5th Feb 2020 : The Hindu Editorials Notes : Mains Sure Shot
Question – Discuss the impacts of attaching medical colleges to existing district hospitals in the PPP mode.
Context – The experiment of PPP model in hospitals.
- Setting up of medical colleges in existing district hospitals under the Public Private Partnership (PPP) mode.
- The States which fully allow the facilities of the hospital to the medical college and wish to provide land at a concession would be eligible for viability gap funding.
- To address the shortage of doctors.
- It is practically not possible for Central and State governments to bridge the gaps in medical education with their limited resources and finances, necessitating the formation of a PPP model.
- It combines the strengths of both sectors – public and private.
- It augments the number of medical seats available.
- moderates the costs of medical education.
- Allowing private parties to “operate and maintain the district hospital and provide healthcare services” could seriously dent public health services
- The draft indicates that the private firm “can demand, collect and appropriate hospital charges from patients”.
- It destabilizes people’s access to affordable public health services, which can be disastrous.
- The government must consider raising health-care spending beyond the usual under 2% of GDP.
- It should ensure more resources are available to provide free, quality health care to all.
Note – Today there is an article on the 15th Finance Commission. The following are the major highlights:
15th FINANCE COMMISSION:
- The appointment of the Fifteenth Finance Commission by the President of India under Article 280 of the Constitution was notified on November 27, 2017.
- It was required to submit the report by October 30, 2019 for five years for the period 2020-21 to 2024-25.
- However, due to various political and fiscal developments, the tenure of the Commission was extended to submit its report.
- Now it will submit two reports, one for 2020-21 and the second covering the period of five years beginning April 1, 2021.
Finance Commission and its functions:
The Finance Commission has the following functions or duties:
- The Commission makes recommendations to the President of India on the distribution of tax proceeds between the Union and the States and the share of each state.
- The Commission also decides the principles that govern the payment of grants-in-aid to states from the Consolidated Fund of India.
- The President of India can also refer any other matter to the Finance Commission in the interest of building a sound financial system.
Reasons for extension:
- The abolition of Statehood to Jammu and Kashmir required the Commission to make an estimation excluding the Union Territory.
- The deceleration in growth and low inflation has substantially slowed down the nominal GDP growth which is the main tax base proxy; making projections of tax revenues and expenditures based on this for the medium term could have posed serious risks.
Recommendations suggested in the Report:
- The Commission has continued with the approach and methodology adopted by the previous Commissions for tax devolution and revenue-gap grants.
- vertical division of taxes – States’ share is 41%
- For the horizontal shares, however, the formula has been changed to consider “fiscal needs, equity and efficiency”.
- Factors considered – income distance, population and area and forest cover, two additional factors — demographic performance and tax effort were also used.
o 15% weight to the 2011 population,
o reduced the weight of income distance to 45%,
o increased the weight to forest cover and ecology to 10%
o 12.5% weight to demographic performance and
o 2.5% weight to tax effort.
- In terms of relative shares in tax devolution, among the major States the biggest loser is Karnataka followed by Uttar Pradesh, Kerala, Telangana and Andhra Pradesh.
- The major reason for Karnataka and Kerala losing on devolution is that their per capita income growth has been faster than most other States.
- Suggested grants for local bodies amount to ₹90,000 crore comprising ₹60,750 crore for panchayats and the remaining ₹29,250 crore for municipal bodies.
- For PRIs, 50% of the grant is tied to improving sanitation and supply of drinking water, rest untied.
- The Commission has recommended the creation of a disaster mitigation fund at the Central and State levels.
- For 2020-21, it has recommended ₹7,735 crore for improving nutrition based on the numbers of children in the 0-6 age group and lactating mothers.
- Proposed to give grants for police training, modernisation and housing, railway projects in States etc.