ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846
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Distorted Perspective on Health Care

The only solution to the many problems of providing health care for all would be a nationalised health system. DESPITE all the rhetoric about "adjustment with a human face" that the Narasimha Rao-Manmohan Singh and the pro- government Media Cabal have been dishing out, there is absolutely no doubt that the government of India's structural adjustment programme (SAP) is having deleterious effects on social welfare. Confirmation for this fact comes from no less a source than the World Bank itself, the prime motivator of the programme. In its India Health Financing Study (May 1993) a country- specific document complementary to the better known World Development Report 1993, it says, "In the face of budgetary pressure and the start of the adjustment process, the health sector faces a critical decision point today" (p 88). The Bank was acutely concerned because the very first budget under the SAP drastically reduced the already meagre allocation for health. In the 1992-93 budget, central allocation to health was Rs 303 crore the same as the previous year. However, this included Rs 58 crore, for AIDS control committed by the World Bank. So in fact, the actual allocation was Rs 245 crore, a cut of 20 per cent. The ministry of health and family welfare absorbed this fierce reduction by simply slashing allocations for various important programmes. Thus, for example, the National Malaria Eradication Programme got Rs 50 crore compared to Rs 83 crore the previous year, allocation for tuberculosis was cut from Rs 16 crore to Rs 13.5 crore and some ongoing programmes like the control of encephalitis, filaria and guinea-worm received no funds at all. The World Bank was worried that too much and too sudden a reduction in social welfare activities would provoke widespread unrest. Subsequent budgets have reflected the Bank 's concern and there has been some rise in allocations for health although even today it remains a miserable 0.58 per cent of the budget.

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