The hike in the health budget this time is half of what it ideally should be, year on year, to meet the allocation target of 2.5 per cent of the GDP.
The interim budget allocation for health has seen a hike of close to 13 per cent in 2019-20 at ₹61,398.12 crore, as compared to the 2018-19 revised estimates of ₹54,302.50 crore. Last year, the budget increase was close to 11.8 per cent as compared to the 2017-18 allocation, said officials. In both years, the allocations were grossly less than projections made by the National Health Policy.
“In the National Health Policy 2017, the Government committed to increase the health allocation to 2.5 per cent of the GDP by 2025. In order to reach this target, the government needs to increase the health budget by 26 per cent, year on year, till 2025. While last year we had demanded close to ₹70,000 crore, this year, we asked for ₹80,000 crore,” said an official.
Only 24 lakh first-time mothers were paid through the PMMVY
Shortfall in disbursement
The nation’s pet scheme, the Pradhan Mantri Jan Arogya Yojana (PM-JAY) — popularly known as ‘Ayushman Bharat’— which is a country-wide cashless health insurance service, has been allocated ₹6,400 crore in the interim budget. Officials said this will be insufficient to meet the scheme’s needs. An estimated expense of ₹12,000 crore was drawn by National Health Agency (NHA) officials for the implementation of PM-JAY. The Centre contributes 60 per cent of these funds, which amounts to ₹7,200 crore. “The Finance Ministry has assured us that the shortfall of ₹800 crore will eventually be reimbursed, in case we need more funds,” said Indu Bhushan, CEO, Ayushman Bharat.
BusinessLine had earlier reported that ₹3,135 crore were approved by the Cabinet for expenses under Ayushman Bharat for 2018-19. According to latest budget documents, this has been brought down to ₹2,400 crore in the revised estimates. “At present, the Centre is reeling under a liability of ₹1,700 crore towards payments to States, as of the ₹2,400 crore sanctioned by the Finance Ministry, ₹1,000 crore are yet to come by. Central payments have been delayed as of now,” said a senior NHA official.
Under-utilisation of funds
Meanwhile, the budget for the Ministry of Women and Child Development (WCD) has been hiked by 18 per cent, as compared to the revised estimates for 2018-19. The current year’s allocation stands at ₹29,164.90 crore, as opposed to last year’s revised estimates of ₹24,758.62 crore.
Despite higher allocations, the catch lies in under-utilisation of these funds over the years. Latest actual numbers for use of 2017-18 funds stands at ₹20,396.36 crore, much lower than the revised estimates. Officials said this was because of delay in the implementation of schemes, due to which the budget was redirected to other Ministries such as Transport, Railways and Urban Affairs.
Prime Minister Narendra Modi’s flagship scheme — the Pradhan Mantri Matru Vandana Yojana (PMMVY) — which promised to give ₹6,000 to first-time pregnant mothers, was allocated ₹2,400 crore in the 2018-19 budget, but revised estimates state that only ₹1,200 crore will be necessary. Officials said that of the ₹6,000, as much as ₹5,000 is contributed by the WCD, and ₹1,000 by the Ministry of Health. The scheme was running with a lag of six months, and payments delayed due to logistical issues.
“The amount lay unutilised because we have been able to pay only 24 lakh mothers this year, while our target is to pay 50 lakh,” said the official.
Allocation for ‘one-stop centres’ for women, proposed under the Nirbhaya Fund, has been reduced to ₹274 crore in the interim budget, as opposed to a revised estimate of close to ₹302.80 crore in 2018-19 This is because only ₹30.10 crore, close to a tenth of the budget, was used to create the centres, according to the actual expenditure estimates of 2017-18.