Health Minister displeased with Finance Ministry

By A Staff Reporter,Kathmandu, Mar. 25: While taking the oath of office five months ago, Minister of Health and Population Dr. Sudha Sharma Gautam presented her six major priorities in healthcare services.

The Health Insurance Programme, which was on the verge of collapse, and the issue of improving mental health were identified as major challenges for her. Despite these difficulties, she attempted to implement policy reforms, including efforts to revive the Health Insurance Programme.

During her five-month tenure, Dr. Gautam prioritised several reform areas, such as expanding mental health services at the community level, establishing a special mechanism for the health protection of workers employed abroad, reducing maternal and neonatal mortality rates, and ensuring a delay-free and transparent procurement process for medicines and equipment.

Many had high expectations of Dr. Gautam regarding health policy reforms, given her background as a health expert and former official.

However, she later acknowledged that the challenges were greater than she had initially anticipated. Just before the end of her five-month term, she openly expressed dissatisfaction with the lack of budgetary support. She emphasised that the Ministry of Health had not been able to perform as expected due to insufficient budget allocation.

Dr. Gautam strongly criticised the working style of the Ministry of Finance. While presenting her five-month progress report, she warned that government hospitals across the country were facing a serious crisis due to budget shortages.

During the presentation, she highlighted the difficulties in resource management. She expressed dissatisfaction that the Ministry of Finance had released only 1 billion rupees out of the 7 billion requested for the operation of essential hospital services, withholding the remaining amount under the pretext of a “cooling-off period.”

“When we calculated the required amount up to mid-November, we requested Rs. 7 billion but received only 1 billion. Although we were assured that the remaining amount would be provided after the election, the Ministry of Finance now seems to be observing a ‘cooling-off period,’ ignoring the problems faced by hospitals,” she said.

She added that such behaviour is unacceptable in a sensitive sector like health and has directly affected hospital services. Dr. Gautam claimed that during her tenure, long-standing distortions in the health insurance system had been identified and a foundation for reform had been laid. She also stated that the Health Ministry had reallocated 750 million rupees from its own programmes to help resolve the financial crisis of the Insurance Board.

“These reforms will save billions of rupees for the state in the coming days. However, the insurance challenge is not over yet. We have been pushed into a situation where we can do nothing but mourn,” she said emotionally.

She further noted that while health workers operate on a priority basis during emergencies, the behaviour of the Ministry of Finance has been quite the opposite. Dr. Gautam, who led the Health Ministry under the government formed after the Gen Z movement, claimed to have achieved some “quick wins” of long-term importance despite challenging circumstances.

Her ministry identified service delivery and policy reform as its two main pillars. While some progress was made in policy reform, many important tasks remained incomplete. As a result, she has repeatedly stated that the lack of adequate budget support from the Ministry of Finance prevented her from working effectively.

A few months earlier, Dr. Gautam had requested a budget of 12 billion rupees to sustain the Health Insurance Programme. However, the Ministry of Finance declined, arguing that the situation had been created by the Health Ministry itself. This led to a dispute between Dr. Gautam and the Finance Ministry Secretary.

Amidst these challenges, the National Planning Commission recently set a budget ceiling of 31 billion rupees for the Health Ministry for the upcoming fiscal year, 9 billion rupees less than the previous year. This decision has further provoked Dr. Gautam’s dissatisfaction.