The healthcare allocation is only 4 percent of the total budget, which is lower than the expected 8 percent and the same as last year.
Chief Minister Siddaramaiah presenting the Budget. (Supplied)
Since taking office, Karnataka Health Minister Dinesh Gundu Rao has emphasised preventive care, a priority clearly reflected in the Congress government’s healthcare budget for 2024.
The amount allocated by the government for healthcare, however, is only 4 percent of the total budget, which is lower than the expected 8 percent and the same as the previous year.
While several appreciated the government’s intent towards improving healthcare infrastructure, a few said it was inadequate in terms of addressing the huge public health gaps for the state of Karnataka.
Praising the government, public health doctor Dr Silvia Karpagam said, “The health budget looks good and promising. I hope the implementation will have good oversight.”
She added: “The ultimate objective is that healthcare should be accessible to all and comprehensive. It should not be fragmented.”
However, Prasanna Saligram, a public health researcher at the Sarvatrika Arogya Andolana from Karnataka, expressed disappointment with the budget.
Terming it “very low key” he said, “Other than some infrastructure announcements nothing substantive regarding structural changes have been brought about. The budget allocation for health still languishes at very low levels.”
He explained: “For instance, the National Health Policy document had proclaimed that state sector health spending would be more than 8 percent of the state budget by 2020, but the current budget announcement of 4 percent is half of that commitment.”
The Karnataka government has decided to provide digital mammography machines for early diagnosis and treatment of breast cancer and cervical cancer screening.
With a rise in the number of cancer cases in the state, the health minister recently expressed concern and even started door-to-door screening for cancer.
The government has also announced colposcopy machines to be provided to KC General Hospital in Bengaluru and the district hospitals of Udupi, Kolar, and Davanagere. The amount allocated is ₹21 crore.
Meanwhile, the government has also decided to extend ST-Segment Elevation Myocardial Infarction (STEMI, or severe heart attack) treatment in the next two years through the hub-and-spoke model to all the taluka hospitals.
Also, ₹32 crore has been earmarked for the procurement of thrombolytic drugs for the treatment of STEMI and stroke.
“The health budget allocation of 4 percent by the Karnataka government remains similar to last year’s budget, and the focus seems to be on improving public health infrastructure, strengthening lab services through a hub-and-spoke model and establishing critical care hubs in every district,” said Dr Narayana Subramaniam, a senior consultant and the director of head-and-neck surgery and oncology at Sparsh Hospitals in Bengaluru.
To ensure TB screening happens faster and in a better manner, ₹6 crore has been allocated for the procurement of 87 True-Nat machines in all Primary Health Centres (PHCs). This screening is expected to achieve the elimination of TB by 2025.
The government acknowledged that there was a shortage of proper facilities for the treatment of haemophilia and thalassemia in the Kalyana Karnataka region.
The chief minister announced ₹7 crore to strengthen ICDT centres in the Kalaburgi and Koppal districts.
The government also acknowledged that there were no blood storage units in the First Referral Units (FRUs) of many districts in North Karnataka. It noted that this made it difficult to supply blood during emergencies.
Thus, the government announced that 50 new blood storage units would be established in the next two years.
Apart from focus on screenings and preventive care, the state government has allocated a large chunk of its health budget on building infrastructure.
The state has announced ₹187 crore to set up state-of-the-art critical-care blocks in each district of the state to provided better healthcare to patients with critical illnesses.
“The construction has already started in 15 districts, and will be taken up in the current year in the Udupi, Davangere, Vijayapura, Mysuru, Mandya, Dharwad, and Koppal districts at the cost of ₹187 crore. These CC blocks will be set up in the remaining nine districts next year,” the budget read.
Meanwhile ₹280 core has been allocated to construct 100-bed taluka hospitals in the Anekal, Nelamangala, Hoskote, Shringeri, Khanapura, Shirahatti, and Yelandur talukas, where there are no such hospitals.
For repair and renovation of dilapitated buildings of the health department, ₹75 crore has been allocated.
The government has announced it will set up a mother-and-child buildings and other infrastructure facilities on the premises of KC General Hosptial in Bengaluru at the cost of ₹150 crore.
With an intention of providing 24×7 emergency healthcare services to rural people, the state government has allocated ₹350 crore to upgrade 25 PHCs to Community Health Centres (CHCs).
“In the current year, 15 CHCs will be operationalised with necessary human resources,” Chief Minister Siddaramaiah said in his budget speech.
Meanwhile 46 new PHCs will be set up at a cost of ₹221 core.
Also, ₹130 crore will be provided for the construction of 199 health and wellness centres across the state.
Amongst the other measures, the state government also announced tele-ICU systems to ensure that the services of paediatric, critical-care medicine, and other specialists working in district hospitals and medical colleges were available to taluka hospitals.
Also, given that there were no chemotherapy treatment centres in most of the districts to provide treatment and for continuous follow-up to cancer patients, daycare chemotherapy centres would be set up in each district at a cost of ₹20 crore.
An integrated and Public Health Laboratory (IPHL) would also be set up in each district hospital in the next four years to provide qualitative and affordable laboratory services, said the chief minister.
The labs would be set up in the Chikkamagaluru, Vijayanagar, Shivamogga, Belagavi, Mandya, Hassan, and Kodagu districts in 2024 and Chitradurga, Bagalkote, Chamarajanagar, Bidar, Koppal, Raichur, Kalaburagi, Uttar Kananda, and Gadag during 2025-26.
Meanwhile taluka-level Block Public Health Laboratories (BHPL) would be established in Hunagaunda, Sira, and Hagaribommanahalli in 2024. A total grant of ₹11 core has been allocated towards this.
Also, ₹20 crore has been announced over next two years to set up 430 laboratories in a hub-and-spoke model to provide affordable and qualitative laboratory service to people of Bengaluru.
Praising these, Subramaniam said, “Leveraging technology can result in early and low-cost diagnosis of non-communicable diseases, which will enable patients to seek treatment closer to home and not necessitate travel to tier-1 cities.”
He added: “Better public-private partnerships can ensure that patients are not waiting for long periods of time at government institutions for treatment, which can be achieved by ensuring wider coverage of government health schemes, as has been achieved in other states.”
The Karnataka government, going with the Central government’s idea of promoting AYUSH healthcare, has decided to set up one Ayurveda diabetes unit in each of the four divisions of the state to provide alternative medical treatment to the public for the control of diabetes.
Interestingly, the state has also announced setting up a commission to conduct a judicial inquiry into the serious allegations made in the Public Accounts Committee Report of 2021 regarding the management of the Covid-19 pandemic.
The government is set to take action based on the report of the commission.
While in 2023 it did not focus on big-ticket expenditures, it looks like the government in 2024 is focused on investments in healthcare infrastructure including medical equipment.
Public health experts and doctors from the private sector expressed disappointment with the budget. While a few felt the percentage of total budget allocated to health was merely not enough, others asked why the government didn’t think of upgrading the existing infrastructure.
Expressing disappointment, HOSMAT Hospitals COO Dr R Sandeep said, “I thought healthcare would get more importance in terms of budget allocation, especially after Covid-19.”
He added: “I was expecting that the budget would upgrade and invest to improve the government’s healthcare delivery system or come up with public-private partnerships so that quality healthcare became more accessible to the poor and the middle class.”
Asking why the government did not budget towards upgrading existing facilities, he also said, “In the recent past, we have seen Sri Jayadeva Institute of Cardiovascular Sciences and Research branches starting in other parts of Karnataka. The government could have budgeted to upgrade them so that it would help the people of those parts of the state.”
He concluded: “Overall, I feel the allocation for health has more or less remained the same (4 percent) for many years, which could have been better.”
Voicing similar concerns, Drug Action Forum President Dr Gopal Dabade said the public health system of Karnataka needed to be ramped up because “when we compare Karnataka’s health status with other South Indian states like Tamil Nadu or Kerala, we have much to achieve”.
He noted, “This budget does not fulfil those needs. Karnataka needs a robust public health system so that out-of-pocket expenses are reduced. Investing in health and education will definitely improve the overall economy of the state and should not be seen as just welfare. This budget is inadequate in terms of addressing the huge public health gaps for the state of Karnataka.”
However, Dr Denny John, a professor of public health at the MS Ramaiah University of Applied Sciences in Bengaluru, praised the government and said, “While 2023 did not focus on big-ticket expenditures, it looks like in 2024 the government is focused on investments in healthcare infrastructure including medical equipment.”
Former Karnataka health and medical education minister Dr K Sudhakar slammed the health budget.
He said the budget presented by Chief Minister Siddaramaiah proved the BJP’s allegation that the Congress government had no money for development and capital expenditure.
Citing an example, he told reporters: “The budget speech says ₹400 crore will be allocated for the construction of new medical colleges and purchase of equipment. This is inadequate and unrealistic.”
He said that during the BJP’s tenure, the government built four new medical colleges in four districts: Chikkaballapura, Haveri, Yadgir, and Chikkamagaluru.
He asked, “Is it possible to build even one medical college with ₹400 crore?”
He added that this showed that the budget was full of hollow claims and bogus promises that lacked adequate budgetary support.
Sudhakar also said the BJP government established 438 Namma Clinics in urban centres across the state to ensure affordable and accessible universal primary healthcare.
This budget completely ignored both Namma Clinics and upgradation of PHCs, he claimed.
Speaking about the establishment of human milk banks under the medical education budget, he said the BJP government started the first state-owned human milk bank at Vanivilas Hospital in Bengaluru.
It was a welcome move that the budget had announced the setting-up of three more human milk banks — in Raichur, Ballari, and Mysuru.
“However, there is no allocation for the establishment of new mother and child hospitals. The budget has also completely ignored mental healthcare and has not mentioned anything about taking further BJP government’s successful and popular mental initiatives such as Brain Health Clinics and e-Manas,” he said.
Expressing disappointment about state budget not mentioning the cervical cancer vaccination drive, he said the Central government in its budget announced vaccination against cervical cancer for girls aged between 9 to 14 years.
The following are the highlights of the 2024 Karnataka health budget:
The following are the highlights of the medical education budget for Karnataka:
May 19, 2024
May 19, 2024
May 19, 2024
May 19, 2024
May 19, 2024
May 19, 2024
