PESHAWAR, Feb 4: NWFP Health Minister Inayatullah Khan has said that the provincial government is committed to the principle of according financial autonomy to teaching hospitals and district headquarter hospitals to improve the health-delivery system.

Addressing the concluding session of a two-day workshop entitled “Evaluation of Teaching Hospitals Autonomy in NWFP” on Friday, the minister said that the government has already upgraded district level hospitals to provide better healthcare to the people at their doorsteps and lessen the burden on teaching hospitals in the city.

Earlier, experts cited non-existence of referral system and concentration of high medical expertise in teaching, lack of management training for health professionals, no proper system for drug prescription and lack of nursing staff at hospitals as the reasons hampering quality medical care.

“The government should install a system for incentives and penalities and the hospitals needed to become autonomous step by step whereby they should look for their staff plan in letter and spirit to improve the healthcare delivery system,” said UK-based consultant Dr Christopher Potter.

The workshop was organised by the health department in collaboration with the German Technical Agency (GTZ).

He said that patients were directly rushed to tertiary-care hospitals for minor ailments, which pushed up the cost by nine times. Such patients can be provided better treatment at primary- and secondary-level hospitals. Huge number of patients adversely affected the quality of service and hygiene.

Dr Potter, who along with non-consultant Dr Andreas Roth of Austria, four teaching hospitals and some district headquarter hospitals in the Frontier province, said that lack of non-availability concerning performance, quality, morbidity and mortality, drugs, dedication of staff, unawareness of doctors about the cost of procedures, a poor waste-disposal mechanism as major hindrances standing in the way of improvement in healthcare-delivery system.

“Paediatric services and labour rooms are insufficient. There is no intensive neo-natal care unit for children, who formed 40 per cent of the NWFP population, throughout the province,” he said.

Threats of infectious diseases, like hepatitis, stem from non-availability of isolation rooms. Buildings, infrastructure, water and electricity are not up to standard, he said.

In the absence of a prescription strategy, chemist shops are selling drugs for treatment of all diseases, he said, adding, there is no system to decide whether a patient is poor. In such circumstances, the rich manage to get free treatment while the poor are forced to pay.

Doctors at teaching hospitals are highly educated, but they lacked training in management, which has incapacitated them to participate in the development of strategies for hospitals.

“Most of the senior doctors have their private clinics in the town. It seems that patients are deviated through their private practice as well as through private diagnostic facilities such as radiology and laboratories,” he deplored.

Dr Andreas Roth in his presentation said that the hospitals they saw were short of nursing services because of lack of service structure for nurses, low pay, no job description and their unacceptability to society.

About the scant drug scenario in the province, he said that medical representatives of pharmaceutical companies hang around hospitals the whole day asking doctors to prescribe their products.

He said: “There is a well-known and remarkable incentive for doctors to do so. Prevalent laws forbid such practices but they happen on a large scale. There are no committees at hospitals which can look into drug-related affairs.”