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Bureaucratic hurdles halt purchase of ventilators for ICUs in Punjab

Updated July 10, 2019

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Procedural hiccups and bureaucratic bottlenecks have hindered the procurement of medical equipments, including 279 ventilators and 333 monitors, to meet the chronic shortage of life-saving facilities at the intensive care units (ICUs) of public sector hospitals in Punjab. — Amir Yasin/File
Procedural hiccups and bureaucratic bottlenecks have hindered the procurement of medical equipments, including 279 ventilators and 333 monitors, to meet the chronic shortage of life-saving facilities at the intensive care units (ICUs) of public sector hospitals in Punjab. — Amir Yasin/File

LAHORE: Procedural hiccups and bureaucratic bottlenecks have hindered the procurement of medical equipments, including 279 ventilators and 333 monitors, to meet the chronic shortage of life-saving facilities at the intensive care units (ICUs) of public sector hospitals in Punjab.

The health bureaucracy seems least bothered about the patients, which was evident from the fact that the scheme was proposed in the financial year 2017-18 at a cost Rs778 million and the procurement of the equipments has been delayed since then, raising procedural deficiencies in the health sector.

Less-privileged patients requiring life-saving treatment at the ICUs of government hospitals were being forced to avail this facility from the private sector where a 12-hour package with a ventilator facility has shot up to Rs40,000.

This is the second time that the health authorities completed the bidding process during a year and the finance department released funds last month, but the scheme was awaiting approval from the health secretary, an official privy to the information told Dawn.

He said that a few days ago the department surprisingly reduced the quantity of the equipment after issuing an order to open the letter of credit under an agreement signed on June 18, the final step to initiate a purchase.

As per the scheme proposed in 2018, the health authorities had planned to purchase 279 ventilators, 333 monitors and 199 beds for the ICUs of state-run hospitals of Punjab, he said. They have now reduced the monitors to 279 and beds to 94 despite signing a contract, he added. The department also excluded all the accessories of the equipments, which had been declared mandatory under the agreement, citing devaluation of the rupee.

The official also said the first bidding process was completed and June 30, 2018 was given as the final deadline. However, unfortunately the process was delayed due to procedural hiccups, he stated.

He said the issue again surfaced when the then chief justice of Pakistan (CJP) took suo motu notice of the miseries of patients when he was apprised about the dearth of beds and equipments at the ICUs of state-run hospitals in Punjab.

The health department then assured the apex court of speeding up the process, re-tendered the equipments and completed the bidding process in November last year. The finance department released the funds accordingly, but the health department again delayed the approval for at least a month.

Consequently, the former CJP in December called the health minister and secretary to court and expressed displeasure over willful delay in purchase of the ventilators. While addressing Health Minister Dr Yasmin Rashid, the then CJP had remarked: “You are taking this issue very casually. Should I summon the chief minister along with his team to make him approve the summary in court?”

The then health secretary Saqib Zafar had told the court that the latest summary had been forwarded to the chief minister for the procurement of 279 ventilators. He assured the apex court that it would take a week to open a letter of credit after the approval of the summary, while the procurement would be completed within three and a half months.

After another delay, the equipments were re-tendered in June this year, he said, adding that five companies qualified for the purchase of ventilators and beds and three for the monitors. The contract was awarded to the lowest bidders respectively and the finance department released the funds to initiate procurement.

The health department signed a contract on June 18 with the firms concerned and ordered opening of the letter of credit fearing that another delay may further cause a burden on the national exchequer due to the fast devaluation of the rupee.

“The process was once again delayed after the transfer of Saqib Zafar a day after the agreement,” the official added.

Newly appointed Health Secretary Momin Agha assumed charge on June 22 and the matter was pending for approval with him.

Meanwhile, instead of issuing order to open the LC, the authorities reduced the quantity of the equipments. Hence, the official said, the long-awaited purchase of life-saving equipments for ICUs continued to suffer at the hands of the health bureaucracy.

Additional Health Secretary Asif Tufail told Dawn that there were multiple reasons for the delay of more than a year. He said that when the bidding process was near completion, the finance department had released 50 per cent of the total funds, which led to some delay. Later, the process came to a halt when a firm moved the Lahore High Court.

Similarly, he said, the procurement also got delayed as it was a very technical and hectic job that required time at various stages. As the court decided the case in April, the health department re-tendered the contract in June and almost completed the entire process.

“The former health secretary played a pivotal role by saving Rs778 million when it was about to lapse,” Tufail added.

The incumbent secretary expedited the process, which required approval of some official documents, he said.

To a question, he said, the quantity of the medical equipments was reduced due to cost escalation following the devaluation of the rupee. However, the department would not lessen the number of ventilators. “If and when required, the health department will try to get supplementary budget to purchase those equipments reduced in the current process”, Mr Tufail added.

Published in Dawn, July 10th, 2019