PESHAWAR: The proposed Khyber Pakhtunkhwa Regional and District Health Authorities Act, 2019, will result in the abolition of the decades-old district health system depriving senior doctors from the management cadre of lucrative positions, say officials.

The officials told Dawn that the health system functioned under the district health officer, a BPS-20 management cadre doctor, but after the proposed law was passed and enacted, DHOs would become redundant in all districts.

They said around 40 DHOs and their assistants would be of no use in the new system, whose implementation awaited the provincial assembly’s approval.

Officials say many will lose lucrative posts after enactment of Regional, District Health Authorities Act

The officials said the law, which was modelled after the Medical Teaching Institutions Reforms Act, 2015, to grant administrative and financial autonomy to district hospitals but faced delay in approval due to reservations of stakeholders, would do away with the management cadre positions and give powers to the chief executive officers to be recruited from the market.

They said 34 district health authorities had been proposed to cover all districts, including merged tribal districts.

The officials said over 300 positions of medical superintendents of district headquarters hospitals and category B, C and D hospitals would cease to exist after the proposed law was approved and enacted.

They said like the MTI-covered hospitals, which had relieved their MS and DMS and hired hospital and medical doctors, the district health system would have the similar administrative setup.

The officials said the new system would adversely affect the office of the director-general health services, which currently controlled the entire health system in the province, as it would be powerless after the law’s enactment as the control over human resources, administration, procurement and accounts functions would become domain of the respective authorities.

They said around 30 administrative positions at the directorate would become useless and that the directorate would be left with only the functions of monitoring and evaluation and district health information system, provincial health services academy and its allied institutions, independent monitoring unit, health sector reforms unit, faculty of paramedics and allied health sciences.

The officials said the province would retain health foundation, Sehat Sahulat Programme and primary health care programmes.

They said as the proposed law suggested, the chief executive officers and hospital directors would be hired afresh, while those losing their administrative positions after the law’s enforcement could re-apply for management positions on a contractual basis on fixed but lucrative pay.

The health officials have been protesting the draft law arguing it is meant to privatise hospitals denying them job security.

The government has formed a committee including members of the medical community to look into the law prior to its passage from the assembly.

The officials said the proposed law, which was to free local hospitals from the influence of politicians, sought to form a board to ensure uniformity of powers under the health minister with the health secretary and respective CEOs.

They said the CEO would be a doctor by profession and resident of the respective region or the province.

The officials the district health authority would have two doctors as members with 10 years experience in medicines and allied medical sciences and surgery.

They said the government wanted to improve the district health services but that had yet to happen despite increase in salaries of doctors, nurses and paramedics during the last few years.

The officials said the introduction of MTIs was a good experience but four years later, the hospitals, where it had been extended, hadn’t showed marked signs of improvement.

Published in Dawn, August 4th, 2019

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