PESHAWAR: The government has outsourced health facilities in Federally Administered Tribal Areas to NGOs under the public-private partnership programme to provide specialised healthcare to patients despite nonexistence of any such law there, according to sources.

They said that three hospitals — one each in South Waziristan Agency (SWA), Orakzai Agency (OA) and Khyber Agency — had already started operations under the public-private partnership while seven more were being outsourced to NGOs.

Officials said that there was neither any example of such arrangements in Fata nor any procedure existed but Khyber Pakhtunkhwa governor approved it for the sake of patients’ care.

They said that Fata directorate of health was finding it hard to ensure presence of staff, particularly specialist doctors and female staff, at the hospitals to provide healthcare to tribal people.

Employees of hospitals haunted by uncertainty

The former chief of army staff had visited South Waziristan Agency in 2015 and directed to make operational Sholam Hospital. The hospital has been built with the financial assistance of the UAE. The Fata secretariat decided to make it functional through public-private partnership as it was not possible to run it in the existing system where specialists were unwilling to be posed due to unattractive salaries and law and order situation. An NGO ‘Search’ manages it.

Officials said that despite spending Rs80 million to Rs90 million annually there, the outcome wasn’t up to the mark. One firm out of the three, who took part in the bidding process for the hospital, was awarded contract of the hospital for one year, subject to renewal on basis of performance.

Officials said that they were dissatisfied unsatisfied with the performance of 979 health facilities, which had the services of 8,796 employees. Of the 108 posts of specialists, 84 are vacant. Fifty posts of women medical officers and about 200 of lady health workers and nurses are also unfilled.

The NGO will manage the affairs of the hospital and regular staff will play second fiddle to its management.

Fata secretariat will give Rs190 million annual grant to the NGO in addition to regular budget. The NGO will be responsible for putting in place specialised health services and would take care of maintenance of the hospital too.

Two committees, one each at local level and Fata secretariat, have been formed to hold monthly meetings and listen to the complaints of patients and take action accordingly. The committees would also monitor the performance of NGO through a set of performance indicators.

In July 2017, Type-C hospital in Meshti Mela, Oroakzai Agency was also handed over to NGO ‘Merf’ that deployed five specialties there. The hospital was built by Germany. There are 11 specialties and OPD in the hospital.

The other hospitals to be handed over to NGOs include agency headquarters hospital in Mohmand Agency; tehsil headquarters hospital in Mirali, North Waziristan Agency; Type-A hospital in Landi Kotal, Khyber Agency; tehsil headquarters hospital in Dogra Bara, Khyber Agency; Type-D hospital in Darazinda FR Dera Ismail Khan; Type-D hospital in Toi Khula and Type-D hospital in Moula Khan Sar (Sarwakai), South Waziristan Agency. The bidding process for the contract of these hospitals is underway.

Despite non-existence of any such an agreement in history of Fata health, officials said, they completed all legal formalities.

Sources said that administrations of those hospitals hadn’t been taken into confidence about the new arrangements and uncertainty haunted the staffers, who said it was a model of PPHI in Khyber Pakhtunkhwa which was ultimately discontinued after nine years.

The director health Fata declined to comment and referred this reporter to another official, who was not supposed to give his version on the issue.

Published in Dawn, October 19th, 2017