Recently, the Standing Committee on Health and Family Welfare submitted its report to the Parliament on the National Commission for Human Resource for Health Bill, 2011.  The objective of the Bill is to “ensure adequate availability of human resources in the health sector in all states”.  It seeks to set up the National Commission for Human Resources for Health (NCHRH), National Board for Health Education (NBHE), and the National Evaluation and Assessment Council (NEAC) in order to determine and regulate standards of health education in the country.  It separates regulation of the education sector from that of professions such as law, medicine and nursing, and establishes professional councils at the national and state levels to regulate the professions. See here for PRS Bill Summary. The Standing Committee recommended that this Bill be withdrawn and a revised Bill be introduced in Parliament after consulting stakeholders.  It felt that concerns of the professional councils such as the Medical Council of India and the Dental Council of India were not adequately addressed.  Also, it noted that the powers and functions of the NCHRH and the National Commission on Higher Education and Research (to be established under the Higher Education and Research Bill, 2011 to regulate the higher education sector in the country) were overlapping in many areas.  Finally, it also expressed concern over the acute shortage of qualified health workers in the country as well as variations among states and rural and urban areas.  As per the 2001 Census, the estimated density of all health workers (qualified and unqualified) is about 20% less than the World Health Organisation’s norm of 2.5 health workers per 1000 population. See here for PRS Standing Committee Summary. Shortfall of health workers in rural areas Public health care in rural areas is provided through a multi-tier network.  At the lowest level, there are sub health-centres for every population of 5,000 in the plains and 3,000 in hilly areas.  The next level consists of Primary Health Centres (PHCs) for every population of 30,000 in the plains and 20,000 in the hills.  Generally, each PHC caters to a cluster of Gram Panchayats.  PHCs are required to have one medical officer and 14 other staff, including one Auxiliary Nurse Midwife (ANM).  There are Community Health Centres (CHCs) for every population of 1,20,000 in the plains and 80,000 in hilly areas.  These sub health centres, PHCs and CHCs are linked to district hospitals.  As on March 2011, there are 14,8124 sub health centres, 23,887 PHCs and 4809 CHCs in the country.[i]  Sub-Health Centres and Primary Health Centres

  • § Among the states, Chhattisgarh has the highest vacancy of doctors at 71%, followed byWest Bengal(44%),Maharashtra(37%), and Uttar Pradesh (36%). On the other hand, Rajasthan (0.4%), Andhra Pradesh (3%) and Kerala (7%) have the lowest vacancies in PHCs.
  • § Nine states do not have any doctor vacancies at all at the PHC level. These states includeBihar, Jharkhand andPunjab.
  • § Ten states have vacancy in case of ANMs.  These are: Manipur, Uttar Pradesh, Chhattisgarh,Gujarat,Goa, Himachal Pradesh, Tamil Nadu, Haryana, Kerala and Andhra Pradesh.
  • § The overall vacancy for ANMs in the country is 5% while for doctors it is 24%.

Table 1: State-wise comparison of vacancy in PHCs

 

Doctors at PHCs

ANM at PHCs and Sub-Centres

State Sanctioned post Vacancy % of vacancy Sanctioned post Vacancy % of vacancy
 Chhattisgarh 1482 1058 71 6394 964 15
 West Bengal 1807 801 44 10,356 NA 0
 Maharashtra 3618 1326 37 21,122 0 0
 Uttar Pradesh 4509 1648 36 25,190 2726 11
 Mizoram 57 20 35 388 0 0
 Madhya Pradesh 1238 424 34 11,904 0 0
 Gujarat 1123 345 31 7248 817 11
 Andaman & Nicobar Isld 40 12 30 214 0 0
 Odisha 725 200 28 7442 0 0
 Tamil Nadu 2326 622 27 9910 136 1
 Himachal Pradesh 582 131 22 2213 528 24
 Uttarakhand 299 65 22 2077 0 0
 Manipur 240 48 20 984 323 33
 Haryana 651 121 19 5420 386 7
 Sikkim 48 9 19 219 0 0
 Meghalaya 127 23 18 667 0 0
 Delhi 22 3 14 43 0 0
 Goa 46 5 11 260 20 8
 Karnataka 2310 221 10 11,180 0 0
 Kerala 1204 82 7 4232 59 1
 Andhra Pradesh 2424 76 3 24,523 2876 12
 Rajasthan 1478 6 0.4 14,348 0 0
 Arunachal Pradesh  NA  NA NA NA NA 0
 Assam  NA  NA NA NA NA 0
 Bihar 2078  0 NA NA NA 0
 Chandigarh 0 0 NA 17 0 0
 Dadra & Nagar Haveli 6 0 NA 40 0 0
 Daman & Diu 3  0 NA 26 0 0
 Jammu & Kashmir 750  0 NA 2282 0 0
 Jharkhand 330  0 NA 4288 0 0
 Lakshadweep 4  0 NA NA NA 0
 Nagaland  NA  NA NA NA NA 0
 Puducherry 37 0 NA 72 0 0
 Punjab 487 0 NA 4044 0 0
 Tripura  NA  NA NA NA NA 0
 India 30,051 7,246 24 1,77,103 8,835 5
Sources: National Rural Health Mission (available here), PRS.Note: The data for all states is as of March 2011 except for some states where data is as of 2010.  For doctors, these states are Bihar, UP, Mizoram and Delhi.  For ANMs, these states are Odisha and Uttar Pradesh.

 

Community Health Centres

  • § A CHC is required to be manned by four medical specialists (surgeon, physician, gynaecologist and paediatrician) and 21 paramedical and other staff.
  • § As of March 2011, overall there is a 39% vacancy of medical specialists in CHCs.  Out of the sanctioned posts, 56% of surgeons, 47% of gynaecologists, 59% of physicians and 49% of paediatricians were vacant.
  • States such as Chhattisgarh, Manipur and Haryana have a high rate of vacancies at the CHC level.

Table 2: Vacancies in CHCs of medical specialists

  Surgeons Gynaecologists Physicians Paediatricians
State

% of vacancy

 Andaman & NicobarIsland 100 100 100 100
 Andhra Pradesh 74 0 45 3
 Arunachal Pradesh NA NA NA NA
 Assam NA NA NA NA
 Bihar 41 44 60 38
 Chandigarh 50 40 50 100
 Chhattisgarh 85 85 90 84
 Dadra & Nagar Haveli 0 0 0 0
 Daman & Diu 0 100 0 100
 Delhi 0 0 0 0
 Goa 20 20 67 66
 Gujarat 77 73 0 91
 Haryana 71 80 94 85
 Himachal Pradesh NA NA NA NA
 Jammu & Kashmir 34 34 53 63
 Jharkhand 45 0 81 61
 Karnataka 33 NA NA NA
 Kerala NA NA NA NA
 Lakshadweep 0 0 100 0
 Madhya Pradesh 78 69 76 58
 Maharashtra 21 0 34 0
 Manipur 100 94 94 87
 Meghalaya 50 NA 100 50
 Mizoram NA NA NA NA
 Nagaland NA NA NA NA
 Odisha 44 45 62 41
 Puducherry 0 0 100 NA
 Punjab 16 36 40 48
 Rajasthan 57% 46 49 24
 Sikkim NA NA NA NA
 Tamil Nadu 0 0 0 0
 Tripura NA NA NA NA
 Uttar Pradesh NA NA NA NA
 Uttarakhand 69 63 74 40
 West Bengal 0 57 0 78
 India 56 47 59 49
Sources: National Rural Health Mission (available here), PRS.

[i].  “Rural Healthcare System in India”, National Rural Health Mission (available here).  

In light of the COVID-19 pandemic, all passenger trains were suspended till April 14, 2020.  However, goods services have been continuing with trains carrying essential commodities to various parts of the country.   Railways has also made railway parcel vans available for quick mass transportation for e-commerce entities and other customers including state governments to transport certain goods.   These include medical supplies, medical equipment, food, etc. in small parcel sizes.  Besides these, Railways has taken several other actions to provide help during the pandemic. 

Since the travel ban extends from March 23 till April 14, 2020 (and may extend further), it will impact Railways’ finances for both 2019-20 and 2020-21.  In this post, we discuss the situation of Railways’ finances, and what could be the potential impact of the travel ban on Railways’ revenues.  

Impact of the travel ban on Railways’ internal revenue

Railways generates internal revenue primarily from passenger and freight traffic.  In 2018-19 (latest actuals), freight and passenger traffic contributed to about 67% and 27% of the internal revenue respectively.  The remaining is earned from other miscellaneous sources such as parcel service, coaching receipts, and sale of platform tickets.  In 2020-21, Railways expects to earn 65% of its internal revenue from freight and 27% from passenger traffic.  

Passenger traffic:   In 2020-21, Railways expects to earn Rs 61,000 crore from passenger traffic, an increase of 9% over the revised estimates of 2019-20 (Rs 56,000 crore).  

As per numbers provided by the Ministry of Railways, up to February 2020, passenger revenue was approximately Rs 48,801 crore.  This is Rs 7,199 crore less than the 2019-20 revised estimates for passenger revenue, implying that this much amount will have to be generated in March 2020 to meet the revised estimate targets (13% of the year’s target).  However, the average passenger revenue in 2019-20 (for the 11 months) has been around Rs 4,432 crore.  Note that in March 2019 passenger revenue was Rs 4,440 crore.  With passenger travel completely banned since March 23, Railways will fall short of its target for passenger revenue in 2019-20.

As of now, it is unclear when travel across the country will resume to business as usual.  Some states have started extending the lockdown within their state.  In such a situation, the decline in passenger revenue could last longer than these three weeks of lockdown. 

Freight traffic:   In 2020-21, Railways expects to earn Rs 1,47,000 crore from goods traffic, an increase of 9% over the revised estimates of 2019-20 (Rs 1,34,733 crore).   

As per numbers provided by the Ministry of Railways, up to February 2020, freight revenue was approximately Rs 1,08,658 crore.  This is Rs 26,075 crore less than the 2019-20 revised estimates for freight revenue.  This implies that Rs 26,075 crore will have to be generated by freight traffic in March 2020 to meet the revised estimate targets (19% of the year’s target).   However, the average freight revenue in 2019-20 (for the 11 months) has been around Rs 10,029 crore.  Note that in March 2019, freight revenue was Rs 16,721 crore.  

While passenger traffic has been completely banned, freight traffic has been moving.  Transportation of essential goods, and operations of Railways for cargo movement, relief and evacuation and their related operational organisations has been allowed under the lockdown.  Several goods carried by Railways (coal, iron-ore, steel, petroleum products, foodgrains, fertilisers) have been declared to be essential goods.  Railways has also started operating special parcel trains (to carry essential goods, e-commerce goods, etc.) since the lockdown.  These activities will help continue the generation of freight revenue. 

However, some goods that Railways transports, such as cement which contributes to about 8% of Railways’ freight revenue, have not been classified as essential goods.  Railways has also relaxed certain charges levied on freight traffic.  It remains to be seen if Railways will be able to meet its targets for freight revenue.  

Figure 1: Share of freight volume and revenue in 2018-19 (in %)

image

Sources: Expenditure Profile, Union Budget 2020-21; PRS.  

Freight has been cross-subsidising passenger traffic; it may worsen this year

Railways ends up using profits from its freight business to provide for such losses in the passenger segment, and also to manage its overall financial situation.  Such cross-subsidisation has resulted in high freight tariffs.  With the ban on passenger travel and if the lockdown (in some form) were to continue, passenger operations will face more losses.  This may increase the cross-subsidy burden on freight.  Since Railways cannot increase freight charges any further, it is unclear how such cross-subsidisation would work. 

For example, in 2017-18, passenger and other coaching services incurred losses of Rs 37,937 crore, whereas freight operations made a profit of Rs 39,956 crore.   Almost 95% of profit earned from freight operations was utilised to compensate for the loss from passenger and other coaching services.  The total passenger revenue during this period was Rs 46,280 crore.  This implies that losses in the passenger business are about 82% of its revenue.  Therefore, in 2017-18, for every one rupee earned in its passenger business, Indian Railways ended up spending Rs 1.82.  

Railways expenditure 

While the travel ban has meant that Railways cannot run all its services, it still has to incur much of its operating expenditure.  Staff wages and pension have to be paid and these together comprise 66% of the Railways’ revenue expenditure.  Between 2015 and 2020 (budget estimate), Railways’ expenditure on salary has grown at an average annual rate of 13%.  

About 18% of the revenue expenditure is on fuel expenses, but that may see some decline due to a fall in oil prices.  Railways will also have to continue spending on maintenance, safety and depreciation as these are long-term costs that cannot be done away with.  In addition, regular maintenance of rail infrastructure will be necessary for freight operations.  

Revenue Surplus and Operating Ratio could further worsen

Railways’ surplus is calculated as the difference between its total internal revenue and its revenue expenditure (this includes working expenses and appropriation to pension and depreciation funds).  Operating Ratio is the ratio of the working expenditure (expenses arising from day-to-day operations of Railways) to the revenue earned from traffic.  Therefore, a higher ratio indicates a poorer ability to generate a surplus that can be used for capital investments such as laying new lines, or deploying more coaches.  A decline in revenue surplus affects Railways’ ability to invest in its infrastructure.  

In the last decade, Railways has struggled to generate a higher surplus.  Consequently, the Operating Ratio has consistently been higher than 90% (see Figure 2).  In 2018-19, the ratio worsened to 97.3% as compared to the estimated ratio of 92.8%.   The CAG (2019) had noted that if advances for 2018-19 were not included in receipts, the operating ratio for 2017-18 would have been 102.66%.

In 2020-21, Railways expects to generate a surplus of Rs 6,500 crore, and maintain the operating ratio at 96.2%.   With revenue generation getting affected due to the lockdown, this surplus may further decline, and the operating ratio may further worsen.  

Figure 2: Operating Ratio 

image

Note: RE – Revised Estimates, BE – Budget Estimates.
Sources:  Expenditure Profile, Union Budget 2020-21; PRS.  

Other sources of revenue

Besides its own internal resources, Railways has two other primary sources of financing: (i) budgetary support from the central government, and (ii) extra-budgetary resources (primarily borrowings but also includes institutional financing, public-private partnerships, and foreign direct investment).  

Budgetary support from central government:  The central government supports Railways to expand its network and invest in capital expenditure.  In 2020-21, the gross budgetary support from the central government is proposed at Rs 70,250 crore.  This is 3% higher than the revised estimates of 2019-20 (Rs 68,105 crore).  Note that with government revenue also getting affected due to the COVID pandemic, this amount may also change during the course of the year. 

Borrowings:  Railways mostly borrows funds through the Indian Railways Finance Corporation (IRFC).  IRFC borrows funds from the market (through taxable and tax-free bond issuances, term loans from banks and financial institutions), and then follows a leasing model to finance the rolling stock assets and project assets of Indian Railways.

In the past few years, Railways’ borrowings have increased sharply to bridge the gap between the available resources and expenditure.  Earlier, majority of the Railways’ capital expenditure used to be met from the budgetary support from central government.  In 2015-16, this trend changed with the majority of Railways’ capital expenditure being met through extra budgetary resources (EBR).   In 2020-21, Rs 83,292 crore is estimated to be raised through EBR, which is marginally higher than the revised estimates of 2019-20 (Rs 83,247 crore).  

Note that both these sources are primarily used to fund Railways’ capital expenditure.  Some part of the support from central government is used to reimburse Railways for the operating losses made on strategic lines, and for the operational cost of e-ticketing to IRCTC (Rs 2,216 crore as per budget estimates of 2020-21).  

If Railways’ revenue receipts decline this year, it may require additional support from the central government to finance its revenue expenditure, or finance it through its borrowings.  However, an increased reliance on borrowings could further exacerbate the financial situation of Railways.  In the last few years, there has been a decline in the growth of both rail-based freight and passenger traffic (see Figure 3) and this has affected Railways’ earnings from its core business.  A decline in growth of revenue will affect the transporter’s ability to pay off its debt in the future. 

Figure 3: Volume growth for freight and passenger (year-on-year)

 

Note: RE – Revised Estimates; BE – Budget Estimates. 
Sources:  Expenditure Profile, Union Budget 2020-21; PRS.  

Social service by Railways

Besides running freight trains, Railways has also been carrying out several other functions, to help deal with the pandemic.  For example, Railways’ manufacturing capacity is being harnessed to help deal with COVID-19.  Production facilities available with Railways are being used to manufacture items like PPE gear.  Railways has also been exploring how to use its existing manufacturing facilities to produce simple beds, medical trolleys, and ventilators.  Railways has also started providing bulk cooked food to needy people at places where IRCTC base kitchens are located.   The transporter also opened up its hospitals for COVID patients.  

As on April 6, 2,500 rail coaches had been converted as isolation coaches.  On average, 375 coaches are being converted in a day, across 133 locations in the country. 

Considering that railways functions as a commercial department under the central government, the question is whether Railways should bear these social costs.  The NITI Aayog (2016) had noted that there is a lack of clarity on the social and commercial objectives of Railways.  It may be argued that such services could be considered as a public good during a pandemic.  However, the question is who should bear the financial burden of providing such services?  Should it be Indian Railways, or should the central or state government provide this amount through an explicit subsidy?  

For details on the number of daily COVID cases in the country and across states, please see here.  For details on the major COVID related notifications released by the centre and the states, please see here.  For a detailed analysis of the Railways’ functioning and finances, please see here, and to understand this year’s Railways budget numbers, see here.