Of the many budgetary provisions put forward by Finance Minister Nirmala Sitharaman in the area of healthcare sector, doctors and industry experts hail the government's initiative to eliminate sickle cell anaemia by 2047 and also a proposal to set up 157 new nursing colleges and boost medical education and research. Sickle cell anaemia is a genetic condition which is prevalent among the tribals—one in 86 births among the Scheduled Tribes have SCD (Sickle Cell disease) as per the numbers from the Ministry of Tribal Affairs. The announcement made by the finance minister in the budget will help in screening of 70 million people up to the age of 40 years in affected tribal areas.
"Creating awareness of prevention and early screening is not only essential in eliminating sickle cell anemia, but would also be a great stepping stone for similar diseases. However, its success will depend on effective implementation," said Gautam Khanna, CEO P.D. Hinduja Hospital and Chairman FICCI Health Services.
In the area of pharmaceuticals, the finance minister said that a new programme to promote research and innovation in pharmaceuticals will be taken up through centers of excellence. Dedicated multidisciplinary courses for medical devices will be supported in existing institutions to ensure availability of skilled manpower for futuristic medical technologies, high-end manufacturing and research, she said. Alongside, there has been a push for the Indian medical device market.
The FM also said that 157 new nursing colleges will be established in various locations across the nation. The pharmaceutical industry, she said, will be encouraged to invest in research through the creation of a new programme for research and development in the field. Dr Azad Moopen, Founder Chairman and MD, Aster DM Healthcare said, “The Union Budget 2023-24 has excellent focus on skill development and addresses one of the core challenges that the healthcare industry is facing today – shortage of nursing staff, through the announcement to start 157 nursing colleges alongside existing medical colleges."
According to a World Health Organization (WHO) report published last year, India would require at least 4.2 million more trained nurses by 2024 to take care of its over 1.44 billion expected population. The current ratio of nurses and the population stands at a poor 1.7 nurses per 10,000 people, which is much lower than the WHO recommendation of 4 nurses for 10,000 persons. "However, the overall impetus for the healthcare delivery sector is missing. We were hoping for an increase in budget allocation for the industry which is essential to fulfil the need gaps. The need to have more hospitals and healthcare facilities in rural and suburban areas to meet the rising demand remains untouched. Hope the government would put more focus on public- private partnerships (PPP) to address this. We were also hoping for concessions for NRIs residing abroad like reduction on TDS for those who have a source of income in India and are required to pay taxes in the country they reside in, flight prices, health scheme for those who are returning to India to retire, among others. However, these remain untouched as well,” said Dr Moopen.
The FM also announced the opening of 3 inter-disciplinary AI research and development centres to “Make AI in India and Make AI work for India”. AI in Healthcare has already shown immense promise across the globe in improving care; across diagnostics AI tools have bettered accuracy, speed and also enabled early diagnosis. "Given the potential to create large healthcare data sets in India used to train AI and the pool of highly qualified tech talent, this move by the government makes us more ready than ever to make AI in healthcare a trillion-dollar opportunity. Healthcare continues to be a space where professionals like doctors, nurses, etc. have unequal influence over any individual’s care journey. Additional investment in developing and upskilling healthcare personnel like nurses and technicians was one of our key expectations from the budget," said Namit Chugh, Investment Lead, W Health Ventures.
Yet, many health experts thought that the budgetary increase in healthcare expenditure of 15 per cent does not seem enough to tide over the current challenges of upgradation of infrastructure and providing accessibility and affordability for quality healthcare in the country. “We are looking forward to clear indications of the steps to be implemented for healthcare infrastructure development and move closer towards universal health coverage with increased expenditure. It would have been better if there were tax exemptions for healthcare, which is vital to reduce healthcare expenses and out of the pocket spending,” said Gautam Khanna, CEO, P.D. Hinduja Hospital & Chairman FICCI Health Services.
"Union Budget 2023 focuses on the need to increase investment in the R&D sector when it comes to the health and pharmaceutical industry. Over the past few years, the healthcare industry has been observing exponential growth. Pharmaceutical products and services are subject to taxation ranging from 5-12 per cent, while nutraceutical products are taxed at a rate of 18 per cent. The industry was hoping for a relaxation in the taxation rate. The nutraceutical industry in India is worth $7 billion; it accounts for $400 billion worldwide. One of the major challenges is that it still remains unregulated. We expected tax exemptions or rebates, it could have helped the industry grow," said Arham Jain, Co Founder, NutraBooti.
As per analysts, the health-tech industry is estimated to grow to $50 bn by 2033. "While the government had announced that it will be offering financial incentives to encourage the production of high-end medical devices, this has still not been addressed and no measures taken to help end the 80-85 per cent import dependence forced upon India as well as the ever increasing import bill of around INR 50,000 crore. Supporting policies are required to allow the medical devices industry to make quality healthcare accessible and affordable for the masses and catapult our country into becoming one of the top medical devices manufacturing hubs globally. A gradual phasing out of GST which was definitely the need of the hour was also unfortunately not addressed," said Dr S Senthil Kandeepan, Founder, MD and CEO, Healthwatch Telediagnostics.