“Deep cuts in health spending by the Indian Government will lead to continued inadequate health services and delays in achieving universal access to healthcare,” argued experts in The British Medical Journal on Friday.

The Journal is a knowledge provider that aims to advance healthcare worldwide by sharing knowledge and expertise on the subject.

The Bharatiya Janata Party, elected to power last year, promised to increase access to health, improve quality and lower costs. But in 2014-2015, the Central Government spent much less than it had budgeted for – 20 per cent less in current spending and as much as 50 per cent less in capital spending. “The government has not just belied these promises, it has done precisely the opposite of them,” said Jayati Ghosh, professor of economics at the Centre for Economic Studies and Planning, Jawaharlal Nehru University, Delhi.

For example, the National Health Mission (NHM), which supports a network of accredited social health activists (ASHAs) to provide basic services, is in a “mess” following a 20 per cent cut in funding, a similar reduction in budgets for State governments.

The Integrated Child Development Services (ICDS) scheme, which provides nutrition and other services to pregnant and lactating mothers and infants, received around 10 per cent less than expected. Next year, both programmes will face even sharper cuts: the ICDS will have funding cut by more than half and the NHM by a further 17 per cent. The government explained that the cuts were required to meet the fiscal deficit target since tax collections were lower than expected. But the likely increase in such tax revenues for all States put together will be only around 0.7 per cent of GDP (gross domestic product).

Private hospitals will continue to flourish for India’s wealthy customers and medical tourists from abroad. But in what is still a largely poor country, most of the population will continue to experience inadequate public health, Ms. Ghosh adds.

Massive cuts imply the persistence of huge shortfalls including of healthcare staff, such as doctors, surgeons, and nurses, and insufficient physical infrastructure to support health services. Ms. Ghosh notes that India has among the worst ratio of clinics and hospital beds per head of population in the world.

In a linked article, Leena Menghaney, a lawyer working on public health law and policy in New Delhi, writes that she has seen “huge insufficiencies” in the country’s HIV programme following the cutbacks.