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Cover-54Th Report-H&FW PARLIAMENT OF INDIA RAJYA SABHA 54 DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEE ON HEALTH AND FAMILY WELFARE FIFTY-FOURTH REPORT ON DEMANDS FOR GRANTS 2012-13 (DEMAND NO. 46) OF THE DEPARTMENT OF HEALTH AND FAMILY WELFARE (MINISTRY OF HEALTH AND FAMILY WELFARE) (PRESENTED TO THE RAJYA SABHA ON 26TH APRIL, 2012) (LAID ON THE TABLE OF THE LOK SABHA ON 25TH APRIL, 2012) RAJYA SABHA SECRETARIAT NEW DELHI APRIL, 2012/VAISHAKHA, 1934 (SAKA) Website : http://rajyasabha.nic.in E-mail : [email protected] PARLIAMENT OF INDIA RAJYA SABHA DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEE ON HEALTH AND FAMILY WELFARE FIFTY-FOURTH REPORT ON DEMANDS FOR GRANTS 2012-13 (DEMAND NO. 46) OF THE DEPARTMENT OF HEALTH AND FAMILY WELFARE (MINISTRY OF HEALTH AND FAMILY WELFARE) (PRESENTED TO THE RAJYA SABHA ON 26TH APRIL, 2012) (LAID ON THE TABLE OF THE LOK SABHA ON 25TH APRIL, 2012) RAJYA SABHA SECRETARIAT NEW DELHI APRIL, 2012/VAISHAKHA, 1932 (SAKA) CONTENTS PAGES 1. COMPOSITION OF THE COMMITTEE ......................................................................................... (i)-(ii) 2. PREFACE ............................................................................................................................ (iii) Part – A (HEALTH SECTOR) 3. REPORT .................................................................................................................................. 1—49 4. OBSERVATIONS/RECOMMENDATIONS — AT A GLANCE (HEALTH SECTOR) .............................. 272—89 Part – B (NRHM) 5. REPORT .................................................................................................................................. 50—71 6. OBSERVATIONS/RECOMMENDATIONS — AT A GLANCE (NRHM SECTOR) ................................ 90—97 7. MINUTES ................................................................................................................................ 99—104 8. ANNEXURE ............................................................................................................................... 105—108 COMPOSITION OF THE COMMITTEE (2011-12) RAJYA SABHA 1. Shri Brajesh Pathak — Chairman #2. Shri Janardhan Dwivedi *3. Shrimati Viplove Thakur 4. Dr. Vijaylaxmi Sadho 5. Shri Balbir Punj 6. Dr. Prabhakar Kore 7. Shrimati Vasanthi Stanley @8. Shri Rasheed Masood 9. Shrimati B. Jayashree 10. Shri Derek O’Brien LOK SABHA 11. Shri Ashok Argal 12. Shrimati Harsimrat Kaur Badal 13. Shri Vijay Bahuguna 14. Shrimati Raj Kumari Chauhan 15. Shrimati Bhavana Gawali 16. Dr. Sucharu Ranjan Haldar 17. Dr. Monazir Hassan I8. Dr. Sanjay Jaiswal 19. Shri S. R. Jeyadurai 20. Shri P. Lingam 21. Shri Datta Meghe 22. Dr. Jyoti Mirdha 23. Dr. Chinta Mohan 24. Shri Sidhant Mohapatra 25. Shrimati Jayshreeben Kanubhai Patel 26. Shri M. K. Raghavan 27. Shri J. M. Aaron Rashid 28. Dr. Arvind Kumar Sharma 29. Shri Radhe Mohan Singh 30. Shri Ratan Singh 31. Dr. Kirit Premjibhai Solanki # Ceased to be a Member w.e.f. 27th January, 2012 and re-nominated to the Committee on 2nd February, 2012. * Ceased to be a Member w.e.f. 2nd April, 2012. @ Ceased to be a Member w.e.f. 9th March, 2012. (i) (ii) SECRETARIAT Shri P.P.K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Deputy Director PREFACE I, the Chairman of the Department-related Parliamentary Standing Committee on Health and Family Welfare, having been authorized by the Committee to present the Report on its behalf, do hereby present this Fifty-fourth Report of the Committee on the Demand for Grants (Demand No. 46) of the Department of Health and Family Welfare, Ministry of Health and Family Welfare for the year 2012-13. 2. The Committee considered the various documents and relevant papers received from the Department of Health and Family Welfare, Ministry of Health and Family Welfare and also heard the Secretary and other officials of the Department on the said Demand for Grants (2012-13) in its meeting held on 9th April, 2012. 3. The Committee considered the Draft Report and adopted the same in its meeting held on 23rd April, 2012. BRAJESH PATHAK NEW DELHI; Chairman, 23rd April, 2012 Department-related Parliamentary Vaishakha 3, 1934 (Saka) Standing Committee on Health and Family Welfare. (iii) 1 PART-A HEALTH SECTOR I. BUDGETARY ALLOCATION 1.1 The Department has informed that the expenditure status of the allocated funds under Plan heads for the Eleventh Plan was as follows: (Rs. in crore) Year BE RE Actual Expdt. 2007-08 2985.00 2331.39 2183.83 2008-09 3650.00 3650.00 3008.40 2009-10 4450.00 3825.25 3261.90 2010-11 5560.00 5139.55 4666.04 2011-12 5720.00 4450.00 4101.41 Total – XI Plan 22365.00 19396.19 17221.58 1.2 From a scrutiny of the above Table, the Committee is constrained to observe that there was substantial and persistent under-utilization of the budgeted funds during the Eleventh Plan. That the savings occurred under the Plan head underlines the fact that the development activities have been curtailed. Though the Committee is supportive of the Department’s demand for higher allocation of funds, it deprecates the Department for failing to optimally utilize its Plan Allocations over the last five years. The Committee observes that the underutilization of budgeted funds is indicative of slack monitoring on the part of the Department as well as formulation of the Budget Estimates in a ritualistic manner without application of proper financial yardsticks. The Committee, accordingly, impresses upon the Department to pay focused attention to streamlining its monitoring mechanism and ensure optimal and more efficient deployment and utilization of its financial resources for smooth execution of its Plan programmes. 1.3 The Committee has been informed that the Department of Health & Family Welfare has proposed an outlay of Rs.45,532.18 crore, consisting of Rs.28439.65 crore for NRHM and Rs.17092.53 crore for Health Sector Schemes for Annual Plan 2012-13. As against the proposed plan outlay of Rs.45532.18 crore, approved plan outlay for the Department of Health and Family Welfare for 2012-13 is Rs.27127 crore, which is only 15% hike over the Budget Estimates of 2011-12. Out of this the NRHM component is 76% at Rs.20542 crore and the outlay for various other health schemes is Rs. 6585 crore against the proposed outlay of Rs.17092.53 crore. 1.4 The Committee has also been informed that the Planning Commission in their document- “Faster, Sustainable and More Inclusive Growth: An Approach to the Twelfth Five Year Plan”, has aimed at raising the total public health expenditure to 2.5% of GDP by the end of the Twelfth Plan. 1.5 The Committee has been further apprised that Government of India in partnership with the States has been involved in formulating health policies from time to time to provide better health to the population. Presently States and Union Territories together account for about two-thirds of total public health outlay. 2 1.6 The Committee observes that a shortfall in allocation of funds to the tune of Rs.10507.53 crore vis-a-vis the proposed outlay for 2012-13 that too at a time when the Government has committed itself to raising its expenditure on health from roughly 1% of the GDP to 2.5% of the GDP by the end of Twelfth Plan is baffling, to say the least. The public expenditure on health in the country is one of the lowest in the world and total plan expenditure would need to rise substantially and consistently before the target expenditure level of 2.5% of GDP is achieved. The Committee, therefore, desires to know the reasons behind the substantially reduced allocation for 2012-13. The Committee also desires to know the rate at which the total Plan expenditure would need to grow annually, in order to meet the expenditure level of 2.5% of GDP by the end of the Twelfth Plan and what would be the share of the Centre and the States therein. The Committee, therefore, recommends that the Department should make all out efforts to convince the Planning Commission and the Department of Expenditure for enhancing the annual Plan allocation for the remaining four years of the Twelfth Plan and also at RE 2012-13 in such a way that the target of meeting expenditure level of 2.5% of GDP could be achieved. 1.7 Giving a break-up of the funds allocated vis-a-vis financial outlay proposed for 2012-13, the Secretary during his deposition before the Committee on 9/4/2012 inter-alia furnished the following information: Major ongoing schemes under Health (Centrally Sponsored Schemes) (Rs. in crore) S1. Name of the Schemes/ 2012-13 2012-13 No. Institutions (proposed) (approved) 1 National Programme for Prevention and 1024.95 300 Control of Cancer, Diabetes, CVD and Stroke 2 National Mental Health Programme 704.00 130 3 Trauma Care 656.42 100 4 National Programme for Health Care for the Elderly 200.00 150 5 Human Resources for Health 800.00 505 6 District Hospitals 400.00 350 New Activities proposed under Health (Centrally Sponsored Schemes) (Rs. in crore) Sl. Name of the scheme 2012-12 2012-13 No. (proposed) (approved) 1 Strengthening Govt medical colleges and central 270.00 2.00 govt. health institutions 2 Establishing new Medical colleges 30.00 2.00 3 Setting up of state paramedical institutions/colleges 100.00 2.00 4 Setting up of college of pharmacy in govt. 75.00 2.00 medical colleges 5 Strengthening state drug regulatory system 100.00 2.00 6 Strengthening state food regulatory system 70.00 2.00 7 Innovation based schemes 100.00 50.00 3 Major Activities under Health (Central Sector) (Rs. in crore) Name of the Schemes/ 201213 2012-13 Institutions (proposed) (approved) Strengthening of Hospitals and dispensaries 556.65 393.36 Strengthening of institutions of Medical education, training 1009.18 418.21 and research PMSSY 2022.79 1544.21 National Centre for Disease Control 100.00 52.25 Redevelopment of Hospitals/lnstitutions including AIIMS, 2230.01 1418.85 Safdarjung Hospital, Dr. RML Hospital 1.8 The Committee has been apprised that no provision could be made for the scheme ‘National Urban Health Mission’ and some of the new schemes like ‘Strengthening of District Hospitals, to provide advanced level secondary care, supply of generic medicines and public health facilities etc.
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