under the Concurrent Subject.

“We know that health is not part of the Concurrent List. I am not suggesting health still as a fundamental right, but the least we can do based on our recent experience is to make health a Concurrent Subject, which would make a fundamental difference,” Singh noted.

On the Centrally Sponsored Schemes, he said they need to be somewhat restructured.

“They should be flexible enough for enabling States to adapt and innovate without undoing the basic objectives,” he noted.

In his concluding remarks, he said with India’s G20 Presidency around the corner, the country has a unique opportunity and the area of health and healthcare would be an important theme.

“Harmonization of the multiplicity of rules and regulations which cut across not only boundaries of States in India, but can cut across national boundaries for greater harmonization in this important area could be an important achievement. It would have enormous value to improve the longevity and life quality of all stakeholders,” he concluded.