Union Budget 2026: Why Primary Healthcare Deserves More Funds
As the memories of the pandemic gradually fade, India's health spending has unfortunately slipped, putting critical aspects like preparedness, primary care, and equity at significant risk. With the Union Budget 2026 on the horizon, there is a pressing need to refocus attention and resources on the healthcare sector to ensure a resilient and efficient system for all citizens.
The Decline in Health Spending Post-Pandemic
During the Covid-19 pandemic, funding for health saw a notable increase as the nation rallied to combat the crisis. However, as the virus transitioned from a fearsome foe to a familiar fixture in our ecosystem, other developmental priorities gained greater attention, leading to a tailing off of health allocations. This trend has belied expectations that the Union Budget would set the pace for health spending by states, making it crucial to reignite efforts to reach the avowed target of 2.5% of GDP as the national health spend.
Strengthening Primary Healthcare
Primary healthcare must receive higher levels of financing to deliver the array of services promised under universal health coverage. It serves as the bulwark for community-based surveillance, prevention, and control of both infectious and non-communicable diseases. Even if the National Health Mission undergoes changes in name and form, a strong thrust to strengthen both rural and urban primary health care is essential and must receive a significant financial fillip.
To build an efficiently functioning integrated healthcare system, district hospitals must be strengthened. Digital technologies that extend the reach and enhance the efficiency of bidirectionally connected referral services, as well as provide tele-health, should be prioritized through enhanced allocations to the digital health mission. As artificial intelligence blends with human skills, especially in delivering human-sensitive healthcare, gaps in the numbers and skills of the health human workforce must be addressed through a dedicated Human Resources For Health Mission.
Budgeting for Healthcare Professionals
As health systems adapt to the changing nature of health challenges, so should health budgets. With the rising numbers of the elderly, health services must become more responsive to their treatment and care needs. Non-communicable diseases, mental health disorders, and disabilities demand more attention than in the past, requiring primary care to focus on prevention, early detection, effective home or community-based care, and appropriate referral when needed.
To ensure that this expanded agenda of primary care is adequately addressed, the number of ASHAs and multipurpose health workers at the frontlines must be doubled. Increased employment in primary care not only benefits public health but also contributes positively to the economy. Additionally, the paradoxical situation of shortages in the availability of doctors in some states, despite increased production and even 'unemployment' in others, must be corrected by creating a central pool of doctors who can be deployed to districts experiencing shortages or public health emergencies.
Family Medicine should be incentivized in postgraduate education and employment in health services, while public health cadres must be created in all states with central support to ensure a robust and responsive healthcare workforce.
The Ayushman Shield and Financial Protection
Apart from improving service coverage across the country, financial protection must be ensured for those who access care. The Pradhan Mantri Jan Arogya Yojana (PMJAY) must extend coverage across all population groups and ensure more accredited hospitals are available to guarantee quality care in currently underserved areas. Healthcare financing should progressively move towards a 'single payer' system that operates on a 'capitation' mode of provider payment. The budget can catalyze this process by initiating reforms in central health services and Union territories.
Ensuring Drug Safety and Environmental Health
Ensuring drug safety through effectively enforced regulatory measures, extending from production to marketing, is of utmost importance. Drug testing laboratories must be expanded in number and enhanced in quality. A national network of testing laboratories should be established, drawing together public and private sectors, universities, and research institutes to strengthen oversight and safety.
Nutrition, water, sanitation, clean air, and pollution control programmes must be energised by the exchequer. Higher taxes should be levied on ultra-processed foods and sugar-sweetened beverages, as recommended in the Economic Survey 2025-26. Additionally, Heat Adaptation Plans must be designed and adopted for urban and rural areas that will be subjected to scorching heat waves unleashed by climate change, integrating health with environmental sustainability.
Conclusion: A Call for Action in Budget 2026
As the Finance Minister prepares to deliver the Union Budget 2026, the question remains: will these prosaic expectations be met amidst the eloquent and poetically embellished budget speech? The need for increased funding in primary healthcare is not just a matter of policy but a critical step towards safeguarding the nation's health and ensuring equity for all. By prioritizing these areas, India can build a resilient healthcare system that is prepared for future challenges and delivers on the promise of universal health coverage.
