New Delhi: Uttar Pradesh's massive budget outgo on salaries, pensions and debt servicing, which comes to around 54% of budget spending, makes it very difficult for the state government to find resources to spend on health, or anything else for that matter.

After the tragic death of 60 infants in a government hospital in Gorakhpur, News18 looked at budget allocations of India's largest state to fathom why health expenditure was not getting the priority it deserves. The Baba Raghav Das Medical College Hospital in Gorakhpur owed Rs 60 lakh to the company that supplied it bottled oxygen, the Indian Express reported. Seven reminders in the past 6 months to pay up went unheeded.

The first thing that catches the eye upon a breakdown of the numbers is that massive expenditure on the salaries and pensions of government employees and servicing debt. The Yogi Adityanath government presented a budget worth Rs 3.84 lakh crore for the fiscal year 2017-18 out of which around Rs 2.07 lakh crore, or 54% is spent on the above mentioned heads, according to a PRS Legislative Research analysis. In budgeting terms, these are considered to be essential, but unproductive expenditure since they do not create new social or economic assets.

This means that Uttar Pradesh has only 46% of its stated budget to spend on everything else, including health. Remember, this is India's largest state with more than 200 million people. If it were a separate country, UP would be the fifth most populous in the world.

To be fair, the Yogi government increased the health budget by 9% from a year ago. However, Akhilesh Yadav had slashed the health budget by a similar amount in his last year, so the increase this year merely brought it back to parity. This amounts to 1.2% of the state GDP, which is less than the national average.

However, the big ticket item for UP this year is the farm loan waiver package. Yogi Adityanath allocated a whopping Rs 36,000 crore, the highest in the country. In fact, the Agriculture department budget saw an increase of 813% over last year on account of the package.

Interestingly, Rs 3,255 crore, or half a billion dollars, was allocated for construction of toilets under the Swachh Bharat Abhiyan (rural). The Chief Minister in a speech yesterday exhorted people to maintain public hygiene and said that diseases like encephalitis were caused due to open defecation. The government also set a goal of making the state open defecation free by October 2018. So the question arises: What happened to the money allocated to build toilets?

Budgeting is the art of choosing to allocate finite resources to unlimited wants. Medical and Public Health was allocated Rs 17,181 crore. However, the highlight of the health budget seems to be augmenting the 108 emergency service with 712 more ambulances.