Health, Education, Sanitation Budget appears to be most in 3 years. It isn’t

While funding for health, education and sanitation programmes in budget 2018-19 appears to be the highest over the last three years—a 13% rise from the previous year—the money set aside has declined from actual allocations of 2017-18, according to a FactChecker analysis of budget data.

With an eye on the 2019 general elections, finance minister Arun Jaitley announced the world’s largest national health insurance programme, scholarships for 1,000 doctorate engineering students at the Indian Institutes of Technology and Indian Institute of Science, and the construction of 18.8 million toilets by 2019. The estimated budgetary expenditure on health, education and social protection for 2018-19 is now ₹1.38 lakh crore, a 13% rise over the estimated expenditure of ₹1.22 lakh crore in 2017-18.

However, our analysis shows:

• A 2.1% decline in the allocation towards the national health mission, India’s largest programme for primary health infrastructure;
• A 0.23 percentage-point decline over 2017-18 in the union budget’s share of funding to the Human Resource Development (HRD) ministry, making it the lowest since 2014-15;
• A 7% cut in allocation for the Swachh Bharat Mission budget from 2017-18’s revised estimates.

Most of the rise in spending is for the social-protection sector, which includes scholarships after grade X for scheduled castes students and other backward classes and special Central Assistance to scheduled castes-centred sub schemes, the analysis revealed.

To fund the increased spending announced for 2018-19, Jaitley said a health and education cess that taxpayers pay would rise to 4% from 3%.

“This will enable us to collect an estimated additional amount of ₹11,000 crore,” said Jaitley, as he presented the budget in the Lok Sabha (lower house of parliament) on February 1, 2018.

With India poised to become the fifth largest economy holding the youngest and largest workforce “the world has ever seen” (as this World Bank document described it), the government must now deliver on its promise of Swasth [healthy] Bharat for Samriddha [prosperous] Bharat, as Jaitley said.

Budget for India’s primary health infrastructure drops by 2.1%

In the budget speech, the finance minister focused on the health sector and introduced a new national health insurance scheme–he declared it was “the world’s largest”–to insure 100 million households for ₹5,00,000 per family per year. This “National Health Protection Scheme” is the latest avatar of the Rashtriya Swasthya Suraksha Yojana (RSSY), which was previously the Rashtriya Swasthya Bima Yojana (RSBY) under the labour ministry. The latest scheme includes 30 million more households than the RSBY, which had been renamed as the RSSY in 2017-18 and has now again been renamed as the National Health Protection Scheme.

To meet these ambitious targets, however, there has only been a 2.7% increase in allocations to the health sector, from ₹53,198 crore in 2017-18 (revised estimates) to ₹54,667 crore (budget estimate).

‘Budget estimate’ for any ministry or scheme is the amount allocated to it in the budget papers for the following year. Once the financial year gets underway, some ministries may need more funds than were allocated to them under the ‘budget estimates’; these are then reflected as “revised estimates”.

Spending on the health ministry has declined to 2.1% of the total union budget from 2.4% in 2017-18. Health expenditure should be 2.5% of gross domestic product (GDP) by 2025, according to the National Health Policy.

Further, there has been a 2.1% decline in the allocation for the National Health Mission–a national health programme that funds infrastructure for primary healthcare–from ₹31,292 crore in 2017-18 (revised estimates) to ₹30,634 crore (budget estimate).

On a positive note, the budget for the National Nutrition Mission–a programme that seeks to reduce stunting, undernutrition, anemia and low birth weight of babies–under the women and child development ministry, rose over three times, from ₹950 crore in 2017-18 (revised estimates) to ₹3,000 crore in 2018-19 (budget estimate). This restores the government’s commitment to the improving nutrition status among Indian children, after the programme’s budget was cut in the revised estimate for 2017-18. From an allocation of Rs 1,500 crore, the revised estimate came down 36.6% to ₹950 crore for that year.

India has 48.2 million stunted—short for their age—children, more than any other country, IndiaSpend reported on January 30, 2018.

Under the Ayushman Bharat Initiative, there are two schemes–the national health protection scheme and the ‘Revitalising Infrastructure and Systems in Education (RISE) by 2022’ programme. The latter aims to improve infrastructure for medical education and health, with a provision of ₹1 lakh crore over four years.

“The Ayushman Bharat will build a New India 2022 and ensure enhanced productivity, well being and avert wage loss and impoverishment,” said Jaitley. “These schemes will also generate lakhs of jobs, particularly for women.”

Health costs push 39 million Indians back into poverty every year, IndiaSpend reported in January 2018.

The government will also set up 24 new medical colleges and hospitals and upgrade existing district hospitals in the country, Jaitley said.

Other investments for health include:

• Rs 600 crore for nutritional support to all tuberculosis patients: Rs 500 per month per patient for 10 months for the duration of their treatment;
• Rs 1,200 crore for the National Health Policy, 2017; with 150,000 health and wellness centres, it hopes to address a rising tide of non-communicable diseases, such as diabetes and cardiovascular ailments.

Swachh Bharat Mission faces 7% cut from previous year’s revised estimate

Inadequate sanitation–management of human excreta, solid waste, and drainage–costs India ₹2.4 trillion ($53.8 billion) every year in losses due to health, damage to drinking water and tourism costs, IndiaSpend reported on January 31, 2018.

In keeping with India’s mission to make India open-defecation free by 2019, the finance minister reiterated the government’s focus on toilet construction. In 2018-19, the government aims to build 18.8 million toilets under the Swachh Bharat-Gramin (Clean India-Rural) scheme, Jaitley said, adding, “This will create employment of 170 million person days.”

This will raise the total number of toilets to 147 million from 127 million–89% of the targeted 164 million toilets under the programme. Less than 20 months remain to the October 2019 deadline of making India open-defecation free.

While budget estimates for the Swachh Bharat Mission in 2018-19 are the highest since its inception in 2014, the Modi government has actually cut allocation to the mission by 7%–to ₹17,843 crore in 2018-19 from ₹19,248 crore in 2017-18 (revised estimate), according to a FactChecker analysis of budget data.

Of the total allocation for the scheme, only 4% of funds have been spent on information and education–below the recommended 8-12%, IndiaSpend reported on January 31, 2018. The budget for information, education and communication activities under Swachh Bharat-Gramin (rural) is down 6%—to ₹300 crore in 2018-19 from ₹318 crore in 2017-18.

Little attention to education and changing attitudes means that at least 522 million Indians still defecate in the open—leaving many millions susceptible to disease and poverty—according to this IndiaSpend report on January 31, 2018.

Share of education in budget lowest in five years

In his budget speech, finance minister Arun Jaitley, raised concerns over the quality of education delivered to children in school. The government has defined learning outcomes and conducted a national survey of more than 2 million children to assess the on-ground status of education in the country, Jaitley said.

“This will help in devising a district-wise strategy for improving quality of education. We now propose to treat education holistically without segmentation from pre-nursery to Class 12,” the finance minister said, allocating ₹85,010 crore to the HRD ministry.

In absolute terms, this budget of ₹85,010 crore breaks a declining trend in allocation to the HRD ministry under the Modi government and is a ₹5,324 crore or 6.7% rise from 2017-18, when ₹79,685 crore was allocated. However, as a share of the total union budget, the HRD ministry’s allocation has dropped 0.23 percentage points to 3.48% in 2018-19—the lowest since 2014-15—from 3.71% in 2017-18, shows a FactChecker analysis of budget data. In five years to 2018-19, that is a drop of 2.7 percentage points to 3.48% from 6.15% in 2014-15.

In July 2017, the deadline to formally train 1.3 million teachers was extended to March 2019 (from March 2015) under the Right of Children to Free and Compulsory Education (Amendment) Act, 2017, Jaitley said in his budget speech. “Improvement in quality of teachers can improve the quality of education in the country,” the finance minister said, introducing an integrated bachelor’s of education programme.

However, the budget does not address the vacancies in government-run schools. In 2016, a million teaching posts—9,00,000 in elementary schools and 1,00,000 posts in secondary schools—were vacant, IndiaSpend reported on December 12, 2016.

“The Government is committed to provide the best quality education to the tribal children in their own environment,” Jaitley said. For this, by 2022, Eklavya Model Residential Schools (EMRS) will be set up in every tribal block or area with at least 20,000 tribal persons who comprise 50% of the population, the finance minister announced. Similar to the Navodaya Vidyalayas or ‘new-age schools’, launched under the National Policy on Education of 1986, the EMRS scheme was launched in 1997-98, according to this release from the Press Information Bureau on August 6, 2010.

As of January 2018, such schools had been sanctioned in 271—or 40% of 672—tribal blocks nationwide, according to this Lok Sabha response from January 1, 2018. As of March 2017, 161 EMRS were functional, according to this Lok Sabha response from March 27, 2017.

This report was first published in factchecker.in