ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Trends and Consequences for Health and Education

Political Economy of Brihanmumbai Municipal Corporation Budgets

The paper focuses on the changing trends in budget allocations of the Brihanmumbai Municipal Corporation, especially since the structural adjustment programme that came to be implemented from 1990 and how it has affected civic services, especially health and education. The paper concludes that it has increasingly directed public resources to the private sector and reduced access adversely access to both healthcare and school education for Mumbaikars.

 

Mumbai has a population estimated at 16 million,1 inc­luding the floating population, with the net population of the Municipal Corporation of Greater Mumbai (MCGM, also known as Brihanmumbai Municipal Corporation [BMC]) area being estimated at 12.8 million. Mumbai’s civic services are one of the best in the country, but over the last two decades they are witnessing a declining trend due to lowered budgetary commitments on the one hand, and privatisation on the other, which has affected access, especially for the bottom half of the city’s population. Roads are not maintained well, the drainage system is choked, water and sanitation facilities are found wanting, solid waste management is in shambles, public health facilities are crumbling with mounting vacant positions, lack of supplies, and poor maintenance, and schools are closing down and enrolments dropping. For instance, Mumbai has a bed to population ratio of less than 200 and a doctor to population ratio of less than 150, but their proportion in the public sector is now about one-third of beds, down from about two-thirds two decades ago, indicative of the rapid private sector expansion. Besides this, Mumbai has one public dispensary per 62,000 population and one health post (equivalent of the primary health centre or PHC) per 70,000 population when the requirement as per the Nati­onal Urban Health Mission (NUHM) is one dispensary per 15,000 population and one health post per 50,000. In the last 10 years, 229 MCGM schools have closed down with enrolment dropping from 4,04,251 in 2013–14 to 3,11,663 in 2017–18 and a shift in enrolment towards private schools (Praja 2019).

Mumbai is also one of the finance capitals of the world. It aspires to become a global city but given its stunting of physical and social infrastructure this hope has perhaps moved further away. While plans for physical infrastructure are well ­under way, and with large-scale private sector involvement, those for social infrastructure like health and education have not even reached the drawing board. That apart, Mumbai does have the best health infrastructure in India, both in the public and private sectors. Until the start of the 1990s, which began with neo-liberal economic reforms, the public health sector was quite robust and there was also a reasonably well-functioning not-for-profit private sector hospitals which was also accessible to those with limited resources. For ambulatory or outpatient care, private general practitioners and consultants have always been predominant and this trajectory continues to strengthen with public primary healthcare services being marginalised. This public–private combination had succeeded in giving Mumbai the kind of edge it enjoyed in terms of health status and healthcare. Similarly, municipal schools were one of the best and had standards even better than the Kendriya Vidyalayas.

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Updated On : 7th Aug, 2021
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