PESHAWAR: Majority of the doctors were running private clinics despite getting non-practicing allowance from the government, officials said.

“The government gives non-practicing allowance to the doctors to ensure their availability to the patients in their respective wards at the hospitals in evening and night shifts. However, the financial incentive has not kept the doctors away from private medical practice,” they said.

Officials said that about 6,000 doctors, who worked in government-run healthcare facilities, drew non-practicing allowance (NPA) but despite that attended their private practice in the evening at the cost of patients at their respective hospitals.

“Neither the government has developed a mechanism to monitor the doctors and take action, nor the doctors are willing to fulfil their ethical responsibility of not doing private practice in line with the undertaking, they sign to get NPA,” they said.

Officials say there is no mechanism to monitor medics

Sources said that doctors signed affidavit that they would not do private clinic and would remain available to the patients at their respective hospitals round-the-cloak but in absence of action they violated the laid down rules outlined in the NPA.

The government is paying hefty amount under the head of NPA to doctors.

Presently, the health department pays Rs20,000 to doctors in BPS-17; Rs25,000 to BPS-18; Rs30,000 to BPS-19 and Rs35,000 to doctors in BPS-20 per month. They are required to remain available to the patients.

Officials said that professors in basic medical science departments of the medical colleges also ran private clinics. The imitative, meant to improve primary, secondary and tertiary care facilities, didn’t work and was described as the most abused facility in the department, they added.

As a rule, the government can approach Pakistan Medical and Dental Council (PMDC) to proceed against the violators by stating that their registration may be cancelled for resorting to unethical practice.

“No action has ever been taken against anyone owing to which benefits of the incentive haven’t trickled down to the patients,” officials said.

Even the teaching hospitals remained without senior doctors in evening and night shifts and the patients were seen by junior doctors, they added.

About 35 per cent of doctors in the province are based in Peshawar and they run private clinics either in the city or in rural areas.

“The management cadre doctors who hold administrative posts like director, assistant director, district health officer, medical superintendent, deputy medical superintendent and resident medical officers in hospitals also have private clinics and hospitals,” officials said.

The government began awarding NPA to doctors in early 90s to improve healthcare deliveries in evening and night shifts in the health facilities. It was also aimed at providing additional financial support to the junior doctors, who could take up jobs in the rural areas. Later, the incentive was availed by doctors working anywhere in the province.

The hospitals’ senior registrars, who used to be non-practicing and non-teaching staff until 2002, also drew NPA when they were awarded teaching status.

“Majority of the senior registrars of Lady Reading Hospital, Khyber Teaching Hospital and Hayatabad Medical Complex are awarded NPA. They are supposed to take round of the wards in afternoon,” officials said.

However, the programme proved a wastage of resources as the desired objective could not be achieved, they added.

Health Secretary Dr Aftab Akbar Durrani told Dawn that the government was establishing independent monitoring unit to check irregularities.

The government planned to ensure effective health delivery through a proper mechanism under which measures were devised to ensure transparency in health department, he said.

Published in Dawn, June 16th, 2014