PESHAWAR / ISLAMABAD: The federal government has asked Khyber Pakhtunkhwa to absorb the health card beneficiaries from the merged districts of erstwhile Federally Administered Tribal Areas (Fata) into the province’s Sehat Card Plus programme, as the Centre is going to discontinue funding for the tribal region’s health insurance scheme by June 30.

The KP government has sharply reacted to the move, which comes after the Centre’s decision to freeze the merged districts’ budget for next year at the current fiscal levels.

On June 8, the Ministry of National Health Services, Regulation and Coordination had written to the KP health department that phase-II of the health insurance programme for the merged districts (except Khyber and Bajaur) was going to be completed by June 30, 2023. Therefore, it was requested to take immediate actions to execute the approval of the prime minister regarding harmonization of the health card packages to the arrangement dating back to February.

“The funding-related issues should be dealt with by the departments concerned of the KP government. The health ministry will fully support this effort,” the letter stated.

Province asks Islamabad to transfer necessary funds

In its response, the KP health department noted that the provincial government reaffirmed its interest to absorb the residents of the merged districts into the Sehat Card Plus programme and its “capacity to service and expand the funds” necessary for the endeavour. However, this interest was contingent on the transfer of the amount by the federal finance division allocated for this purpose in the Public Sector Development Programme (PSDP).

The letter said all implementation-level arrangements had been finalised, including the data of the families ready to be absorbed into the KP Sehat Card Plus programme.

The health department also pointed out that the people of the merged districts did not factor into KP’s share under the National Finance Commission (NFC) Award, hence it was imperative that the federal government shift its Sehat Sahulat programme for ex-Fata to the province along with the corresponding financial resources. “In the event that these steps are not taken, the lack of Sehat Card Plus availability in the merged districts will not be the responsibility of the KP government,” it categorically said.

KP Health Minister Taimur Saleem Jhagra told Dawn that it was unacceptable that the federal government wanted the province to take over the ex-Fata health insurance programme and also deal with the “funding-related issues”. He maintained that the facility for the merged districts was already reflected in the federal PSDP and it had been proposed to simply transfer that funding to KP at zero additional cost to the Centre. “The federal government wants to deprive the people of ex-Fata of health coverage to save Rs5 billion,” he claimed.

Earlier in October 2021, the KP health department had taken up with Centre the issue of harmonisation of the health insurance scheme for former Fata with that of the province, as the PSDP allocation for the merged districts did not include the same coverage as it did for other KP residents. The province had proposed transfer of the amount allocated for the purpose in the PSDP to the provincial government on a monthly basis until permanent arrangements were made -- through the NFC or other means. The then Pakistan Tehreek-i-Insaf-led federal government had approved the proposal.

However, a source in the federal government disputed the KP government’s claim, saying former prime minister Imran Khan had only approved transfer of the programme to KP, and there was no mention of the funds in the summary. He said former finance minister Shaukat Tarin had only verbally agreed with the KP government, and the Economic Coordination Committee (ECC) had not approved the proposal.

“There is nothing on paper to support the KP government’s claims,” he stressed.

Documents available with Dawn show that the then premier Imran Khan had on Feb 21 approved a summary to shift the federal Sehat Sahulat Programme beneficiary families belonging to the merged districts to KP along with the related project management unit staff, assets and liabilities. Besides, he had also approved revision of the PC-I of the programme.

Former minister Tarin told Dawn that his ministry and that of planning and development had formally agreed to take the issue to the ECC to regularise the programme in the budget, which was a procedural requirement. However, before they could do anything their government was shown the door.

Meanwhile, the national health ministry, in a written statement, claimed that shifting of the health scheme of the newly merged tribal districts to the KP government had been approved by former prime minister Imran Khan on Feb 21 upon the province’s request and, thereafter, it was the responsibility of KP. The federal government will act upon the approval for onward continuity of services to beneficiary families, it added.

“During the last six to seven years the federal government was funding and managing the programme for former Fata districts, and upon their merger with KP, it is now for the provincial government to manage and ensure package benefits to all KP residents,” it stated.

Also, a representative of the State Life Insurance Corporation, Anas Khurshid, told Dawn that so far there was no direction to stop treatment of patients belonging to the erstwhile Fata.

“All the patients, who belong to erstwhile Fata, can get treatment from the empanelled hospitals across the country,” he maintained.

On the other hand, federal Finance Minister Miftah Ismail told Dawn: “The PTI government had decided to shift the programme to the province from July 1. There is nothing on record to support KP’s claim. Any accusation against the current federal government is contrary to the facts.”

Published in Dawn, June 19th, 2022