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Even as the Union Health Ministry is at loggerheads with its own expert committee on how much to allocate for tribal health, its own data show that an estimated 10.4 crore tribal population has been given a raw deal by both Central and State governments.
Ministry statistics accessed by BusinessLine show that the actual expenditure in 2017-18 on Scheduled Tribes (STs) as a part of public health schemes was ₹2,971.41 crore.
The Ministry argues that this complies with the 2013 guidelines of the then Planning Commission that 8.6 per cent of the total health budget allocation (which was ₹27,210 crore for 2017-18) should be spent on tribal health. But the expert committee appointed by the Ministry to study tribal health has pointed out aberrations in the way allocations are being made at the State and Central levels.
In its report to the Ministry, the committee recommended that the Centre allocate an additional ₹2,862 crorefor tribal health.
“The Planning Commission guidelines clearly state that the Tribal Sub Plan (TSP) money is an additionality. Here, it’s important to note the principle of additionality. It means that the regular activities and expenditure in the tribal areas by Ministry of Health and Family Welfare are not part of the stipulated 8.6 per cent,” noted the expert committee report.
While the Central government and the expert committee remain at loggerheads, the States are more delinquent: they are allocating little or no funds from their share for tribal health.
“Only Andhra Pradesh, Himachal Pradesh, Gujarat, Odisha, Rajasthan, Tamil Nadu and West Bengal had allocated money to TSP, and none of them followed the guideline of earmarking funds in proportion to the percentage of ST population in the State,” Abhay Bang, Chairman of the expert committee, told BusinessLine.
Collective failure
The expert committee has concluded that there has been a collective failure on the part of the Centre and the States to allocate enough funds for tribal health.
“The provision has not been effective in improving the status of the tribal population because it has been reduced to an exercise in notional allocation at the time of the budget presentation and subsequent re-appropriation to ensure timely utilisation,” the report states. According to the report, the ideal combined allocation of the Centre and the States should have been ₹15,676 crore, which is 8.6 per cent of ₹1,60,112 crore (the total health budget of the Centre and the States).
“States should have earmarked ₹12,814 crore, which is an additional 8.6 per cent of ₹1,26,830 crore, and the Centre should have earmarked ₹2,862 crore, an additional 8.6 per cent of ₹33,282 crore according to Budget Estimates of 2015-16 as analysed for the report - and likewise for subsequent years. Tribal communities have been given a raw deal,” said Bang.
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