“Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyze.
Approach · directive: “analyze”
What it asks · Show that primary health care is both a duty of the Welfare State and a foundation for development, and identify the gaps that weaken it.
It asks 3 things — answer each
- Analyse primary health structure as a moral imperative of the Welfare State
- Analyse primary health structure as a necessary precondition for sustainable development
- Identify the gaps in India's primary health structure and the way forward
Open with · Article 47 makes improving public health a primary duty of the State, and the Supreme Court holds the right to health part of Article 21; primary health care is where that duty is met.
Cover
- Moral imperative: Article 47 and the right to health under Article 21 (Common Cause, 2018) make first-contact care a State duty, not charity.
- Equity and protection: free primary care shields the poor; out-of-pocket spending fell from 64.2% (2013-14) to 39.4% (2021-22) of total health expenditure.
- Development link: healthy people learn and work better; early, cheap care prevents costly hospitalisation; SDG 3's universal health coverage rests on it (Alma-Ata 1978, Astana 2018).
- Gaps: government health spending only 1.84% of GDP (2021-22) against NHP 2017's 2.5% by 2025; shortages of doctors and specialists; inter-State disparities.
- Way forward: 15th Finance Commission's two-thirds of health spending for primary care; Health and Wellness Centres (over 1.5 lakh by December 2022) with referral links and digital records.
Close with · The 15th Finance Commission wants primary health care to be every State's number one fundamental commitment; only then can SDG 3's universal health coverage and lasting growth go together.
Add value (verified)
- Article 47 makes raising the level of nutrition and the standard of living and improving public health among the State's primary duties.The Constitution of India (as on 1 May 2024), Article 47 - Legislative Department ↗“The State shall regard the raising of the level of nutrition and the standard of living of its people and the improvement of public health as among its primary duties”
- The Supreme Court has held that the right to health is a part of Article 21 (Common Cause v. Union of India, 2018).Supreme Court of India, Head Notes of Leading Cases, Vol. II (Common Cause v. Union of India, [2018] 6 SCR) ↗“Right to health is a part of Article 21 of the Constitution.”
- National Health Accounts 2021-22: out-of-pocket spending fell from 64.2% (2013-14) to 39.4% (2021-22) of total health expenditure; government health spending reached 1.84% of GDP.National Health Accounts estimates 2020-21 and 2021-22 - PIB, Ministry of Health and Family Welfare ↗“The decline in Out-of-Pocket expenditure out of Total Health Expenditure from 64.2% in 2013-14 to 39.4% in 2021-22 reflects a very positive indicator” Government Health Expenditure’s share in the country’s total GDP increases from 1.13% (2014-15) to 1.84% (2021-22)”
- National Health Policy 2017 sought to raise government health spending from 1.2% to 2.5% of GDP by 2025.Economic Survey 2022-23, Chapter on Social Infrastructure - Ministry of Finance ↗“the policy recommended an increase in the Government’s health expenditure from the existing 1.2 per cent to 2.5 per cent of GDP by 2025”
- The 15th Finance Commission recommended that primary health care be every State's number one commitment and that primary health spending rise to two-thirds of total health expenditure.Fifteenth Finance Commission Report 2021-26, Vol. I, Chapter 9 (Health) ↗“We recommend that primary health care should be the number one fundamental commitment of each and every State and that primary health expenditure should be increased to two-thirds of the total health expenditure by 2022.”
- More than 1.5 lakh Health and Wellness Centres had been set up by 31 December 2022 to deliver comprehensive primary health care.Economic Survey 2022-23, Chapter on Social Infrastructure - Ministry of Finance ↗“As on 31 December 2022, more than 1.5 lakh HWCs have already been set up.”
Question: UPSC's CS (Main) 2021, GS Paper II — paper ↗. Approach: Minimalist IAS, checked 3 Oct 2026 (how we verify) — UPSC publishes no model answers. ·
Model answer· 225words · Minimalist IAS
Article 47 makes improving public health a primary duty of the State, and the Supreme Court holds the right to health part of Article 21 (Common Cause, 2018). Primary health care is where that duty is met.
A moral imperative of the Welfare State
- Equity: free first-contact care reaches women, children and the rural poor.
- Financial protection: out-of-pocket spending fell from 64.2% (2013-14) to 39.4% (2021-22) of health spending.
A precondition for sustainable development
- Human capital: healthy children learn and healthy adults work better.
- Cost-effectiveness: immunisation, maternal care and early screening avert costly hospital stays.
- Global goal: SDG 3's universal health coverage rests on primary care (Alma-Ata 1978, Astana 2018).
- Primary care
- early detection
- lower costs
- healthier workforce
- sustainable growth
Gaps in India's primary health structure
- Low spending: government health spending was 1.84% of GDP (2021-22), short of NHP 2017's target of 2.5% by 2025.
- Workforce gaps: doctors and specialists are scarce at PHCs and CHCs, with wide inter-State gaps.
Way forward
- Primary care first: the 15th Finance Commission urged two-thirds of health spending for primary care.
- Comprehensive care: over 1.5 lakh Health and Wellness Centres (by December 2022) need referral links and digital records.
As the 15th Finance Commission urged, primary health care must be every State's number one fundamental commitment; only then can SDG 3's universal health coverage and lasting growth go together.
Prepared by Minimalist IAS to the answer standard of Shivam Singh (mentor, 7 years) · facts checked against official sources (how we verify) · updated 3 Oct 2026. UPSC publishes no model answers: compare your structure and coverage with this, then write your own.
