PESHAWAR: The shortage of qualified people in the board of governors of Khyber Pakhtunkhwa’s medical teaching institutions is hampering the health reforms initiative taken by the government in 2015, insist officials.

The PTI government had got the Medical Teaching Institutions Reforms Bill passed by the provincial assembly in 2015.

The legislation was meant to bring about drastic changes in the healthcare system through the MTI-covered hospitals and affiliated medical and dental colleges and other institutions through boards of governors.

Initially, the boards consisted of 10 members, including six from the private sector and four from the public sector, but later, the government decided that the boards would have members from the private sector only.

BoGs have vast powers but take decisions very slowly, claims a member

Now, each board comprises six to seven members.

The MTI law covers 10 hospitals, which are governed by the respective BoGs unlike the past when the health secretary oversaw them.

A BoG member told Dawn on condition of anonymity that seven years had passed to the enforcement of the MTI law but there’re few reforms in the health sector.

“There has been no tangible improvement due to a acute shortage of qualified people in BoGs, which are supposed to take vital decisions and enforce the vision of the ruling party,” he said.

According to him, health reforms are a technical matter but boards mostly consist of the people, who have no knowledge of the province’s healthcare system.

“Though the MTI BoGs have immense administrative and financial powers with little oversight of the health department, the decision-making process is very slow due to a lack of health-related information or experience,” he said.

Sources in the health department claimed that members of many MTI boards were retired professors and worked in private clinics and hospitals showing a conflict of interest.

They said the BoGs were authorised to abolish or re-designate posts and create new as the need arose and that they could receive one-line budget from the government and consume it in line with own needs.

The sources said the government incorporated amendments to the MTIRA 2015 from time to time for things to have a smooth sailing.

They said one such amendment was made last year to empower the chief minister to remove a member or dissolve the entire board.

Previously, the law had no room for the removal of board’s members or its dissolution before the completion of their three years term.

The sources said the MTI law amendments enabled the government to get rid of Nowshera and Dera Ismail Khan MTI boards over misappropriation of resources.

They, however, said the health department was struggling to select qualified professionals as the BoG members to implement the desired reforms.

When contacted, Prof Nausherwan Barki, the architect of the MTI law, acknowledged a serious shortage of qualified people in hospital BoGs.

“According to the process of selection, individual names are solicited by the health minister’s office from a variety of sources. Their CVs are reviewed and the health minister’s office elicits opinions about them from their colleagues and others, who know them,” he said.

Prof Barki said an attempt was made to have people from diverse fields like finance, administration, law, philanthropy and medicine.

“Ideally, they [BoG members] should be from the area served by the respective MTI but I do not know if the health minister personally meets them,” he said.

Prof Barki also said it was the system in theory and to some extent, in practice.

“It [MTI system] is imperfect but remember the pool of really qualified people is small and the positions are entirely voluntary,” he said.

Prof Barki said the board members were unpaid but they appointed the people to the top MTI positions, including medical directors, hospital directors, nursing directors, finance directors and others, and such people should have knowledge of health sector, administration, law and finance.

Prof Barki, who is also chairman of the Policy Board, which is required to give guidelines to all MTIs for the enforcement of uniformed policies, said targets had been set for the respective BoGs, which were reviewed every six months.

He said the non-performing board members would be replaced with the relevant professionals.

Meanwhile, leaders of the Provincial Doctors’ Association called for the selection of MTI BoG members through proper interviews saying such people are required to take important decisions in MTIs.

They said the appointment of members ‘on merit’ would ensure better performance of the boards.

According to PDA leaders, the ‘irrelevant’ professionals, politicians and their relatives and some retired doctors are calling the shots in MTIs with no prospects for reforms.

They said proper selection of board members could make a difference.

Published in Dawn, July 24th, 2021

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