Maleque blames bottlenecks for slow implementation of health budget amid calls for increasing efficiency

Procedural delays, shortage of manpower and other complications are slowing down implementation of the budget for health, Health Minister Zahid Maleque said, amid calls for increasing efficiency in spending the budget allocation for the health sector.

"We have often been told that the health ministry is slow in implementing the budget, but in most cases, we are unable to do anything about it," the minister said, speaking to journalists and experts at a meeting at the Directorate General of Health Services (DGHS) on Wednesday.

He said "most of our work is done by the Public Works Department, and they work much slower. They are not under the health ministry and there is little we can do about it."

Speakers at the meeting organised by the Health Reporters Forum complained the budget allocation for the health sector is not sufficient, but the health ministry cannot even spend this allocation properly.

They called for increasing efficiency in budget implementation and also for creating new sectors to expedite spending.

Speaking on the issue, Minister Maleque said, "For any kind of spending, first we need to ask the finance ministry to release the money. This [process] takes a lot of time.

"We have a manpower crisis and our spending process is lengthy. It takes a long time to get the approval at the beginning and to get the tender later."

The minister continued, "All in all, it is not the lack of capacity, but the accompanying conditions that cause the delay in spending. After the budget, it takes one-and-a-half months to get the moneys released [from the finance ministry]."

Also speaking on the occasion, Prof Dr Syed Abdul Hamid of the Institute of Health Economics, Dhaka University said, "There is nothing new in the [proposed] health budget for this year except for the expansion of some projects. The increase in allocations will mainly offset rising costs and inflation."

"Officials involved in budget preparation and implementation need to be trained and new sectors need to be created for budget expenditure in order to increase efficiency in spending the budget allocation," he added.

Monjun Nahar, lead of Advocacy and Communication for Marie Stopes Bangladesh, said the health ministry has a monitoring framework for budget expenditure and coordination.

She urged the framework be regularised, saying it will resolve a lot of the existing problems.

Nahar also said out-of-pocket expenditure cannot be reduced by following conventional ways. Health insurance is needed for it, he said.

Health Directorate Additional Director General (Administration), Professor Dr Ahmedul Kabir, said work is on to launch health insurance.

Speakers at the programme said only 5.4% of the total proposed budget has been allocated for the health sector for the next fiscal year. Minister Maleque said, "We think the budget allocation for health should be increased or equal to last year. Money was not spent last year because of  Covid-19, but hopefully, we will be able to spend it this time."