Nothing new, nothing exciting
The proposed budget for the 2021-22 FY does not have anything different compared to the current one.
Each time we see that the new budget pops up with some increased figures than the previous one. It happened this time too.
Except the Tk10,000 crore from the block allocation, the finance minister proposed only 5.4% of the budget to health for the next year – which is a marginal increase, and there is nothing exciting.
But the new budget could have newer things into its consideration.
There could be health insurance or financial protection schemes for the poor. Bringing 1 crore people under the health insurance coverage could create a new spending area and would provide the poor with financial protection. But there is nothing new in the budget.
I think instead of Tk10,000 crore separate block allocation, the finance minister could have added it to the health allocation. The health ministry returned the allocation this year upon spending failure.
Block allocation is an inter-ministerial subject. When the health ministry cannot even spend its original budget funding, how would it spend from the block allocation? On top of the confusion about health's spending capacity, it is unclear when the emergency fund can be put in use.
So, what is the benefit of the budget allocation if it is not used?
The proposed budget says modern equipment, such as ECG machines, nebulizer machines, autoclave, ultrasonography machines, blood collection monitors will be installed in the upazilla complexes.
Besides the purchase, the maintenance is also equally important. But the reality is the health sector purchases usually attract the bureaucrats more than the maintenance. If we only buy health equipment completely ignoring the maintenance, it will not benefit the patients.
The government is concerned over Covid-19 vaccine though the budget does not specify the vaccine allocations. Financing will not be a major problem once the vaccines become available.
The proposed budget mentions Tk100 crore allocation for research, but it is not clear whether it is for the current year or the upcoming one.
A research proposal has been sought a few days ago as this year's budget has not been spent yet.
The proposal will take as long as July this year for evaluation. This means the cost to come from the new fiscal year allocation. So it seems to me that there is no new allocation for research.
But there were many scopes for spending this money during the pandemic. Even those conducting research on vaccine development could get the fund.
The budget proposal offers tax exemption to general hospitals with a minimum of 250 beds and also to specialized hospitals with a minimum of 200 bed capacity for ten years.
There is no survey on whether private sector investment in health is declining due to taxes. It is not right that only providing incentives will meet with big hospitals outside Dhaka. Rather, there could be mushrooming smaller private clinics.
Tax reduction in the pharmaceutical industry is a good decision. Because the pharmaceutical industries in our country still do not produce raw materials. The active pharmaceutical ingredients come from India, Europe and America.
But we have to estimate if the pharmaceutical companies or the people will benefit from the tax exemption. The tax supports are supposed to bring down drug prices, but it may not be the case.
My assumption is that a large portion of the health budget will remain unspent like the 2020-21 FY.
Dr Shafiun Nahin Shimul is an associate professor of University of Dhaka and a health economist
