Bangladesh's health sector received a proposed budget allocation of Tk41,408 crore, marking an 8.82% increase from the previous fiscal year. The crux of the issue, however, lies in the disconnect between budget increases and actual healthcare improvements.
The budget, constituting 5.19% of the total national budget and 0.73% of GDP, has been met with scepticism by public health experts.
Despite the seemingly positive numbers, concerns arise over the real impact on healthcare services, with inflation driving up costs for medicines, medical supplies, and salary hikes, they said.
Dr Rashid-E-Mahbub, chairman of the National Committee on Health Rights Movement, pointed out the paradox in the health ministry's spending.
While out-of-pocket expenses for citizens are rising, the ministry returned Tk8,269 crore from its previous allocation, having spent only Tk29,782 crore of the Tk38,052 crore budget.
"This inefficiency highlights the ministry's lack of capacity and poor planning," he said.
The issue of unspent allocations is exacerbated by the ministry's method of budgeting based on hospital bed numbers, often leading to a mismatch between funds and actual needs.
"Many hospitals cannot spend the allocated money and return the money where some hospitals fall short of money to run the hospital efficiently," Dr Rashid-E-Mahbub added.
He also highlighted that the health managers, particularly the chiefs of several hospitals, lack sufficient orientation and the ministry does not consult with these health managers before determining the budget allocations.
According to the Health Economics Unit under the Health Ministry, patients allocate a substantial part of their health expenses to drugs (64.6%), followed by laboratory charges (11.7%), doctor fees (10.8%), other healthcare practitioners (2.4%), dental services (0.3%), hospital charges (10.1%), and medical products (0.1%).
Professor Syed Abdul Hamid of the Institute of Health Economics at Dhaka University highlighted another critical concern: the impact of inflation and salary increments on the proposed budget's effectiveness.
“The actual benefits for healthcare seekers will decrease due to inflationary pressures and salary increments for healthcare facility staff,” he said.
Inflation has increased the price of medicines and other healthcare products, forcing common people to spend more on these essentials, he explained.
Inflation in Bangladesh has soared to 9.89% in May, the highest in seven months. For almost a year, inflation has remained above 9%, with food inflation surging to 10.76%.
Professor Hamid also raised a question about the proposed allocation, saying, "I wonder if the special allocation of Tk2,000 crore to address health risks and another Tk100 crore for scientific research in various health disciplines are included in the proposed Tk41,408 crore."
He, however, said that in past budget allocations, the revised budget often saw cuts to the health sector.
Earlier in the last fiscal year 2023-2024, the proposed budget was Tk38,052 crore, but it was cut down to Tk29,782 crore in the revised budget. In 2022-2023, it came down from Tk36,863 crore to Tk29,749 crore.
He urged the government to avoid reducing the allocation this time.
