PESHAWAR: The hasty enforcement of the Medical Teaching Institutions Reforms Act has adversely affected the patient care at district level hospitals.

The relevant officials told Dawn that the extension of the MTI law to three districts had been causing financial and administrative problems and that there had been no check on the local hospitals after the new law was put in place.

They said a policy matter, the government initially decided in a reforms workshop under the chief minister in August 2013 that the MTI Act would gradually be enforced in Peshawar’s Khyber Teaching Hospital, Lady Reading Hospital and Hayatabad Medical Complex, and Abbottabad’s Ayub Teaching Hospital in two to three years as these hospitals enjoyed autonomy.

The officials said the government also declared that the law would be extended to district hospitals after getting feedback from the four hospitals.


Officials insist extension of law to three districts caused financial, administrative issues


They however said the law was extended to the three district hospitals without waiting for the outcome of Peshawar and Abbottabad hospitals.

The officials said the first-ever performance audit of the Mardan Medical Complex, and Dera Ismail Khan and Bannu hospitals, where the Khyber Pakhtunkhwa enacted the new law a year ago, showed the declining standards of patient care, financial and human resource management.

They said a patient admitted at the MMC with cardiac problem remained unattended for two days with no recording of his blood pressure, history, temperature etc. with the ward having 25 doctors.

The officials said three dentists were appointed to one sanctioned post of the MMC and that the principal of the affiliated Bacha Khan Medical College acted as the college’s principal accounting officer against the MTI’s law, which laid that powers with the hospital director.

They said the audit also pointed out that a woman with hand fracture was found to be awaiting surgery for three days.

The officials said HD ran private clinic in the evening in violation of the MTI law according to which the post was non-practicing and that it was a case of conflict of interests.

They said the health department had lost administrative control of those hospitals and acted only to plead funding cases with the finance department on their behalf adversely affecting patient care.

The officials said it been agreed in a roadmap workshop that the MTI law would be spread to district facilities only when its enforcement at four hospitals showed results but in Madan, Bannu and Dera Ismail Khan, the situation wasn’t up to the desired level.

They said the MTI-covered hospitals were run by the respective governing bodies through medical director, HD and others.

The officials said the MTI didn’t come under the health department and there was no official member at the board of governors.

They said the performance audit being carried out by the Health Care Commission through the Aga Khan Foundation and Provincial Health Services Academy was aimed at recording quality of services provided there and take measures for addressing issues.

The officials said the administrative, financial and clinical irregularities had been found necessitating corrective measures.

They said the auditors weren’t satisfied with the way the MTIs operated in districts though the KTH, LRH, HMC Peshawar and ATH Abbottabad had performed better under the MTI law.

MMC medical director Dr Amir Khan didn’t respond to this correspondent’s repeated calls and text messages.

Published in Dawn, April 2nd, 2017

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