Institution-based practice takes back seat in amended health law

Published February 22, 2019
BoGs authorised to allow consultants to work on MTIs administrative posts without doing IBP.— File
BoGs authorised to allow consultants to work on MTIs administrative posts without doing IBP.— File

PESHAWAR: The Medical Teaching Institutions Reforms Act (Amendment) 2018 has authorised the Board of Governors to allow the consultants to work on administrative posts at the hospitals even if they don’t do institution-based practice.

The administrative posts at the teaching hospitals include dean, medical and hospital directors. According to the original law of 2015, the consultants, who were not doing practice inside the hospitals, were not allowed to hold such positions.

Section 17 says that after the commencement of this Act, all consultants working in government hospitals, clinics, imaging facilities and laboratories shall be given an option either to do their private practice within the hospitals, clinics, imaging facilities and laboratories of the medical teaching institutions (MTIs) or to do their private practice outside hospitals, clinics, imaging facilities and laboratories of the MTIs, as the case may be. The option shall be exercised within a period of 60 days after the commencement of this Act.

The amended law says that the BoG may in its discretion specify further periods for exercise of this option as may be prescribed. It means that institution-based practice (IBP), an important component of the MTIRA, has taken a back seat. Many had expected that the ruling PTI would make the IBP mandatory in the amended law.

BoGs authorised to allow consultants to work on MTIs administrative posts without doing IBP

Its sub section (3) says that employees, who do not opt for the private practice on the premises of the hospital, clinics, imaging facilities and laboratories of the medical teaching institution, shall not be entitled to any increase, adjustment, bonuses or other ancillary benefits or administrative posts, except in case of extraordinary need, as decided by BoG.

This has paved the way for the consultants to hold administrative positions without doing IBP, which was supposed to generate resources for the respective MTI.

Under the MTIRA 2015, IBP was optional for consultants while it was mandatory for the dean, medical and hospital directors of the institutions.

The amended law has given powers to the BoGs to decide in extraordinary cases, giving administrative positions to the consultants even if they don’t do the IBP.

Amendment in section 17 sub-section (1) provides that board can give more and more time for option which can be used positively as well as negatively. More important is the amendment in section 17 sub-section (3), which says that even if one is not opting for IBP, the BoG can still allow him/her to work on administrative posts of chairperson of the wards and dean of the department.

“If the BoG can authorise dean, medical director or hospital director not to do IBP inside the institution, then how can others be persuaded to do it,” questioned a senior consultant. He said that the government must make it binding on those holding administrative position to do IBP inside the hospitals. The amendments were meant to benefit those consultants, who didn’t do IBP but were still in good books of the controllers of the law, he added.

Published in Dawn, February 22nd, 2019

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