Total Health budget for state slashed by 13%
Maharashtra may have one of the highest per capita incomes in the country, but its neglect of public health services continues. The astoundingly low level of budgetary commitment to the public health sector of a mere 0.44% of its GSDP during the coming year (2016-17) will prevent people in the state from accessing even basic health services, that are required in keeping with the state’s level of economic development.
Highlights of Maharashtra health budget 2016-17, as tabled in the Assembly on 18th March 2016:
- In the 2016-17 budget, the allocation for the health sector (Public health and Medical education) has seen a huge decline of 13% from Rs. 12015 crores (RE 2015-16) to Rs. 10472 crores in 2016-17, the coming year’s health budget being reduced by a whopping Rs.1543 crores.
- Even in per capita terms there is a decline in commitment, from Rs 1001 per person in the current year to Rs.865 per person in 2016-17. This is a decline from 5.1% of total govt budget in the previous year to 4.1% in 2016-17.
- In terms of Health budget as percentage of the Gross State Domestic Product (similar to GDP for the State) there is even a bigger drop in the coming year compared to the current year, from 0.6% of GSDP to 0.44% of GSDP. So clearly with such a depleted budget the deficiencies of the public health department already plagued with huge staff shortages and loss of credibility is going to worsen in the coming year.
- The National Health Mission appears to be one of the affected programmes due to these budget cuts. From Rs 3142 crores in 2015-16 (RE), the available budget figures show reduction to Rs 2067 crores. Although not clearly mentioned in the budget documents, this appears to be related to some reduction of allocations from the Central government.
- Further, the total Central assistance to a number of critical national programs like tuberculosis, vector borne diseases, non-communicable diseases, mental health, blindness and leprosy appears to have been reduced from Rs. 215 crores to a mere Rs. 93 crores.
- When we look at the treasury database of 2015-16 expenditures, we see huge shortfalls in the disbursement of centrally sponsored programs in this year, so far releases as on 17th March 2016 being only around one third of budgeted commitments.
- For the Rajiv Gandhi Jeevandayi Arogya Yojana program in 2015-16 (BE) the govt allocated Rs.307 crores and then revised it to Rs 853 crores. As per the treasury database in mid- March 2016 the disbursement for RGJAY was Rs. 809 crores, the amount being almost fully utilised. Yet in the 2016-17 the govt has made a budgetary allocation of only Rs. 397 crores for this scheme, a major reduction.
These reduced budgetary allocations will worsen the human resources and supplies within the public health system of Maharashtra. The huge vacancies of doctors, nurses and other paramedics at one level and inadequate budgets for medicines, diagnostics and maintenance at another level will further adversely impact the functioning of the public health system.
In the overall health budget, it is very likely that many of the cuts are due to substantially reduced Central assistance, but the blame for reduction cannot be put entirely on the Central government because the state government’s substantial increase in share of devolved taxes under the 14th FC award does not seem to have found its way into the health and other social sector budgets. Given the new fiscal architecture, it is now time for the state government to review critically its budgetary commitments to the health and social sector, and shift its priorities towards these equity creating allocations, rather than giving overriding importance to smart cities, metros, flyovers, information highways etc.
Table: Maharashtra Health Budgets 2015-16 and 2016-2017
Contact for Jan Arogya Abhiyan:
Dr. Abhijit More – 9158494784
Ravi Duggal – 9869024868 / 9665071392