PESHAWAR: The Khyber Pakhtunkhwa government has started a performance review of the hospitals operating under the public-private partnership programme before release of the pending amount to the partner organisations, according to sources.

“The amount will be released only after completion of a report by a committee headed by finance secretary having additional secretaries of health and law departments as its members,” they said. They added that finance department had withheld Rs938 million of the outsourced health facilities due from June to December last year.

Sources said that the panel was reviewing the performance of 11 hospitals that were outsourced under the Public Private Partnership Act, 2016. The government has withheld funds of the private organisations and is looking into evidence of any improvement since outsourcing of the hospitals.

“The ill-performing hospitals have been contracted out to financially stable organisations having the desired technical experience in health management. They were required to improve patients’ care in the secondary level facilities. The government would provide them with one-line budget in four instalments,” they said.

Sources said that the review of performance was meant to know if the partners provided equipments, staff, including specialists, medicines, blood banks, operation theatres, emergency units and mother and child health services to the hospitals.

Funds will be released to the health facilities after completion of the process

“The partners have been given contract that they will put in place infrastructure to fully utilise the health facilities while getting funds from government as usual. Prior to release of the amount, complete record is being checked,” sources said. The agreements make the partners bound to fill up vacant posts of lady doctors by offering them lucrative packages.

They said that a record of payments would also be checked as the firms were required to present their performance report to the government to get funds. They said that there were also complaints about delay in payment of salaries to staff, which the partner agencies blamed on withholding of their outstanding funds by government.

Sources said that according to law, the partners were authorised to utilise funds as per their needs under the respective district health and finance offices.

Health Foundation, a government body, which facilitates outsourcing process of health outlets, is not involved in payment issues. It has been requesting the department to approve a plan to ensure quick cash flow mechanism and resolve the issue of delayed payment of funds once for all.

Sources said that law department had also rejected the HF’s request for smoothening cash flow without completion of probe into performance of the partner organisations.

“The finance department will release the pending amount on completion of audit by the committee. These issues would continue to crop up again and again during the five-year contracts,” they said.

They said that the outsourced health facilities were situated in Waziristan, Orakzai and other newly-merged districts besides Kohistan.

Officials in health secretariat told Dawn that the concept behind partnership with private organisations was to operate the hospitals, which despite having human resources and infrastructures, had gone into disuse. They said that specialist doctors and other professional staffers were hesitant to be posted to those facilities and the partners pledged to ensure availability of staff there.

Health Foundation is also in the process of outsourcing 58 more health facilities including district headquarters hospitals in the province. The same organisations, which are already running health facilities under Public Private Partnership Act, are in the run to secure contracts. “There are 19 outsourced hospitals. There will be strict financial discipline to benefit patients,” they said.

The health department used to receive regular reports of absenteeism and shortage of medicines and diagnostic services due to which patients would have been rushed to the adjacent settled districts for minor health issues prior to outsourcing of these hospitals.

Last year, a report compiled by third party showed that visits by patients to those hospitals increased after they were contracted out. Under the study, availability of services in three government were compared with as many outsourced facilities in the nearby areas, which rated the latter better than the former.

Published in Dawn, January 23th, 2023