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Jan Swasthya Abhiyan India says the Centre collected ₹96,627 crore as health cess between 2018-19 and 2024-25.
The group says only Rs 46,554 crore was transferred to public accounts, leaving Rs 50,072 crore, or about 52%, outside the designated fund.
The CAG report says Rs 6,646 crore of the health cess collected in 2024-25 was not transferred to the Pradhan Mantri Swasthya Suraksha Nidhi.
JSAI has demanded that Finance Minister Nirmala Sitharaman explain why separate accounting heads were not created until March 2021 despite repeated CAG objections.
The group says the money could have helped build hospitals, upgrade health centres and recruit health workers in rural, tribal and underserved areas.
A recently released audit report on the Central Government’s financial accounts for 2024-25 by the Comptroller and Auditor General of India (CAG) has once again raised serious questions about the functioning of the Union Ministry of Health and Family Welfare.
Jan Swasthya Abhiyan India (JSAI), said that between 2018-19 and 2024-25, the central government collected a total of Rs 96,627 crore as health cess, but only Rs 46,554 crore was transferred to public accounts.
This means a total of Rs 50,072 crore, or approximately 52 per cent of the amount, was not transferred to the designated fund, the organisation said.
Out of Rs 21,085 crore collected from the health cess during 2024-25, only Rs 14,439 crore was transferred to the Pradhan Mantri Swasthya Suraksha Nidhi, while Rs 6,646 crore was not transferred, according to the CAG report.
JSAI has demanded that Union Finance Minister Nirmala Sitharaman explain in Parliament why, despite the implementation of the health and education cess, separate accounting heads were not created in public accounts until March 2021. It has also asked why constitutional provisions were not followed despite repeated objections from the CAG.
The CAG report states that the Union Ministry of Finance is not depositing the full amount of the health cess into the designated reserve fund. When asked for a response, the Union Ministry of Health said the Union Ministry of Finance was responsible for collecting the cess and transferring the funds to the relevant funds.
However, the CAG clarified that no satisfactory response had been received regarding the “short transfers”. JSAI has argued that when designated funds are merged into the Consolidated Fund, it becomes difficult to determine whether those funds are actually being used for their stated purpose. The organisation said transparency was an essential feature of public financial accountability.
The question, it said, is whether the funds collected through the health cess are being fully used to strengthen the public health system.
It should also be noted that while the government is collecting funds through a health cess, the Union Ministry of Health and Family Welfare is not adequately utilising the approved budget for human resources, medical education and health.
According to the CAG report, thousands of crores of rupees have remained unspent in the last three years under schemes such as health, human resources, medical education and the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission.
JSAI said the withheld Rs 50,072 crore could have fundamentally transformed India’s public health system.
The organisation said the amount could have helped establish more than 100 district hospitals and 100 government medical colleges across the country. It said the money could also have been used to upgrade primary health centres and community health centres to Indian public health standards.
Furthermore, JSAI said, the funds could have been used to recruit and pay millions of doctors and other health workers in rural, tribal and other neglected areas, where large numbers of vacancies continue to weaken health services.
The concerns raised by the CAG report and JSAI have therefore brought back into focus a larger question: whether money collected in the name of public health is being transferred, tracked and used in a way that strengthens India’s healthcare system.
