PESHAWAR: The Khyber Pakhtunkhwa government is adamant to implement the Medical Teaching Institutions (MTI) Reforms Act despite the health department’s recommendations a few months ago that it cannot be put into practice until removal of basic flaws in it, according to documents.

Former secretary health Mushtaq Jadoon had written two letters to the government in April and Oct and raised objection over the unfettered administrative powers invested in the board of governors (BoGs) in the MTIs, saying that it would result in court cases in future.

The law leaves a little scope for elaboration and legal coverage through the rules because the BoG wields immense regulatory powers.

The finance and establishment departments facilitate the enforcement of law, which cannot be done through regulations by BoG of the Lady Reading Hospital (LRH), he said. A BoG, meant for internal management of an MTI, cannot prescribe Standard Operating Procedures for the health, finance and establishment departments as regards the LRH, Mr Jadoon had pointed out in the letters.

Former secretary had raised objection to the unfettered administrative powers of BOGs

Prior to the MTI Act 2015 all the four teaching hospitals were managed by the chief executives (CEs), who were looking after the clinical and management functions with the assistance of medical superintendents and deputy medical superintendents who were assisted by management committees with people from the health and establishment departments.

He had raised the point that the appointment of directors wouldn’t work and there should be a chief executive at the top instead of medical director for clinical functions, hospital director for administrative and financial functions and nursing director, all answerable to the BoG, which wouldn’t deliver because the hospitals work round the clock while BoGs meet every three months.

Representatives of the health, finance and establishment departments have attended BOG meetings held from May to July and there has been no complaint against their representation in the BOG as non-voting members.

So far each of the four BoGs set up at the LRH, KTH, KMC, Peshawar, and ATH, Abbottabad, has 10-members – three government secretaries and seven private members.

Mr Jadoon stated that another amendment was being sought to exclude the government’s representatives from the BoG. The administration under CE will be able to take prompt decisions. BoG, a management policy body comprising unpaid people, isn’t a fulltime entity, he said.

The law has been facing 11 lawsuits and more are expected in future over the appointments of deans, head of departments etc, he Govt adamant to implement MTI law despite flaws stated. Within five months, 13 amendments have been incorporated and more are in pipeline on the recommendation of the BoG.

Mr Jadoon, who was transferred on Nov 4 apparently for his failure to implement the law, on his part had taken prompt steps to pave the way for enforcement of the PTI’s pet project. He had proposed that public sector should oversee the management of the respective institutions instead of the BoG.

Sources in the health department said that doctors had accepted the BoGs as fait accompli because the paramedics had been given service structure and promotion coupled with incentives to nurses and TMOs, while the specialists stood effectively isolated. However, after the removal of Mr Jadoon the government is again carrying out amendments as a result of pressure by doctors.

According to the documents, the regulation drafted by LRH BoG was largely inconsistent with the Act and Rules which drew strong reaction from the stakeholders.

The secretary had also termed advertisement for the posts of medical and hospital director a violation of the MTI Act due to which the whole exercise had been facing litigations. He stated that Rs742.709 million had been transferred to the four MTIs and the health department established works directorate to ensure quality work and timely completion of the projects.

The former secretary, however, had vowed to enforce the reforms, saying buckling under pressure from doctors to step back on the law would defeat the government’s objectives. The secretary had also opposed raise in user charges at the MTI-covered hospitals.

Published in Dawn, November 30th, 2015