Monday, April 16, 2012

UHC Conference on HLEG April11-12, 2012

The UHC Conference in Delhi was a good pitch for the HLEG recommendations and very useful and insightful debate happened amongst a wide array of stakeholders. The discussions were good but there was one glaring deficit. I think the most problematic issue with HLEG report is that the Ministries of Health have been sidelined, both at the Centre and in States. The central problem is that even if the Planning Commission accepts it lock stock and barrel (which apparently it is not as we see differences with the Steering Committee Report and what may finally come into the 12th Plan) the Health Ministries get alienated and being the implementers of healthcare programs the latter are often at variance with the Planning Commission. The HLEG has also fallen into the same trap and despite reasonably good and broadly acceptable recommendations they are not going to be accepted because of not taking the Health Ministries fully into confidence. The role of Health Ministries have been marginal at best in developing the HLEG recommendations. The April 11-12 consultation on UHC in Delhi precisely suffered from that deficiency. An opportunity to get Ministries of Health on board was lost. The presence of secretaries from two states was only a consolation and there was no significant engagement with the Union Ministry of Health either. So it is not surprising that the grapevine is ripe with stories of the disjunct between the Planning Commission and the Ministry of Health on 12th Plan lines of action. So a lot of useful effort of HLEG is going to be wasted. During the 8th-10th Plan periods on various working groups of the PC I had raised this issue of sidelining the Ministry of Health in developing the trajectories of the Plans for health but these have been ignored and that is the reason after the 10th Plan I have turned down requests to be on any committees.
The above trajectory of the role being played by the Planning Commission seems to be across the board - the recent mess up with the Railways budget, which for the first time was influenced by the Planning Commission is a case in point; the Planning Commission wants to take it in the direction of privatization. These dangerous trends within the Planning Commission need to be monitored and countered.


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