KARACHI, March 12: The health department is poised to become the most troubled unit of the City District Government Karachi because of the centralization of financial and administrative powers, which have been taken away from medical officers and superintendents of hospitals, resulting in indiscipline and shortage of medicines in the healthcare institutions of the defunct KMC.

A majority of the hospitals and smaller units belonged to the defunct KMC, while the rest had been devolved from the provincial government.

The largest of these institutions is the Abbasi Shaheed Hospital, followed by the Sobhraj Maternity Hospital, Spencer Eye Hospital, the Leprosy Hospital, the SRS employees’ clinic, etc., with a total strength of 1,537 beds.

However, the devolution system has centralized all powers of the health department officers, especially medical superintendents, as a result no tender for medicines purchase has been finalized even after the passage of eight months of the current fiscal year.

The allocation for medicines in these hospitals was more than Rs715 million during the financial year 2002-2003, but not even 15 per cent of the amount has been utilized for procurement of emergency medicines on a quotation basis.

Protesters during a recent strike at the Abbasi Shaheed Hospital said that shortage of medicines even in the emergency ward of the hospital was the main cause of their protest as patients and their attendants reportedly harassed doctors and other staff due to non-availability of medicines.

Similarly, among all hospitals, only the x-ray clinic of the Sobhraj Maternity Hospital remains functional but its lab like that of the ASH, the SRS and other institutions, has been inoperative due to lack of required chemicals.

During the previous system, medical superintendents of major hospitals had financial powers to release up to an amount of Rs50,000 and for small hospitals the limit was up to Rs30,000 for purchase through quotations in case of an emergency for a limit of 20 per cent of the total budget.

But after the devolution of power, the MS of a hospital does not have any administrative or financial power, and for emergency purchase all files are forwarded to the EDO (health), whose financial power is Rs20,000 for a single quotation.

However, it takes about twenty days to get the approval of the EDO as the MS of a hospital after preparing a file of purchase forward it to DO (admin-II) who sends it to the EDO and then it returns to the hospital, after which the supplier is called to deliver the medicines.

Though, the DO is the administrative in-charge of all medical units belonging to the defunct KMC, and this post is equivalent to director medical services in the former setup, the present role of the DO is a little more than that of a postman — only forwarding files to EDO and back.

The tender procedure is even more complicated as a result no approval has been finalized so far despite the fact that hospitals had initiated the process in August, September and October.

During a recent briefing to DCO Karachi, the DO, Dr Humayun Farrukh, said that the department was involved in the purchases of ten different types of items.

He added that according to the new formula, hospitals moved requests and obtained permissions for inviting tenders. The move is forwarded to the EDO (health) through DO (admin-II), which is then released to the media management department for release to the press.

The tenders are opened by a committee and then forwarded to the concerned hospitals for comparative statement.

A committee formed by City Nazim scrutinizes them and their recommendations are forwarded to the EDO (health) through the DO; the EDO (health) forwards the file to EDO (finance and planning) for formalities and financial consideration.

The files return to concerned hospital through the EDO (health) and the DO (admin-II) followed by its resubmission with sanction note for approval from the DCO through the DO and the EDO (health).

Whether it gets approval or any query is raised the file returns through the same channel and if it is approved, the hospital will inform the successful tenderer about acceptance of their tender and deposit 10 per cent of the total amount as security fee.—PPI