Lok Sabha Question No. 101 (STARRED), answered on 2017-12-22
Subject: National Health Accounts
Ministry: HEALTH AND FAMILY WELFARE
Asked by: ANANDRAO  ADSUL, VINAYAK BHAURAO RAUT

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA STARRED QUESTION NO. 101 TO BE ANSWERED ON THE 22 TH DECEMBER, 2017 NATIONAL HEALTH ACCO UNTS

## *101. SHRI ANANDRAO ADSUL: SHRI VINAYAK BHAURAO RAUT:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) the details of the per capita expenditure incurred on healthcare by th during each of the last three years and the current year;
- (b) whethe r the Government has recently released any data relating to Nation Accounts (NHA) for 2014 - 15 and if so, the details thereof;
- (c) whether some of the States have not spent the allocated funds properly or expedite spending of the allocations made under various healthcare schemes to and if so, the details thereof along with the reasons therefor;
- (d)  whether  the  Governme nt  has  warned  these  States  for  failing  to  spend  th allocated under the healthcare schemes and if so, the details thereof, State - wise; and
- (e) whether the Government has issued any directions and guidelines in this r so,  the  details  the reof  along  with  the  steps  taken  by  the  Government  to  monit implementation of Centrally Sponsored Schemes and utilisation of funds by the

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE ( SHRI JAGAT PRAKASH NADDA )

- (a)to ( e) : A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 101* FOR 22 TH DECEMBER, 2017

- (a) Per capita expenditure on healthcare by Government (Centre and St for last three years and current year, at current prices, is estimated as under:
- (i) 2014- 15 - Rs. 1108
- (ii) 2015- 16 - Rs. 1251
- (iii)2016-17  (RE) - Rs. 1526
- (iv) 2017- 18 (BE) -Rs. 1797
- (b) The  Government  has  recently  released  data  relating  to  National Accounts (NHA) 2014 - 15 and the key health financing indicators for India Estimates 2014 - 15 is  given at Annexure - I .
- (c) & (d) The State - wise  release of funds and expenditure under the National Health  Mission  (NHM)  is  provided  at Annexure - II .  A  few  States  failed  to utilize  the  released  funds  expeditiously.  Letters  were  issued  to  the State Governments   to utilize the funds expeditiously.
- (e) Public Health being a State su bject, primary responsibility of implementati and  monitoring  of  schemes  under  NHM  rests  with  the  State  Government However,  details  of  steps  taken  by  the  Central  Government  to  monito implementation of NHM and utilization of funds by the States are provided at Annexure - III .

## The key health financing indicators for India: NHA Estimates 2014 - 15

|   Sl. No. | Indicator                                            |   NHA 2014 - 15 |
|-----------|------------------------------------------------------|-----------------|
|         1 | Total Health Expenditure (THE) as % GDP $            |            3.89 |
|         2 | THE per capita (Rs.) #                               |         3826    |
|         3 | Government Health Expenditure (GHE) as % of THE      |           28.96 |
|         4 | GHE as % of GDP                                      |            1.13 |
|         5 | GHE as % of General Government Expenditure (GGE) @   |            3.94 |
|         6 | Per capita Government Health Expenditure (Rs.)       |         1108    |
|         7 | Union Government Health Expenditure as % of GHE      |           37    |
|         8 | State Government Health Expenditure as % of GHE      |           63    |
|         9 | Government based Voluntary Health Insurance as % GHE |            3.28 |
|        10 | OOPE as % of THE                                     |           62.58 |
|        11 | Per capita OOPE (Rs.)                                |         2394    |
|        12 | External/ Donor Funding as % of THE                  |            0.7  |
|        13 | AYUSH as % of THE                                    |           14.9  |

Note :(i ) $ GDP value for FY 2014 - 15  (Rs.1,24,33,749 Crores) -Statement 2: Second Advance Estimates of National Income and Expenditures on GDP, 2016 - 17;Press Information  Bureau  Government  of  India  Ministry  of  Statistics  &  Prog Implementation; 28 - February - 2017.

(ii)  # The population for 2014 is projected by National Health Systems Centre using Census population estimates -2011 published by Office of the Registr General & Census Commissioner, India.

(iii)@ GGE value for FY 2014 - 15 (Rs.35,55,332 cr ores) Table 114 :  Receipts an Disbursements  of  Central  and  State  Government,  Page  no.  180,  Handboo Statistics on Indian Economy, 2016, Reserve Bank of India.

## Statement Showing State wise Central Release and Expenditure under NHM for the year 2015 - 16 and  2016 - 17

| Sl. No.   | States              | 2015- 16        | 2015- 16   | 2016- 17        | 2016- 17   |
|-----------|---------------------|-----------------|------------|-----------------|------------|
| Sl. No.   | States              | Central Release | Exp        | Central Release | Exp        |
| 1         | A & Nicobar Islands | 37.30           | 11.47      | 44.81           | 28.83      |
| 2         | Andhra Pradesh      | 643.52          | 1090.17    | 590.14          | 1247.63    |
| 3         | Arunachal Pradesh   | 162.65          | 146.27     | 160.35          | 165.16     |
| 4         | Assam               | 971.35          | 1186.01    | 1040.46         | 1331.77    |
| 5         | Bihar               | 1159.49         | 1621.67    | 958.11          | 1536.72    |
| 6         | Chandigarh          | 23.89           | 20.98      | 21.22           | 20.36      |
| 7         | Chhattisgarh        | 412.26          | 758.28     | 575.05          | 987.40     |
| 8         | Dadra & NagarHaveli | 14.37           | 15.54      | 16.99           | 17.22      |
| 9         | Daman & Diu         | 10.53           | 15.69      | 11.25           | 9.97       |
| 10        | Delhi               | 163.80          | 137.29     | 234.38          | 147.56     |
| 11        | Goa                 | 16.77           | 24.92      | 19.29           | 40.52      |
| 12        | Gujarat             | 693.78          | 1272.42    | 844.90          | 1376.91    |
| 13        | Haryana             | 291.96          | 493.23     | 310.46          | 510.00     |
| 14        | Himachal Pradesh    | 246.49          | 281.26     | 209.30          | 343.39     |
| 15        | Jammu & Kashmir     | 367.90          | 420.94     | 357.30          | 414.43     |
| 16        | Jharkhand           | 411.50          | 590.18     | 391.70          | 570.60     |
| 17        | Karnataka           | 740.45          | 1141.61    | 695.77          | 1268.33    |
| 18        | Kerala              | 304.14          | 632.88     | 445.06          | 737.69     |
| 19        | Lakshadweep         | 5.69            | 2.72       | 3.81            | 4.32       |
| 20        | Madhya Pradesh      | 1132.19         | 2046.60    | 1458.76         | 1956.84    |
| 21        | Maharashtra         | 1085.92         | 1734.44    | 1221.34         | 1773.47    |

| Sl. No.   | States        | 2015- 16        | 2015- 16   | 2016- 17        | 2016- 17   |
|-----------|---------------|-----------------|------------|-----------------|------------|
| Sl. No.   | States        | Central Release | Exp        | Central Release | Exp        |
| 22        | Manipur       | 112.16          | 105.51     | 78.50           | 78.99      |
| 23        | Meghalaya     | 102.22          | 133.55     | 159.86          | 145.68     |
| 24        | Mizoram       | 94.68           | 172.38     | 80.66           | 90.45      |
| 25        | Nagaland      | 104.85          | 81.05      | 94.88           | 134.55     |
| 26        | Odisha        | 652.62          | 1205.77    | 685.20          | 1255.88    |
| 27        | Pudducherry   | 18.61           | 21.77      | 35.50           | 32.56      |
| 28        | Punjab        | 295.23          | 649.49     | 284.99          | 687.75     |
| 29        | Rajasthan     | 1287.84         | 1799.11    | 1204.84         | 1856.77    |
| 30        | Sikkim        | 41.01           | 50.71      | 41.67           | 50.57      |
| 31        | Tamil Nadu    | 1093.22         | 1633.37    | 752.76          | 1816.97    |
| 32        | Tripura       | 136.29          | 118.77     | 123.89          | 141.27     |
| 33        | Uttar Pradesh | 2862.83         | 4451.78    | 3095.17         | 4901.10    |
| 34        | Uttarakhand   | 276.41          | 335.95     | 260.87          | 346.01     |
| 35        | West Bengal   | 959.51          | 1487.62    | 741.99          | 1743.92    |
| 36        | Telangana     | 436.63          | 505.55     | 384.47          | 687.15     |
|           | Sub Total     | 17370.07        | 26396.94   | 17635.67        | 28458.73   |
|           | Others        | 92.82           | 0.00       | -               | -          |
|           | Total         | 17462.89        | 26396.94   | 17635.67        | 28458.73   |

Note:    Expenditure includes expenditure against State share and unspent balance previous year.

## ANNEXURE - III

## Statement showing details of steps taken by the Central Government to monitor the implementation of NHM and utilization of funds by the States

-  Performance Audit under National Rural Health Mission (NRHM)  by the CAG.
-  Annual Statutory Audits by CAG empanelled major Chartered Accountant audit fir ms.
-  Concurrent Audits by Chartered Accountant audit firms.
-  Examination  &  follow  up  of  quarterly  Financial  Management  Reports (FMR) furnished by the States.
-  Visits by the teams of the Financial Management Group of the Department to States for periodic revi ew.
-  Annual visits to states by Common Review Mission (CRM) which inter - alia, looks at financial systems and mechanisms.
-  Implementation of Public Financial Management System (PFMS) developed by  the  office  of  the  CGA,  Ministry  of  Finance  for  monitoring  and management of funds on real time basis.
-  Integrated monitoring visits by senior officials of the Ministry and Nat Health System Resource Centre.
-  Quarterly Management Information Systems on key interventions under the NHM.
-  Use of Health Management Information System to monitor the performance of various programmes and different health facilities.

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