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 The Standing Committee recommended that this Bill be withdrawn and a revised Bill be introduced in Parliament after consulting stakeholders.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
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
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 the past few months, retail prices of petrol and diesel have consistently increased and have reached all-time high levels. On September 24, 2018, the retail price of petrol in Delhi was Rs 82.72/litre, and that of diesel was Rs 74.02/litre. In Mumbai, these prices were even higher at Rs 90.08/litre and Rs 78.58/litre, respectively.
The difference in retail prices in the two cities is because of the different tax rates levied by the respective state governments on the same products. This blog post explains the major tax components in the price structure of petrol and diesel and how tax rates vary across states. It also analyses the shift in the taxation of these products, its effect on retail prices, and the consequent revenue generated by the central and state governments.
What are the components of the price structure of petrol and diesel?
Retail prices of petrol and diesel in India are revised by oil companies on a daily basis, according to changes in the price of global crude oil. However, the price paid by oil companies makes up 51% of the retail price in case of petrol, and 61% in the case of diesel (Table 1). The break-up of retail prices of petrol and diesel in Delhi, as on September 24, 2018, shows that over 45% of the retail price of petrol comprises central and states taxes. In the case of diesel, this is close to 36%.
At present, the central government has the power to tax the production of petroleum products, while states have the power to tax their sale. The central government levies an excise duty of Rs 19.5/litre on petrol and Rs 15.3/litre on diesel. These make up 24% and 21% of the retail prices of petrol and diesel, respectively.
While excise duty rates are uniform across the country, states levy sales tax/value added tax (VAT), the rates of which differ across states. The figure below shows the different tax rates levied by states on petrol and diesel, which results in their varying retail prices across the country. For instance, the tax rates levied by states on petrol ranges from 17% in Goa to 39% in Maharashtra.
Note that unlike excise duty, sales tax is an ad valorem tax, i.e., it does not have a fixed value, and is charged as a percentage of the price of the product. This implies that while the excise duty component of the price structure is fixed, the sales tax component is charged as a proportion of the price paid by oil companies, which in turn depends on the global crude oil price. With the recent increase in the global prices, and subsequently the retail prices, some states such as Rajasthan, Andhra Pradesh, West Bengal, and Karnataka have announced tax rate cuts.
How have retail prices in India changed vis-à-vis the global crude oil price?
India’s dependence on imports for consumption of petroleum products has increased over the years. For instance, in 1998-99, net imports were 69% of the total consumption, which increased to 93% in 2017-18. Because of a large share of imports in the domestic consumption, any change in the global price of crude oil has a significant impact on the domestic prices of petroleum products. The following figures show the trend in price of global crude oil and retail price of petrol and diesel in India, over the last six years.
The global price of crude oil (Indian basket) decreased from USD 112/barrel in September 2012 to USD 28/barrel in January 2016. Though the global price dropped by 75% during this period, retail prices of petrol and diesel in India decreased only by 13% and 5%, respectively. This disparity in decrease of global and Indian retail prices was because of increase in taxes levied on petrol and diesel, which nullified the benefit of the sharp decline in the global price. Between October 2014and June 2016, the excise duty on petrol increased from Rs 11.02/litre to Rs 21.48/litre. In the same period, the excise duty on diesel increased from Rs 5.11/litre to Rs 17.33/litre.
Over the years, the central government has used taxes to prevent sharp fluctuations in the retail price of diesel and petrol. For instance, in the past, when global crude oil price has increased, duties have been cut. Since January 2016, the global crude oil price has increased by 158% from USD 28/barrel to USD 73/barrel in August 2018. However, during this period, excise duty has been reduced only once by Rs 2/litre in October 2017. While the central government has not signalled any excise duty cut so far, it remains to be seen if any rate cut will happen in case the global crude oil price rises further. With US economic sanctions on Iran coming into effect on November 4, 2018, India may face a shortfall in supply since Iran is India’s third largest oil supplier. Moreover, Organization of Petroleum Exporting Countries (OPEC) and Russia have not indicated any increase in supply from their side yet to offset the possible effect of sanctions. As a result, in a scenario with no tax rate cut, this could increase the retail prices of petrol and diesel even further.
How has the revenue generated from taxing petroleum products changed over the years?
As a result of successive increases in excise duty between November 2014 and January 2016, the year-on-year growth rate of excise duty collections increased from 27% in 2014-15 to 80% in 2015-16. In comparison, the growth rate of sales tax collections was 6% in 2014-15 and 4% in 2015-16. The figure below shows the tax collections from the levy of excise duty and sales tax on petroleum products. From 2011-12 to 2017-18, excise duty and sales tax collections grew annually at a rate of 22% and 11%, respectively.
How is this revenue shared between centre and states?
Though central taxes are levied by the centre, it gets only 58% of the revenue from the levy of these taxes. The rest 42% is devolved to the states as per the recommendations of the 14th Finance Commission. However, excise duty levied on petrol and diesel consists of two broad components – (i) excise duty component, and (ii) road and infrastructure cess. Of this, only the revenue generated from the excise duty component is devolved to states. Revenue generated by the centre from any cess is not devolved to states.
The cess component was increased by Rs 2/litre to Rs 8/litre in the Union Budget 2018-19. However, this was done by reducing the excise duty component by the same amount, so as to keep the overall rate the same. Essentially this provision shifted the revenue of Rs 2/litre of petrol and diesel from states’ divisible pool of taxes to the cess revenue, which is entirely with the centre. This cess revenue is earmarked for financing infrastructure projects.
At present, of the Rs 19.5/litre excise duty levied on petrol, Rs 11.5/litre is the duty component, and Rs 8/litre is the cess component. Therefore, accounting for 42% share of states in the duty component, centre effectively gets a revenue of Rs 14.7/litre, while states get Rs 4.8/litre. Similarly, excise duty of Rs 15.3/litre levied on diesel consists of a cess component of Rs 8/litre. Thus, excise duty on diesel effectively generates revenue of Rs 12.2/litre for the centre and Rs 3.1/litre for states.