HYDERABAD: The Sindh High Court, Sukkur bench, has observed that the provincial health secretary Rehan Iqbal Baloch is not ‘suitable or competent’ to hold such a sensitive position of this pivotal department.

The bench comprising Justice Zulfiqar Ali Sangi and Justice Riazat Ali Sahar was seized with a public interest petition filed by Advocate Gulzar Almani for the establishment of a cardiac facility in Moro town of Naushahro Feroze district.

Passing its order on the petition, the bench also issued directives to the chief secretary, finance secretary and director general of health services, and warned that failure to comply with the directives “shall entail personal liability” of these functionaries.

The bench set a timeline for different actions and directed them to file compliance reports on the fifth day of every month through court’s additional registrar.

In its October 9 order, a copy of which was provided to Dawn, the bench observed that the secretary half-heartedly conceded lapses in the department and undertook that he would look into all aspects as pointed out by court.

Issues mandatory directives to chief secretary, health secretary and director general of health services; sets timeline for compliance

“Upon court’s query it was revealed incumbent secretary health neither possesses a background in medicine nor holds any prior acquaintance with working or administrative framework in health department, it is therefore a matter of grave concern that such a pivotal department is being overseen by an officeholder, who lacks requisite technical knowledge and understanding essential for effective discharge of its functions,” the bench remarked in its six-page order.

“Upon careful consideration of record we are of the view citizens of Sindh particularly in rural areas, are being denied equal access to healthcare especially cardiac care. There is systemic mismanagement and misappropriation of funds and medicines within health department,” the bench noted.

Set of mandatory directives

The bench directed the chief secretary (CS) to furnish a comprehensive report within two weeks on the status / progress of the 1,000-day Integrated Health and Population Project, including details of fund utilisation, reasons for delay in implementation, measures taken to avert donor cancellation and steps proposed to ensure transparency and timely execution.

It also asked the CS to submit a report regarding sanctioned strength and existing number of employees — doctors, paramedical staff and ancillary personnel — at all basic health units (BHUs), rural health centres (RHCs), as well as taluka, district headquarters and teaching hospitals, across Sindh.

The report should reflect vacant positions, absentee rates and the mechanisms adopted to maintain adequate staffing and functionality in accordance with notified service standards, the bench directed.

The bench wrote in its order that Sindh government should formulate / notify within six months a comprehensive plan for the establishment of SICVD (Sindh Institute of Cardiovascular Diseases) units in each taluka of Sindh. The plan should include phased implementation with priority to high population and remote areas. CS should form high-level oversight committee, including representatives from SICVD, finance and Planning & Development departments, to monitor progress and ensure equitable distribution of facilities.

The health department should initiate third-party audit, through the auditor general’s office, of health budgets and medicine procurement for past five years and submit a report within 90 days.

The chief secretary, health secretary or director general of health services (as case may be) should implement biometric attendance in all hospitals of Sindh within three months.

The doctors found absent or running their private clinics during their duty hours should be issued show-cause notices and proceeded against under the Sindh Civil Servants (Efficiency & Discipline) Rules, 1973.

Health department should ensure provision of essential medical equipment and cardiac emergency facilities at all taluka and district headquarters hospitals within 60 days as an interim measure till a final outcome.

Finance secretary should ensure adequate allocation of funds for health department’s development schemes, especially for SICVD expansion, in the next ADP.

Health secretary should advertise (vacancies) and recruit qualified doctors and specialists through a transparent process, ensuring merit-based appointments.

Adjourning the matter to Nov 5, the bench warned that noncompliance of the directives would entail personal liability of chief secretary, health secretary and DG health services who should file a compliance report on the fifth day of every month through court’s additional registrar.

Published in Dawn, October 18th, 2025