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PESHAWAR: The health department has delegated financial powers to hospitals in eight districts in the first phase of its plan to facilitate precise budget-making and ensure timely utilisation of financial resources besides putting in place a mechanism for tracking of staffers and their performance for bringing improvement in the health delivery system at the grassroots level.

“KP health department has become the first one in the country to give powers to districts in the fulfillment of 18th Amendment, which calls for investing more powers in the officials working at the local level,” officials said. They said that the system would be in place in the whole province by September 2018 in two phases covering nine districts each.

Previously, all powers were held by the district health officers (DHOs), who often remained preoccupied with host of other assignments, regarding policy matters and implementation of the government’s directives and as result performance of the local health facilities dwindled for want of funds and staff.

Decision to facilitate health units in budget-making and utilisation of funds

Peshawar, Mardan, Battagram, Buner, Kohat, Swabi, Tank and Torghar are the districts where medical superintendents of the category D hospitals would act as drawing and disbursing officers for the health facilities located in the same tehsil. They would also keep the track of the budgetary and human resources.

The modus operandi has been adopted on the recommendation of Financial Management Cell (FMC), established in February 2016 on the directives of Health Secretary Abid Majeed to facilitate budget preparation and conduct research to bring about improvement in financial management, accounting, reporting and expenditure analysis.

FMC is also working to establish separate cost centres for every health facility by making separate budgetary and staff allocation to the civil dispensaries, basic health units, mother and child health centre, etc at the district level. In the past there was one budget for 49 basic health units in Mardan but now each of them would be issued separate budget and staff based on the patients load.

The health department has already issued revised delegation of powers schedule 2018 wherein it has given financial authority to the officers to ensure that the institutions work smoothly. The last schedule issued in 2001 has been outdated as the level of prices and costs has gone up steeply since then.

The initiative is aimed at segregation of powers, budget tracking and performance appraisal of staff for accurate budget-making for the local health facilities to be able to translate government’s policies into actions.

Now, the DHOs, who were responsible for administrative and financial affairs of all the facilities in the districts, would focus on the strategic policy and planning, decision-making and implementation of the programme as they are free from looking into financial matters of the health facilities.

Officials said that the department had been facing delay in preparation of budget documents every year prior to approval by finance department because of the flaws as the DHOs concerned didn’t have the desired experience.

“We want to pursue financial regulations and divert resources for the welfare of the patients in a timely manner,” said officials.

The department had been receiving complaints since long that small health facilities had to deny health services to people due to small repair of machines, purchase of essential drugs and getting the required staff because they had to contact DHOs, who had many other important issues to deal with and couldn’t tackle those issues timely.

“The establishment of FMC has helped the health department to have clear picture of the staff and financial resources in every health facility based on which it would send proposals to the finance department,” they said.

Published in Dawn, August 20th, 2018