The Hindu : Kerala News : Health allocation takes a dip in State

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Thursday, Mar 13, 2008
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Kerala

Kerala

Health allocation takes a dip in State

C. Maya

Capital investment in public health is just 2.2%
Revenue expenditure on public health going up

Thiruvananthapuram: The Union government’s allocation for health has been going up, but Kerala is definitely not matching up.

The Centre’s health budget allocation went up by 15 per cent this year, but in sharp contrast, the State government’s current budget (2008-09) shows that the capital investment in public health (Rs.34.60 crore) has gone down to an all-time low of just 2.2 per cent of the total outlay.

The government seems to have taken refuge in the fact that the National Rural Health Mission is providing Rs.133 crores this year for primary and secondary health sectors. According to the MoU signed between the State and the Centre, the State needs to give its commitment that there would be an annual increase in its budget outlay by 10 per cent. But looking at the steady decline in capital expenditure on public health, public health experts have been wondering if the increased health allocation from the Centre is seen as a substitute fund by the State.

Expenditure

The revenue expenditure on public health has been going up; it has gone up from Rs.1,710.13 crore in 2007-08 to Rs. 2,036.94 crore this year. But as public health experts point out, this is just routine, for this is a recurring annual expenditure that the government has to find every year for paying salaries and for consumables. As it is, 70 per cent of the revenue expenditure on health is spent on salaries and only about 15 per cent for materials and supplies.

The State Health department has been defensive about its share in this year’s budget. According to a statement issued by the Health Minister’s office, the total health expenditure this year would be Rs.2,071.54 crore (including the revenue expenditure of Rs.2,036.94 crore and the capital expenditure of Rs.34.60 crore) and that this works out to 14.04 per cent of the government’s total budget.

The statement says this apart, another Rs.19.81 crore of additional Central assistance provided under State Plan for tsunami relief, would be spent in the health sector. The Health department also claims that the scheme for health insurance for BPL families in the current budget should also been seen as an incentive for the health sector.

Household spending

“One should not be fooled by the annual increase in revenue expenditure on health, which is necessitated by inflation and this does not diminish the fact that the State’s capital investment in public health sector has been going down. It is true that in recent years, more funds are being made available for the State’s health sector through Central or external assistance,” a public health expert asked.

Until the late 1970s, the State government’s share of health expenditure in the total budget had been consistently higher than what it was in other States. The annual growth rate of the State’s health expenditure during the first three decades was 13.04 per cent, even outstripping the growth of the State Gross Domestic Product, which was 9.81 per cent. This paved the way for the health indices that the State is so proud of today. But since the 1980s, the State’s share in health has been going down steadily.

Today, 77 per cent of the total health expenditure in the State comes from direct spending of households. According to the report of the National Commission on Macroeconomics and Health, released by the Union Ministry of Health in August 2005, Kerala accounts for the highest household spending on health in India (a little over Rs.2,500 a year). Evidently, Kerala no longer believes that investing in health is an incentive to economic growth. .

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