Skip to main content

Gujarat 'neglects' healthcare: Budget down from 5.54% to 4.98% despite 8% policy plea

By Mahender Jethmalani* 

The Gujarat Finance Minister recently presented the state’s annual budget of Rs 2,27,029 crore for 2021-22. The budget for next financial year indicates an increase of Rs 22,003 crore (10.73%) from the revised estimates of 2020-21. The lockdown impact is quite visible on the expenditure budget of 2020-21, as the revised estimated expenditure would be Rs 2,05,026 crore, down by Rs 12,261 crore against the budget estimate of Rs. 2,17,287 crore in 2020-21.
The Gross State Development Product (GSDP) of Gujarat would register growth of a mere 0.57% in 2020-21. The advance estimate for GSDP in 2020-21 is Rs. 16,58,865 crore. Hence, the fiscal space available as percentage of GSDP with the state is around 12%.
The state would spend around Rs 77,137 crore on non-development heads. This includes Rs 27,922 crore on payment of interest on accumulated debt, Rs 24,887 crore for paying the pension to state’s retired employees, and Rs.24,330 crore for repayment of debt. Thus, around 4.1% of the GSDP would be spent for non-developmental activities, and the state would be left with just 8% of GSDP for running the state’s development and welfare programmes.
Interest, Pension and Debt Payment (IPD) account 33.98% of state’s expenditure. The percentage share of IPD was 30.63% in 2019-20, which will be around 33.98% in 2021-22. The expenditure for IPD will keep increasing over the years from now on due to accumulated public debt, increasing pension bill and repayment debt on accumulated debt. On the whole, the expenditure for social sector development has been pegged at 32.54% in the state’s total expenditure.
The social services include education, health care, nutrition, water and sanitation, labour welfare, welfare of socially disadvantageous groups, social security, housing and urbanization, sports, technical education, art and culture etc. The state needs to make higher public provisioning for the development of social sector to enhance the quality of life and improve social development indicators of infant and maternal mortality, malnutrition, and quality education level.
The state has earmarked 10.73% of budget outlay for general education – which includes elementary, secondary, higher education, college and university. General education does not include the budgetary expenditure for professional, medical, technical, engineering, agriculture universities, and management studies aided by the state budget.
The budget outlay for urban development is 4.98% of state’s total expenditure in 2021-22. The state provides grants to all urban local bodies (ULBs) for basic amenities development.
The budget outlay for the welfare of scheduled tribes (STs), schedules castes (Scs) and other socially marginalized groups is 2.13%. 
The expenditure for social welfare includes scholarships, education support, assistance for livelihood and others. The budget outlay for social security and welfare is 1.08%. The schemes directed at providing social security include widow pension, old age pension, assistance to people with disability, etc.
The budget outlay for water and sanitation is 2.11%.

Healthcare

The budget outlay for nutrition is 1.62%, which includes such schemes like Integrated Child Development Scheme (ICDS), Midday Meal (MDM) and Pradhan Mantri Matru Vandana Yojana (PMMVY), as also nutrition to adolescents girls, lactating and pregnant women. The state needs higher allocation for nutrition services for the children accessing the anganwadi services to reduce the prevailing malnutrition among the children below six years of age.
The pandemic has exposed the state’s healthcare services capabilities to address the health care emergency like Covid-19. The state’s investment for augmenting the public healthcare systems is not substantial, and whatever investment being made is in urban areas with focus on tertiary care. The public healthcare system in rural areas is characterised by deficit of doctors and specialists. Therefore, people in rural areas have to depend upon the private health care providers for the treatment.
Despite the prevailing pandemic conditions, the budgetary expenditure on healthcare and family welfare services is estimated to increase by a mere Rs 72 crore to Rs 11,304 crore in 2021-22. Notably, the healthcare expenditure also includes medical college education and health insurance (Ma Amrutam).
The revised budget expenditure for healthcare in 2020-21 would be Rs 11,232 crore against the budget estimates of Rs 11,225 crore. It seems that the state did not incur any additional expenditure on health emergencies on account of Covid-19, one reason why it made additional expenditure of just Rs 7 crore.
In fact, the percentage share on healthcare services has been declining. It was 5.54% in 2018-19, which came down to 4.98% in 2021-22.
This despite the fact that the National Health Policy (NHP) 2017 recommended that states should allocate 8% of the budget outlay in the state’s total expenditure from 2020-21 onwards for better and affordable health care services. The Gujarat healthcare budget in percentage terms is far below the NHP-17 recommendation; on the contrary the budget on healthcare is declining in percentage terms as well.
The per capita expenditure on healthcare was Rs 1,585 in 2019-20, while it has been proposed to be Rs 1,709 in 2021-22, though it should be around Rs 3,300 for reducing the out of pocket expenditure on healthcare. 
The public healthcare services in rural areas is affected by shortage of doctors and specialist at Public Health Centres (PHCs) and Community Health Centres (CHCs), which compels the poor to access healthcare from private healthcare providers by shelling their lifetime hard savings.

Socially disadvantageous groups

The allocation for the welfare and development of the state’s 15% STs and 7% SCs has been put at 6.37% and 2.33%, respectively. The expenditure for the socially disadvantageous communities indicates under-spending of the budgeted amount to the tune of Rs 1,538 crore (10.9%) for tribal development under the Tribal Sub Plan (TSP) and Rs 534 crore for STs (9.90%) under Special Component Plan for Schedule Caste (SCP).
The under-spending of 10% the budget outlay is substantial budgetary resource for the development of STs and SCs. These social groups have poor human development indicators. The tribal areas face deficit in basic infrastructure facilities, especially healthcare. Healthcare services in the tribal areas are without doctors. Education institutions are without teachers. Not without reason, the tribal areas witness out-migration in search of livelihood in urban areas.
The TSP budget should be re-prioritized for the welfare of the tribal people and the development of the tribal areas. There should be monitoring mechanism to check the under-spending of budgetary resources. The budget outlay should ensure more direct benefits to the underprivileged sections, even as developing the basic amenities related to drinking water, education and health care.
The infrastructure development expenses should be incurred from the general budget. In the present planning for TSP and SCP, the focus has been to spend more on notional expenditures or large infrastructure development. Such essential expenditures, therefore, should be accounted for under the general budget.
---
*With Pathey Budget Center, Ahmedabad

Comments

freyer energy said…
Thanks for sharing this information
Bhagwan Mahaveer Viklang Sahayata Samiti (BMVSS) is the world's largest organisation rehabilitating over 1.78 million amputees and polio patients by fitting / providing artificial limbs (Jaipur Foot variety), calipers, and other aids and appliances, mostly in India and also in 27 countries across the world.
Bhagwan Mahaveer Viklang Sahayata Samiti

TRENDING

Reducing emission? India among top nations whose coal as energy source going up

By NS Venkataraman*  The State of the Global Climate report by the World Meteorological Organization (WMO) confirmed that the year 2023 was the warmest year on record, with the global temperature of 1.4 degree celsius above pre-industrial 1850-1900 base line.

Lockdown 'total failure' of science more than of politics: Open letter on 4th anniversary

Counterview Desk  In an open letter to fellow academicians, scientists and medical practitioners in India, marking the fourth anniversary of India's lockdown (25 March 2024), the Managing Committee* of the Universal Health Organisation (UHO) has insisted on the need to "repair two years of immense damage to science".

Insider plot to kill Deendayal Upadhyay? What RSS pracharak Balraj Madhok said

By Shamsul Islam*  Balraj Madhok's died on May 2, 2016 ending an era of old guards of Hindutva politics. A senior RSS pracharak till his death was paid handsome tributes by the RSS leaders including PM Modi, himself a senior pracharak, for being a "stalwart leader of Jan Sangh. Balraj Madhok ji's ideological commitment was strong and clarity of thought immense. He was selflessly devoted to the nation and society. I had the good fortune of interacting with Balraj Madhok ji on many occasions". The RSS also issued a formal condolence message signed by the Supremo Mohan Bhagwat on behalf of all swayamsevaks, referring to his contribution of commitment to nation and society. He was a leading RSS pracharak on whom his organization relied for initiating prominent Hindutva projects. But today nobody in the RSS-BJP top hierarchy remembers/talks about Madhok as he was an insider chronicler of the immense degeneration which was spreading as an epidemic in the high echelons of th

Magnetic, stunning, Protima Bedi 'exposed' malice of sexual repression in society

By Harsh Thakor*  Protima Bedi was born to a baniya businessman and a Bengali mother as Protima Gupta in Delhi in 1949. Her father was a small-time trader, who was thrown out of his family for marrying a dark Bengali women. The theme of her early life was to rebel against traditional bondage. It was extraordinary how Protima underwent a metamorphosis from a conventional convent-educated girl into a freak. On October 12th was her 75th birthday; earlier this year, on August 18th it was her 25th death anniversary.

Savarkar 'criminally betrayed' Netaji and his INA by siding with the British rulers

By Shamsul Islam* RSS-BJP rulers of India have been trying to show off as great fans of Netaji. But Indians must know what role ideological parents of today's RSS/BJP played against Netaji and Indian National Army (INA). The Hindu Mahasabha and RSS which always had prominent lawyers on their rolls made no attempt to defend the INA accused at Red Fort trials.

'Wrong direction': Paris NGO regrets MNC ArcelorMittal still using coal-based steel

By Rajiv Shah  A new report by Paris-based non-governmental research and campaigning organization, Reclaim Finance, has blamed the MNC ArcelorMittal – formed in 2006 following the takeover and merger of the western European steel maker Arcelor (Spain, France, and Luxembourg) by Indian-owned Mittal Steel – for using use “climate destructive” metallurgical coal for its projects in India.

'Flawed' argument: Gandhi had minimal role, naval mutinies alone led to Independence

Counterview Desk Reacting to a Counterview  story , "Rewiring history? Bose, not Gandhi, was real Father of Nation: British PM Attlee 'cited'" (January 26, 2016), an avid reader has forwarded  reaction  in the form of a  link , which carries the article "Did Atlee say Gandhi had minimal role in Independence? #FactCheck", published in the site satyagrahis.in. The satyagraha.in article seeks to debunk the view, reported in the Counterview story, taken by retired army officer GD Bakshi in his book, “Bose: An Indian Samurai”, which claims that Gandhiji had a minimal role to play in India's freedom struggle, and that it was Netaji who played the crucial role. We reproduce the satyagraha.in article here. Text: Nowadays it is said by many MK Gandhi critics that Clement Atlee made a statement in which he said Gandhi has ‘minimal’ role in India's independence and gave credit to naval mutinies and with this statement, they concluded the whole freedom struggle.

A Hindu alternative to Valentine's Day? 'Shiv-Parvati was first love marriage in Universe'

By Rajiv Shah*   The other day, I was searching on Google a quote on Maha Shivratri which I wanted to send to someone, a confirmed Shiv Bhakt, quite close to me -- with an underlying message to act positively instead of being negative. On top of the search, I chanced upon an article in, imagine!, a Nashik Corporation site which offered me something very unusual. 

Attack on foreign students: Gujarat varsity's reputation, ranking at stake, say academics

Counterview Desk  Expressing anguish over the attack on international students in Gujarat University hostels, a letter claimed to have been signed by 122 current and former academics has asked the Gujarat Vice Chancellor, Dr Neerja Gupta, to provide emotional support to the attacked students and to ensure their physical safety.  

As double engine takes backseat in Odisha, BJP is pitted against 'firmly rooted' BJD

By Sudhansu R Das  BJP has got 25 years to build its party base in Odisha. After 25 years, it felt helpless and insecure to fight elections on its own strength. The party was almost crazy to have an alliance with the ruling BJD in Odisha.  Looking for alliance at the time of election shows that the party has not groomed its grassroots level workers into potential leaders.  The state BJP leaders woke up and convinced the Central leaders that they are capable of going solo; the alliance was stillborn. The question is can BJP defeat BJD which is firmly rooted in Odisha after launching piles of populist programs in the state.