Shri Shatrughan Sinha, Union Minister of Health
& Family Welfare has said that the development of health accounts
is aimed at bringing all the players in the sector in the common
framework. Health accounts have been developed in many other countries
to track the resource flow like, where the resources come from
and where and on what services they are defrayed. A detailed analytical
exposition of financial flows of health sector will provide directions
to make our policies more effective and particularly to address
the equity and efficiency aspects. For this, the focus should
go beyond the traditional approach of public sector or private
sector in a macro sense. Intricacies involved in who delivers
what, who pays for what and what is delivered to whom, etc. are
likely to be brought out through the development of a system of
health accounts.
The development of NHA would require a well coordinated
institutional arrangements to go beyond the Ministry/Department
of Health, such as Central Statistical Organisation, Ministries
of Finance, Railways, Defence and so on, in order to present a
complete picture of financial flows. Experiences of other countries
such as Sri Lanka, Thailand, etc. would throw some light for India.
In the absence of the Minister Shri G.R. Patwardhan, Special Secretary,
Ministry of Health & Family Welfare read out the speech of
Shri Shatrughan Sinha.
Speaking on the occasion, the Secretary, Health,
Shri S.K. Naik said that financing of health sector has been a
serious concern as the private sector spending is beyond the ambit
of the policy makers. Public financing of health sector has been
under severe stress for a decade or so due to overall fiscal stringency
in the economy. Factors like, changing fiscal policies in tune
with rationalisation, adjustments, pay commission recommendations
and so on, have adversely affected the finances of the Central
and State Governments. As a result, the efficiency of health sector
spending in comparison with other countries has been significantly
low.
Elaborating on the equity and efficiency issues
of health financing, Shri Naik said that health sector should
be seen in totality. Countries around the world have been experimenting
and developing a framework, National Health Accounts (NHA) to
trace effectively the financial flows in the health sector with
the above objectives. Neighbouring countries such as Sri Lanka
and Thailand have successfully developed and put in place the
NHA framework. It is time now for India too to develop and structure
the health sector financing to address the issues.
National Health Accounts are a tool, which describe
the expenditure flows – both public and private – within the health
sector of a territory. They describe the sources, uses and channels
for all funds utilised in the entire health sector. The emphasis
in NHA is to describe in an integrated way who pays, how much,
and for what, separating the whom from the what. In other words,
NHA show the amount of funds provided by major sources (e.g. government,
autonomous bodies, non-profit organizations, households) and how
these funds are used in the provision of services, organised according
to the institutional entities providing the services (e.g. MOH
hospitals, state and local bodies health facilities, private doctors,
pharmacies, Ayurvedic providers, etc.). NHA may disaggregate spending
according to the identity of service beneficiaries (e.g. gender,
province/district, income level) and type of service (e.g. inpatient
and outpatient care, dental services, medical research, etc.)
Dr. Tej Walia, Representative, World Health Organisation
also attended the function.
