PESHAWAR: The chief secretary of Khyber Pakhtunkhwa has ordered relevant authorities to conduct audit of all medical teaching institutions in the province to ensure transparency in utilisation of funds and better patients’ care.

Chief Secretary Shahab Ali Shah recently ordered Healthcare Commission (HCC) to carry out complete audit of medical teaching institutions in the province to ensure transparency. Sources said that HCC would conduct audit of all 10 medical teaching institutions (MTIs) through third party.

They said that MTIs had been facing scathing criticism from bureaucracy as well as politicians and lawmakers belonging to ruling Pakistan Tehreek-i-Insaf for enjoying autonomy as under Medical Teaching Institutions Reforms Act (MTIRA), they were managed by the respective Board of Governors as opposed to other hospitals that were managed by health department and were subjected to audit every year.

MTIRA, passed by the provincial assembly in 2015, is meant to grant financial and administrative autonomy to teaching hospitals and their affiliated medical and dental colleges with a view to free them from political and bureaucratic influence.

Directives meant to ensure transparency in utilisation of funds

The MTI-covered hospitals are governed by BoG, whose members are selected from private sector by search and nomination council head by health minister.

Under the law, MTIs receive one-line budget from government that is spent as per requirement of the respective institution. “They are legally authorised to abolish and re-designate posts and recruit employees without government’s approval but BoGs run all affairs which is besetting bureaucrats as well as the politicians,” said sources.

Architects of MTIRA told Dawn that they welcomed the directives of chief secretary about conducting audit of MTIs as it would ensure transparency and would lead to improvement in patients’ care. However, according to the law, all MTIs are accountable to health minister and chief minister as they can terminate members of BoGs and replace them anytime.

“Similarly, all MTIs undergo internal and external audit every year wherein all auditable record, including cash receipts and expenditure, procurements, hiring, bank statements, clinical matters and details of promotion and appointments etc are scrutinised and those pointing fingers at MTIs should see the previous audit reports,” they said.

They said that as per law, government might also conduct special audits anytime by third party. Those opposed to MTIs were talking about financial audits of all teaching hospitals and their accountability but they did not know the law and just wanted interference, nothing else, they said.

Prior to enforcement of MTIRA, these hospitals and affiliated colleges were managed by health department. Now the whole show is run by BoGs but the framers of the new law say that it has led to improvement and the audit will show that all funds are being spent transparently.

“MTIs have been extending 90 per cent curative services to patients in the province. Most patients visit MTIs despite the presence of district headquarters hospitals in their areas. MTIs, being the recipients of most patients in the province deserve funds,” they said.

They said that the people opposed to independence of medical teaching hospitals wanted that they should present their accounts as the money spent there was coming from taxpayers and BoGs had no authority to run matters without government’s approval.

Published in Dawn, April 15th, 2025