PESHAWAR: The doctors have been receiving more consultation fee in the institution-based practice at the public sector hospitals from the patients than private clinics in the city, according to sources.

They said that institution-based practice (IBP), one of the key components of Medical Teaching Institutions Reforms Act, 2015, was meant to extend better health services to the patients at affordable rates.

The MTI, a pet project of the PTI government, is yet to make the desired progress due to fee structure and non-availability of senior specialists like professors and associate professors.

Health reforms law yet to make the desired progress

The IBP is in progress at Khyber Teaching Hospital, Hayatabad Medical Complex and Lady Reading Hospital but patients in some cases pay Rs2,100 as consultation fee.

At LRH, the medical director, a rheumatologist, gets Rs2,100 per visit in IBP. So does a female rheumatologist there.

“There are only four rheumatologists in the whole province. It is my private time where I have the right to charge patients as high as Rs7,000 or more taken by consultants in Islamabad,” Dr Suleiman Khan, the medical director of LRH, told Dawn.

He said that he examined about 70 patients free of cost every Tuesday morning in OPD. “We don’t charge patient extra for ultrasound and administration of joint injections for which they pay Rs1,000 and Rs5,000 in private clinics,” he added.

The MTIs hire fresh specialists as assistant professors at Rs200, 000 and above monthly salaries and they are bound to do IBP. The salaries of dean and medical directors are around Rs500, 000.

A former chief minister had asked the MTIs to charge a maximum Rs600 per patient. Only KTH implemented the instructions but it the fee was increased to Rs1,000 last month.

Sahibzada Mohammad Saeed, the chairman of BoG at HMC, said that of the Rs1,000 fee of doctors, Rs100 was income tax and as many amount went to to the hospital and the consultant got Rs800.

“We have developed state-of-the-art radiological and pathological services for IBP that are used by general patients. Clinical services have improved,” he said.

The basic idea behind IBP was to provide relief to the people by giving services at affordable rates but patients rely on junior specialists at MTIs as they examine most of the patients. Such specialists receive Rs500 and professor gets Rs1,000 at private sector

The patients miss famous doctors, who have stayed away from IBP due to differences with the implementers of the new system.

All the three Peshawar’s hospitals went out of the administrative control of health department after MTIRA’s enactment and were required to utilise the available infrastructure in their facilities to produce resources for common patients. Prior to IBP, the space would remain unutlised after 2pm.

During the last three years, since start of IBP, the private sector has recorded reduction in patients because people prefer these institutions for qualified staff and services. Junior specialists are meanwhile trying their best to keep the IBP afloat and earn in private time. These specialists examine general patients in morning in MTIs.

Published in Dawn, August 2nd, 2019