The expenditure in providing free health services is escalating yearly, in line with the annual per capital health expenditure, as pointed out in the “Annual Health Bulletin, 2015”.
Ministry of Health saw the spending for health increase to Nu 3965 mn in 2012-13 from Nu 3587 mn in 2011-12. The annual per capita health expenditure in 2012-13 was Nu 5409, an increase from Nu 4977 in 2011-12.
The Constitution mandates that the government “provide free access to basic public health services”, and therefore, the government is the sole health service provider in Bhutan.
60 percent of the health expenditure is funded by government, 13 percent by the developmental partners, 25 percent from household contributions, and 0.4 percent from corporations.
According to the report, 2012-13 saw a modest increase of Gross Domestic Product for health to 3.8 percent from 3.61 percent in 2011-12.
In the same fiscal year, Nu.2928mn was allocated for health sector that is about 7.4% of the overall government budget allocation. The major spending, that is 66 percent, occurred for hospital and outpatient curative care, medicines, and supplies.
In 2012-13, procurement of drugs accounted for Nu 150mn as against Nu 105mn in 2008-09. Spending for procurement of expendables and equipment came in at Nu 145mn and 87mn respectively.
The cost of medical referral abroad has also escalated with the number of patients increasing every year, it report states.
At the dzongkhag level, about 45 percent was allocated for primary health care services, while rest, 55 percent went into hospital services.
Out-of-pocket payment accounted for 98 percent of all households spending, whereas half of all households’ spending is incurred for patient’s transportation.
In delivering selective health services, expected to ease the congestion of patient admissions in the public hospitals, there are nine private diagnostic centers in the country. Moreover, a private nursing college in Phuentsholing has been established to train nurses.
The report also states that the concepts of green and sustainable architecture and earthquake resilient features are followed for the construction of medical centers.
The shortage of health workers, especially doctors, is still a concern in Bhutan. Currently, there are 241 doctors (MBBS and specialists) and 2691 other category of health workers.
The ratio of nurse to bed stands at 1:8. The health workforce increased from 1364 doctors and allied professionals in 2001 to 2932 currently. At present, there are 877 health facilities including hospitals, BHU (grade I and II), ORCs and sub-posts in the country.