Concerns over an underfunded health sector extended to the mechanism of Centre-State funding, as raised by the Parliamentary Standing Committee report on health. In its 93rd report, the committee raised serious concerns over shortage of funds reaching states, which would impact majority of the government’s health programmes, including the ones announced this year — free generic drugs, free diagnostics and dialysis initiatives.<!– /11440465/Dna_Article_Middle_300x250_BTF –>The department of health and family welfare made a written submission to the committee of the obstacles funds face to the states, the treasury route that was implemented in 2014-15 has seen “considerable delays”, in transferring the centre’s grants to State Health Societies. As the report goes, of the total Rs 8242.78 crore released now under the RCH Reproductive and Child Health and Health systems strengthening, Rs 7460 were transferred from the state treasury to the state health societies “with a delay of 0 to 142 days”, and Rs 782.74, i.e. 9.5% “is still lying with State TReasury for a period between 90 to 180 days”.According to committee, the treasury route of fund flow has created “unnecessary delays” and “bottlenecks” in the smooth functioning of the National Health Mission, and thus needs a review. If delays persist for another three months and the treasury system “fails to address the persisting delays”, the Committee said that the “society route should replace the Treasury route”.For the new initiatives to be implemented smoothly this year, the Committee asked the for an additional allocation of Rs 5,000 crore for the NHM to be raised at the RE stage.Already much is suffering under the NHM due a reduced allocation in the overall health sector, a mere 46.59% of the money envisaged in the 12th Year Plan, such as strengthening of district hospitals, scaling up of free drugs and diagnostics, scaling up new vaccines, establishing new primary and community health centres, etc. Interestingly along with free drugs, the government has made much of its immunisation programme and the introduction of new vaccines, something that seems to be odds with the state of finances seen in the report.The report also took note of the impact of the decision of the 14th Finance Commission on Centre state funding patterns. The Centre-State allocation went from 75:25 to 60:40, asking states to raise a larger share for programmes and schemes. Though the 10% increase in devolution of the Centre tax share to states was meant to help states step up their allocations, it was not possible in 2015-16 as the states had already decided their budgets, leading to a shortfall in budgets and an uncertainty about money that harmed many ongoing programmes of health and nutrition, as experts had previously told dna. The committee too noted that the suddenness of the change “must have jeopardised the targeted health outcomes in 2015-26”.The report also questioned the lack of mechanism to review how states would spend this extra 10% of tax share, and how it would reflect in the “allocation of additional resources for health”.However, even as it recognised the onus on the states to step up their allocations this year, and not let the health sector slide, the major responsibility remained on the centre, to up the public health expenditure to the much needed 2.5% of the GDP.
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