PESHAWAR: Most of the members of the boards of governors and senior officials at public sector medical teaching institutions say that they would propose to the new government to retain the existing health bureaucracy for continuation of reform process at the tertiary care as well as at the district health system.

“The Medical Teaching Institutions Reforms Act was passed in early 2015 but its implementation faced long delays till a change in health bureaucracy towards the end of first quarter of the 2016 that paved the way for smooth-sailing of the province-wide health reforms,” a senior member of BoG at one of the teaching hospitals told Dawn.

The previous PTI-led provincial government passed the law under which the BoGs were tasked to run the MTI-covered hospitals. Initially, plethora of lawsuits by elected bodies of doctors, paramedics, nurses and individuals hampered implementation of the law that also led to replacement of top health bureaucracy.

A senior official at a hospital said that arrival of new health secretary in March 2016 not only proved a boost for the MTIs but also led to strengthening of the district health system.

Officials say existing staff vital for continuation of reforms process

He said that MTIRA didn’t allow the hospitals to enjoy complete freedom because it was the health department that provided the much-needed financial resources for development and hiring of staff besides giving guidelines in accordance with the government policy. “The existing bureaucracy has performed the task to the desired level,” he added.

An office-bearer of KP Paramedical Association said that health bureaucracy had been kind to them during the past three years due to which they stopped observing strikes. He said that the department resolved their decade-long problems of promotions due to which 15,000 staffers, largest cadre in the health department, supported the reform process started by the previous government.

There are more than 1,550 health facilities that cater to the needs of 80 per cent of the population at the district and rural level while the MTIRA is in place only in nine teaching hospitals.

Provision of equipment worth Rs3 billion to district level hospitals, raising number of doctors from 30,500 to 90,000 and increasing their salary by more than 100 per cent along with doubling the packages of the house officers and trainee medical officers are measures that have started bearing fruits.

“The provincial budget for health was ballooned to about Rs70 billion from Rs20 billion five years ago. The role of health department in establishing 15 new hospitals, for which the PTI government takes credit, is the indication as to how the department has worked,” said the office-bearer of the association.

A senior official at the directorate of health told Dawn that the reform process needed continuity under the present administration. “There is complete harmony in the health department that is useful to implement the government’s policies through director-general health services down to the level of the district health officers,” he said.

He said that for the first time they devised a procurement policy under which drugs and instruments were purchased from manufacturers directly. “During the past two years, we have purchased medicines for hospitals at lower rates as compared to Punjab,” he added.

He said that establishment of independent monitoring units was instrumental in ensuring attendance of the staff. “There has been no polio case in the province due to which the government has drawn widespread appreciation because of our hard work,” he said.

The official said that KP started first oral treatment for hepatitis patients. He added that health department’s policy of delegating powers to district health officers and tehsil level was a cause of improvement in the services at the grassroots level.

“Likewise, innovative intervention have enhanced TB detection rate,” he said. He said that all the MTI had less than 20,000 employees while the health department had over 45,000 workers deployed in provincial facilities.

“The clinical steps taken by the department have helped us to put brakes on diseases, like poliomyelitis, TB, coetaneous leishmaniasis etc. We have been running Sehat Sahulat Programme under which more than 120,000 patients have been provided treatment at a cost of Rs4 billion,” said a senior official.

He said that the programme played vital role in PTI’s victory in the general elections. The associations of doctors that were in the habit of strikes now and then have started their duty owing to better monetary packages by the department,” he added.

Published in Dawn, August 16th, 2018