THIS is apropos the health policy initiatives by the PTI government in the Khyber Pakhtunkhwa under the Regional and District Health Authorities Act, 2019.
Clashes between doctors and law enforcements agencies because of the Act are unfortunate, for it is the public which suffers. However, as things turned out after the imposition of section 144 and the arrest of 13 doctors, the rift seems to have deepened.
One can easily decipher certain weak elements within the new proposed health model of regional and district level devolution of health facilities namely (RDHA) Act, 2019. It apparently looks good as it promises decentralisation, effective monitoring, and inclusion of private enterprise.
However, it seems politicised, as according to the law, the new model will still be overseen by the provincial minster, negating decentralisation and privatisation.
The model, instead of qualitative and motivational structural changes, only offers the qualitative and motivational changes. Even if the model is aimed at reviving the effective administration, fostering privatisation and stopping corruption by public officials it will not yield results because affairs will still be handled by political masters who will determine the ultimate policy outcomes.
If the government really wants to save administrative wastage and stop corruption, it should implement a model with ‘corporate overtones’ whereby the private sector will be introduced to check the effectiveness of the regional and district level healthcare facilities instead of a minister.
This change of delivery mechanism by the KP government is structural in nature. The KP government will still be lacking in inculcating the intrinsic motivation necessary for public service.
Intrinsic motivation requires compassionate and self-sacrificing demeanour to serve the patients and it doesn’t come by simply changing the structural or governing paradigm.
To inculcate the intrinsic motivation amongst public servants it is imperative to have a conducive environment at the organisational level, which entails organisational openness, innovation, wellbeing of employees, employee feedback, appreciation, depoliticisation, training, flexibility, and professional autonomy.
Sajjad H. Channar
Published in Dawn, October 23rd, 2019