The National Health Policy 2017 aims to improve health outcomes and achieve universal health coverage in India. It proposes increasing public health spending to 2.5% of GDP to strengthen primary care services and ensure access to free drugs and diagnostics. The policy focuses on preventing diseases and promoting wellness. It also aims to reform medical education and regulation, and make the public health system more responsive to needs. Key goals include reducing mortality rates and improving access to healthcare, especially in rural areas.

1. National Health Policy 2017

2. Introduction of NHP 2017
• On March 15, 2017 the union cabinet approved the
new National Health Policy.
• 28-page policy text and an accompanying 13-page
situational analysis were placed in Parliament and in
the public domain.
• Road map on how a nation would show “progressive
realization” of health as a basic human right is an
obligation under the International Covenant on
Economic, Social and Cultural Rights.

3. Context, Need and Scope:
• India -- world’s 3rd largest economy
• The gaps in health outcomes continue to widen.
• “The power of existing interventions is not matched by
the power of health systems to deliver them to those in
greatest need, in a comprehensive way, and on an
adequate scale".

4. Evolution
Health Commities
5 Year Plans
Alma Ata Declaration
Health policy 1983
Health policy2002
NRHM
MDG
SDG
Niti Ayog
Health policy2017

5. THIS NHP…
• Addresses the urgent need to improve the performance
of health systems.
• Formulated at the last year of the MDG
• Then introduction of SDG
• In the Global context of all nations committed to moving
towards universal health coverage.
• This year World Health Day Theme

6. • 2 way linkage between economic growth and health
status,  a declaration of the determination of the
Government to leverage economic growth to achieve
health outcomes
• Better health contributes immensely to improved
productivity as well as to equity.

7. Compared to past NHP..1983 &
2002
• The context has changed in four major ways.
• Firstly- Health Priorities are changing.
• Secondly - is the emergence of health care industry
growing at 15% compound annual growth rate (CAGR).

8. • 3rd - incidence of catastrophic expenditure due to health
care costs is growing - major contributors to poverty.
• The 4th -- economic growth has increased the fiscal
capacity available

9. National Health Policy 2017
• The promise of Health Assurance – is an important catalyst
for the framing of a New Health Policy.
• The primary aim of the NHP 2015, is to inform, clarify,
strengthen and prioritize the role of the Government
• Shaping health systems in all its dimensions- investment in
health,
• Organization and financing of healthcare services,
• Prevention of diseases and promotion of good health .

10. Goal
• The attainment of the highest possible level of good
health and well-being,
through a preventive and promotive health care
orientation in all developmental policies, and
Universal access to good quality health care
services without anyone having to face financial
hardship as a consequence.

11. Key policy principles
• Equity:
• Universality:
• Patient Centered & Quality of Care:

12. • Inclusive Partnerships:
• Pluralism:

13. • Subsidiarity:
• Accountability:.
• Professionalism, Integrity and Ethics:

14. • Learning and Adaptive System:
• Affordability:

15. Objectives:
• Improve population health status through concerted
policy action in all sectors and Expand
– preventive,
– promotive,
– curative,
– palliative and
– rehabilitative services provided by the public health
sector.

16. Medical education
• To ensure quality of Medical Education, a common entrance
exam on the pattern of NEET for UG entrance at All India level
needs to be enforced.
• A Licentiate Exam will be introduced for all medical graduates
with a regular renewal at periodic intervals with CME credits
accrued.
• The policy recognizes the need to revise the under graduate
and post graduate medical curriculum keeping in view the
changing needs, technology and the newer emerging disease
trends.
• Development of research centers would be a focus area.

17. Regulatory framework
The regulatory role of the Ministry of Health and Family
Welfare includes:
• regulation of clinical establishments,
• professional and technical education,
• food safety,
• medical technologies and medical products with
reference to introduction, manufacture, quality assurance
and sales,
• clinical trials and research, and
• implementation of other health related laws.
---Each of these areas needs urgent reforms

18. Regulation of clinical establishments
• The Government of India had enacted the Clinical
Establishments Act 2010
• Only nine States and Union Territories have adopted the
Act so far.
• A few States have enacted their own State laws.
• Accreditation of clinical establishments and active
promotion and adoption of standard treatment guidelines
would be one starting point.
• Involvement of communities and their representatives in
this process- especially in client support for publicly
financed health insurance is another

19. Professional and technical education
• Regulatory Framework for Professional Education: The
four professional councils for medical, nursing, dental
and pharmacy council face many challenges in enforcing
quality in professional education or professional ethics
and good practice
• The policy calls for a major reform and strengthening of
these bodies and their accountability.

20. Food safety
• Though enacted in 2006, the Food Safety and Standards
(FSS) Act, was operationalized only from late 2011.
• Implementation of the Act has been far from adequate
due to insufficient infrastructure including manpower,
budgetary constraints and also the framework of the Act,
Regulations and the scope and the degree of
enforcement.
• Since there were few standards in place, science based
standard setting has been one of the challenges to its
implementation

21. Regulatory framework
• India is known as the manufacturing hub and
pharmacy of the world with exports to over 200 nations.
• To ensure the safety, efficacy, and quality of drugs and
medical devices and cosmetics that are manufactured,
imported, or sold in the country, a dynamic regulatory
regime would be put in place.
• This is essential to safeguard the public from sub-
standards or unsafe drugs and medical devices and to
ensure the Indian pharmaceutical industry‟s global and
domestic reputation and leadership.

22. Regulatory framework contd
• Regulation systems -- on par with international
standards and aligned with WHO and other relevant
international guidelines.
• Post market surveillance program for drugs, blood
products and medical devices shall be strengthened.
•
• The Drugs and Cosmetics Act would be amended to
incorporate chapters on medical devices.

23. CLINICAL TRIAL
• With the objective of ensuring the rights, safety and well-
being of clinical trial participants, while facilitating such
trials as are essential a separate chapter is being included
in the Drugs and Cosmetic Act for its regulation,
transparent and objective procedures shall be specified,
and functioning of ethics and review committees
strengthened.
• The Global Good Clinical Practice Guidelines, which
specifies standards, roles and responsibilities of
sponsors, investigators and participants would be
adhered to.

24. VACCINE SAFETY
• Vaccine safety and security requires development of a
rational vaccine policy and effective regulation.
• Units such as the integrated vaccine complex at
Chengalpattu would be set up and vaccine, anti-sera
manufacturing units in the public sector upgraded with
rise in their installed capacity.
• The challenge lies in taking timely steps to ensure
sufficient availability of quality vaccines at affordable
prices

25. Medical Education
• Strengthening the
• 32 publicly funded health research institutes under the Department
of Health Research,
• 15 apex public health institutions under the Department of Health
& Family Welfare,
• research activity in the over 143 Government and over 150 private
medical colleges in the nation.
• 2007,  96% of the research  9 medical colleges.
• Much of this published research is not on priority health concerns.
• The health policy also notes the need for partnerships with the
growing presence in research of universities, and privately owned
research institutes and research laboratories.

26. Concerns in research
• Ethical concern
• Data base
• International assistance

27. Health as a Human Right?
• Many industrialized nations have laws that do so.
• Many of the developing nations that have made significant
progress towards universal health coverage like Brazil and
Thailand have done so and the presence of such a law was a
major contributory factor.
• A number of international covenants to which we are joint
signatories give us such a mandate- and this could be used to
make a national law.

28. • Courts have also rulings that in effect see health
care as a fundamental right- and a constitutional
obligation flowing out of the right to life.
• There has been a ten-year long discussion over
this without a final resolution.
• The policy question is whether we have reached
the level of economic and health systems
development as to make this a justiciable right-
implying that its denial is an offense.
• And whether when health care is a State subject,
it is desirable or useful to make a central law?

29. Health Status and Programme Impact
• Life Expectancy and healthy life
– Increase Life Expectancy at birth from 67.5 to 70 by 2025.
– Establish regular tracking of Disability Adjusted Life Years
(DALY) Index as a measure of burden of disease and its
trends by major categories by 2022.
– Reduction of TFR to 2.1 at national and sub-national level
by 2025.
• Mortality by Age and/ or cause
– Reduce Under Five Mortality to 23 by 2025 and MMR from
current levels to 100 by 2020.
– Reduce infant mortality rate to 28 by 2019.
– Reduce neo-natal mortality to 16 and still birth rate to
“single digit” by 2025.

30. Reduction of disease prevalence/
incidence
– Achieve global target of 2020 which is also termed as target of
90:90:90, for HIV/AIDS i.e, - 90% of all people living with HIV know
their HIV status, - 90% of all people diagnosed with HIV infection
receive sustained antiretroviral therapy and 90% of all people
receiving antiretroviral therapy will have viral suppression.
– Achieve and maintain elimination status of Leprosy by 2018, Kala-Azar
by 2017 and Lymphatic Filariasis in endemic pockets by 2017.
– To achieve and maintain a cure rate of >85% in new sputum positive
patients for TB and reduce incidence of new cases, to reach
elimination status by 2025.
– To reduce the prevalence of blindness to 0.25/ 1000 by 2025 and
disease burden by one third from current levels.
– To reduce premature mortality from cardiovascular diseases, cancer,
diabetes or chronic respiratory diseases by 25% by 2025.

31. Health Systems Performance
• Coverage of Health Services
– Increase utilization of public health facilities by 50% from current levels by 2025.
– Antenatal care coverage to be sustained above 90% and skilled attendance at birth above 90%
by 2025.
– More than 90% of the newborn are fully immunized by one year of age by 2025.
– Meet need of family planning above 90% at national and sub national level by 2025.
– 80% of known hypertensive and diabetic individuals at household level maintain "controlled
disease status" by 2025.
• Cross Sectoral goals related to health
– Relative reduction in prevalence of current tobacco use by 15% by 2020 and 30% by 2025.
– Reduction of 40% in prevalence of stunting of under-five children by 2025.
– Access to safe water and sanitation to all by 2020 (Swachh Bharat Mission).
– Reduction of occupational injury by half from current levels of 334 per lakh agricultural
workers by 2020.
– National/ State level tracking of selected health behaviour.

32. Health Systems strengthening
• Health finance
– Increase health expenditure by Government as a percentage of GDP
from the existing 1.1 5 % to 2.5 % by 2025.
– Increase State sector health spending to > 8% of their budget by 2020.
– Decrease in proportion of households facing catastrophic health
expenditure from the current levels by 25%, by 2025.
• Health Infrastructure and Human Resource
– Ensure availability of paramedics and doctors as per Indian Public
Health Standard (IPHS) norm in high priority districts by 2020.
– Increase community health volunteers to population ratio as per IPHS
norm, in high priority districts by 2025.
– Establish primary and secondary care facility as per norm s in high
priority districts (population as well as time to reach norms) by 2025.

33. Health Management Information
– Ensure district - level electronic database of
information on health system components by
2020.
– Strengthen the health surveillance system and
establish registries for diseases of public health
importance by 2020.
– Establish federated integrated health information
architecture, Health Information Exchanges and
National Health Information Network by 2025.

34. Policy thrust
• Ensuring Adequate Investment - The policy proposes a potentially
achievable target of raising public health expenditure to 2.5% of the GDP
in a time bound manner.
• Preventive and Promotive Health - The policy identifies coordinated
action on seven priority areas for improving the environment for health:
– The Swachh Bharat Abhiyan
– Balanced, healthy diets and regular exercises.
– Addressing tobacco, alcohol and substance abuse
– Yatri Suraksha – preventing deaths due to rail an d road traffic accidents
– Nirbhaya Nari – action against gender violence
– Reduced stress and improved safety in the work place
– Reducing indoor and outdoor air pollution
• Organization of Public Health Care Delivery - The policy proposes seven
key policy shifts in organizing health care services.

35. Primary , Secondary Care
• In primary care : from selective care to assured
comprehensive care with linkages to referral hospitals o In
secondary and tertiary care
• from an input oriented to an output based strategic
purchasing o In public hospitals
• from user fees & cost recovery to assured free drugs,
diagnostic and emergency services to all
• Secondary Care Services: The policy aspires to provide at
the district level most of the secondary care which is
currently provided at a medical college hospital.
• Basic secondary care services, such as caesarian section
and neonatal care would be made available at the least at
sub-divisional level in a cluster of few blocks.

36. To achieve this, policy therefore aims:
• To have at least two beds per thousand population distributed in
such a way that it is accessible within golden hour rule.
• This implies an efficient emergency transport system.
• The policy also aims that ten categories of what are currently
specialist skills be available within the district.
• Additionally four or at least five of these specialist skill categories
be available at sub-district levels.
• This may be achieved by strengthening the district hospital and a
well-chosen, well located set of sub-district hospitals.
• o Resource allocation that is responsive to quantity, diversity and
quality of caseloads provided. o Purchasing care after due diligence
from non-Government hospitals as a short term strategy till public
systems are strengthened.

37. • In infrastructure and human resource development – from
normative approach to targeted approach to reach under-serviced
areas
• In urban health – from token interventions to on-scale assured
interventions, to organize Primary Health Care delivery and referral
support for urban poor. Collaboration with other sectors to address
wider determinants of urban health is advocated.
• An important focus area of the urban health policy will be
achieving convergence among the wider determinants of health –
air pollution, better solid waste management, water quality,
occupational safety, road safety, housing, vector control, and
reduction of violence and urban stress

38. • In National Health Programmes – integration
with health systems for programme
effectiveness and in turn contributing to
strengthening of health systems for efficiency.
o In AYUSH services – from stand-alone to a
three dimensional mainstreaming

39. Re-Orienting Public Hospitals
• Public hospitals have to be viewed as part of tax financed single payer health care
system, where the care is pre-paid and cost efficient. This outlook implies that
quality of care would be imperative and the public hospitals and facilities would
undergo periodic measurements and certification of level of quality.
• The policy endorses that the public hospitals would provide universal access to a
progressively wide array of free drugs and diagnostics with suitable leeway to the
States to suit their context.
• The policy seeks to eliminate the risks of inappropriate treatment by maintaining
adequate standards of diagnosis and treatment. Policy recognizes the need for an
information system with comprehensive data on availability and utilization of
services not only in public hospitals but also in non-government sector hospitals.
• State public health systems should be able to provide all emergency health
services other than services covered under national health programmes.

40. • Women’s Health & Gender Mainstreaming: There will be enhanced
provisions for reproductive morbidities and health needs of women
beyond the reproductive age group (40+)
• Gender based violence (GBV): Women‟s access to healthcare needs to be
strengthened by making public hospitals more women friendly and
ensuring that the staff have orientation to gender – sensitivity issues.
• This policy notes with concern the serious and wide ranging consequences
of GBV and recommends that the health care to the survivors/ victims
need to be provided free and with dignity in the public and private sector.
• Supportive Supervision: For supportive supervision in more vulnerable
districts with inadequate capacity, the policy will support innovative
measures such as use of digital tools and HR strategies like using nurse
trainers to support field workers.

41. Emergency Care and Disaster
Preparedness:
• Better response to disasters, both natural and
manmade, requires a dispersed and effective capacity
for emergency management.
• It requires an army of community members trained as
first responder for accidents and disasters.
• It also requires regular strengthening of their capacities
in close collaboration with the local self-government
and community based organisations.

42. • The policy supports development of earthquake and cyclone resistant
health infrastructure in vulnerable geographies. It also supports
development of mass casualty management protocols for CHC and higher
facilities and emergency response protocols at all levels.
• To respond to disasters and emergencies, the public healthcare system
needs to be adequately skilled and equipped at defined levels, so as to
respond effectively during emergencies.
• The policy envisages creation of a unified emergency response system,
linked to a dedicated universal access number, with network of emergency
care that has an assured provision of life support ambulances, trauma
management centers– o one per 30 lakh population in urban areas and o
one for every 10 lakh population in rural areas

43. Specialist Attraction and Retention
• Proposed policy measures include - recognition of educational
options linked with National Board of Examination & College of
Physicians and Surgeons, creation of specialist cadre with suitable
pay scale,
• up-gradation of short term training to medical officers to provide
basic specialist services at the block and district level, performance
linked payments and popularise MD (Doctor of Medicine) course in
Family Medicine or General Practice.
• The policy recommends that the National Board of Examinations
should expand the post graduate training up to 17 the district level.
• The policy recommends creation of a large number of distance and
continuing education options for general practitioners in both the
private and the public sectors, which would upgrade their skills to
manage the large majority of cases at local level, thus avoiding
unnecessary referrals

44. Mid-Level Service Providers
• This can be done through appropriate courses like a B.Sc. in
community health and/or through competency-based bridge
courses and short courses.
• These bridge courses could admit graduates from different clinical
and paramedical backgrounds like AYUSH doctors, B.Sc. Nurses,
Pharmacists, GNMs, etc and equip them with skills to provide
services at the sub-centre and other peripheral levels.
• Locale based selection, a special curriculum of training close to the
place where they live and work, conditional licensing, enabling legal
framework and a positive practice environment will ensure that this
new cadre is preferentially available where they are needed most,
i.e. in the under-served areas.

45. Financing of Health Care
• The policy advocates allocating major proportion (upto two-thirds
or more) of resources to primary care followed by secondary and
tertiary care.
• Inclusion of cost-benefit and cost effectiveness studies consistently
in programme design and evaluation would be prioritized.
• This would contribute significantly to increasing efficiency of public
expenditure.
• A robust National Health Accounts System would be
operationalized to improve public sector efficiency in resource
allocation/ payments.

46. • The policy calls for major reforms in financing for public facilities – where
operational costs would be in the form of reimbursements for care provision and
on a per capita basis for primary care.
• Items like infrastructure development and maintenance, non-incentive cost of the
human resources i.e salaries and much of administrative costs, would however
continue to flow on a fixed cost basis.
• Considerations of equity would be factored in- with higher unit costs for more
difficult and vulnerable areas or more supply side investment in infrastructure.
• Total allocations would be made on the basis of differential financial ability,
developmental needs and high priority districts to ensure horizontal equity
through targeting specific population sub groups, geographical areas, health care
services and gender related issues.
• A higher unit cost or some form of financial incentive payable to facilities providing
a measured and certified quality of care is recommended

47. Private Sector Contribution
• One form is through engagement in public goods,
where the private sector contributes to preventive or
promotive services without profit- as part of CSR work
or on contractual terms with the Government.
• The other is in areas where the private sector is
encouraged to invest- which implies an adequate
return on investment i.e on commercial terms which
may entail contracting, strategic purchasing, etc. The
policy advocates for contracting of private sector in the
following activities:

48. Regulation of Clinical Establishments
• A few States have adopted the Clinical Establishments Act 2010.
• Advocacy with the other States would be made for adoption of the Act.
• Grading of clinical establishments and active promotion and adoption of standard treatment
guidelines would be one starting point.
• Protection of patient rights in clinical establishments (such as rights to information, access to
medical records and reports, informed consent, second opinion, confidentiality and privacy) as key
process standards, would be an important step.
• Policy recommends the setting up of a separate, empowered medical tribunal for speedy resolution
to address disputes /complaints regarding standards of care, prices of services, negligence and
unfair practices.
• Standard Regulatory framework for laboratories and imaging centers, specialized emerging services
such as assisted reproductive techniques, surrogacy, stem cell banking, organ and tissue
transplantation and Nano Medicine will be created as appropriate.

49. Availability of Drugs and Medical
Devices
• The policy accords special focus on production of Active Pharmaceutical
Ingredient (API) which is the back-bone of the generic formulations
industry.
• Recognizing that over 70% of the medical devices and equipments are
imported in India, the policy advocates the need to incentivize local
manufacturing to provide customized indigenous products for Indian
population in the long run.
• The goal with respect to medical devices shall be to encourage domestic
production in consonance with the “Make in India” national agenda.
Medical technology and medical devices have a multiplier effect in the
costing of healthcare delivery.
• The policy recognizes the need to regulate the use of medical devices so
as to ensure safety and quality compliance as per the standard norms

50. Strengthening Knowledge for Health
• Creation of a Common Sector Innovation Council for the Health
Ministry that brings together various regulatory bodies for drug
research, the Department of Pharmaceuticals, the Department of
Biotechnology, the Department of Industrial Policy and Promotion,
the Department of Science and Technology, etc. would be desirable.
• Innovative strategies of public financing and careful leveraging of
public procurement can help generate the sort of innovations that
are required for Indian public health priorities.
• Drug research on critical diseases such as TB, HIV/AIDS, and Malaria
may be incentivized, to address them on priority. For making full
use of all research capacity in the nation, grant- in- aid mechanisms
which provide extramural funding to research efforts is envisaged to
be scaled up.

51. Digital Health Technology Eco - System
• Recognising the integral role of technology(eHealth,
mHealth, Cloud, Internet of things, wearables, etc) in the
healthcare delivery, a National Digital Health Authority
(NDHA) will be set up to regulate, develop and deploy
digital health across the continuum of care.
• The policy advocates extensive deployment of digital tools
for improving the efficiency and outcome of the healthcare
system.
• The policy aims at an integrated health information system
which serves the needs of all stake-holders and improves
efficiency, transparency, and citizen experience.

52. • Delivery of better health outcomes in terms of access, quality,
affordability, lowering of disease burden and efficient monitoring of health
entitlements to citizens, is the goal.
• Establishing federated national health information architecture, to roll-out
and link systems across public and private health providers at State and
national levels consistent with Metadata and Data Standards (MDDS) &
Electronic Health Record (EHR), will be supported by this policy.
• The policy suggests exploring the use of “Aadhaar” (Unique ID) for
identification. Creation of registries (i.e. patients, provider, service,
diseases, document and event) for enhanced public health/big data
analytics, creation of health information exchange platform and national
health information network, use of National Optical Fibre Network, use of
smartphones/tablets for capturing real time data, are key strategies of the
National Health Information Architecture

53. Critical Analysis
• India’s commitment towards Universal Health Coverage (UHC).
• Strategic purchase of secondary care hospitalization and tertiary care
services from both public and from non-government sector to fill critical
gaps would be the main strategy of assuring healthcare services.”
• It further clarifies that this “strategic purchase” is a short term measure;
in the long term, even in secondary and tertiary care, the public sector
would predominate.
• Order to be followed: “public sector hospitals followed by not-for-profit
private sector and t hen commercial private sector in underserved areas”
• In times of crisis.

54. 2 important prescriptions of the structural adjustment-
driven health sector reforms of the 1990s –
• 1)introduction of selective primary healthcare
• 2)user fees for cost recovery.
• NHP 2017, in contrast, assures a policy shift “In primary care -- from
selective care to assured comprehensive care with linkages to
referral hospitals”
• “In public hospitals – from user fees & cost recovery to assured free
drugs, diagnostic and emergency services to all

55. • Articulation of inter-sectoral preventive and promotive
action packaged into seven priority areas adding up to
a social movement of health - what it calls the Swasth
Nagrik Abhiyan or Health in All.
• “Health and wellness centers”- a term used to denote
transforming the current sub-centre and PHC from its
current and very limited package of services to a much
larger coverage of non-communicable diseases
• The mention of this commitment to upgrade primary
healthcare facilities into 1.5 lakh “health and wellness
centers

56. Merits
• National programmes for noncommunicable
diseases and mental illness
• Retention of doctors and specialists in remote
areas in public services
• Creation of a multi-disciplinary public health
management cadre access, pricing, regulation
and manufacture of technologies
• The crisp definition of the scope and needs of
health technology assessment

57. • Several new ideas and institutions proposed
under research and development
• Firm commitment to Doha Declaration -meant to
ensure affordable access of nations to essential
medicines, even if they are on patent through
compulsory licensing and other such remedies.
 Implementation of this declaration is now
included as Target 11 under Goal 3 of the
Sustainable Development Goals.

58. • Targets in 3categories-
 Health status
 Health sector performance
 Health systems strengthening
Limitation
• A public health expenditure target of 2.5% of GDP was to
have been achieved by 2018 in the 2015 draft , but has now
been shifted back to 2025.
 Such a low expansion of investment is unlikely to match the
funds needed to meet commitments like health and
wellness centres, or free drugs and diagnostics in all public
hospitals.

59. • In urban health ,while the categories of urban
vulnerability have been listed, the commitment to
undertake affirmative action going beyond free care,
that is required to meet these needs, has gone missing.
• In malnutrition, the policy limits itself to
micronutrients
 Ministry’s remit is limited
 it should be clear that without addressing India’s
malnutrition burden the achievement of targets on
child mortality are seriously compromised.

60. Three under-stated policy corollaries
human resource adequacy,
 private sector regulation
Governance
-The “health and wellness centers” which form
the core primary healthcare strategy cannot be
operationalised without substantial investment
in a regular, well-trained and motivated public
provider workforce

61. • Secondly any large-scale private sector
involvement requires a major effort at reform
of the professional councils and regulation of
clinical establishments.
• Way to make money for private
• Community monitoring and involvement of
local bodies, though welcome measures, are
inadequate with respect to the main sources
of mis-governance.

62. • The 2015 draft had identified four main pathways of
corruption in public health systems –
 weak procurement
 logistic systems,
 transfers and postings,
 appointment of the chief district health officer and the
selection of partners for partnership.
• National Health Authority - which would combine in itself
the roles of setting standards, regulation and purchasing
care, possibly abridging the roles of states and central
ministries, with little accountability of its own, and quite
open to professional or corporate capture-it didn’t happen

63. • But there is a need for creating many new
institutions
• National Healthcare Standards Organization
,National Digital Health Authority
• Finally, one area of silence is the role and
remit of the states as compared to the centre
– not only in financing, but also in areas like
setting standards, strategic purchasing and in
the human resources strategies.

64. • Space for states to modify centrally set standards and
guidelines but within specified timelines, and within
frameworks defined on the basis of non-negotiable
principles, was a desirable policy corollary
• The whole contestation over policy directions with respect
to the terms and extent of private sector involvement has
helped identify the key players and their positions.
• And though the corporate hand is strong, and its needs and
thinking well supported by Niti Aayog and international aid
agencies (a space now almost exclusively occupied by the
Gates Foundation, with some support from USAID and the
Bank), it is not a walkover for any side

65. • Budgets have been stagnant under the present
government.
• Just two days after the policy was announced, The
Hindu reported that major public hospitals are
required to raise 30% of the funds required to meet the
Seventh Pay Commission recommendations .
• This would mean that hospitals like JIPMER, which
provides free high quality, comprehensive, tertiary
care, and institutions like AIIMS which charge modest
user fees, would have to raise the funds needed from
their service users.

66. 2018 National Health Protection
Scheme
• Finance Minister Arun Jaitley announced a flagship National Health
Protection Scheme under which Rs 5 lakh cover will be provided a
year to 10 crore poor and vulnerable families in the country.
Flagship national health protection scheme to cover 10 crore poor
and vulnerable families.
• This is approximately 50 crore beneficiaries, by providing them up
to Rs 5 lakh per family per year for secondary and tertiary care
hospitalisation," Jaitley said presenting the 2018-19 Union Budget.
Terming it as the world's largest government funded healthcare
programme, Jaitley said it would take healthcare protection to a
new aspirational level.

67. • Jaitley also announced Rs 1,200 crore for the 1.5 lakh
wellness health centres in the country.
He also announced Rs 600 crore for nutritional support
of Tuberculosis patients in India.
Under the initiative, Rs 500 will be provided to each TB
patient undergoing treatment.
"A total of 24 new government medical colleges have
also been announced as part of the new initiative for
health by the government," said Jaitley.

68. References
• GOI Draft National Health Policy 2017
http://www.mohfw.nic.in
• Sundararaman T. National Health Policy 2017 : a
cautious welcome. Indian J Med Ethics. Published
online on April 4, 2017.
• http://vikaspedia.in/health/nrhm/national-health-
policy-2017
• https://www.thehinducentre.com/resources/article9
591909.ece
• file:///C:/Users/HP/Desktop/Report%20of%20the%
20National%20Commission.pdf

69. Thank you