PESHAWAR, Sept 1: The Khyber Pakhtunkhwa health department has proposed drastic changes to the Autonomy Act, setting definite goals for the chief executives of teaching hospitals in the province so that services of those failing to deliver could be terminated even before the expiry of their three-year contracts.

Officials told Dawn on Saturday that the Act, which was awaiting the cabinet’s approval and the subsequent passage by the provincial assembly for coming into force, had been overhauled to make the chief executives of the teaching hospitals accountable to the respective institutional management councils (IMCs).

According to them, CEs currently manage affairs of their respective teaching hospitals by themselves and there is no check on their performance, blocking the government’s plan to enforce the Act in 2002 to improve patient care.

The government has been spending more than Rs6 billion annually on Khyber Teaching Hospital (KTH), Lady Reading Hospital (LRH) and Hayatabad Medical Complex (HMC) in Peshawar and Ayub Teaching Hospital in Abbottabad since they were granted financial and administrative autonomy years ago.

Officials said the government had been paying Rs200,000 a month each to these teaching hospitals.

A 2010 report evaluating the outcome of the grant of their autonomy showed that patient care at these hospitals had made no improvement despite getting financial and administrative autonomy and had recommended drastic changes to the Act to oversee performance of CEs and prevent them from making arbitrary decisions by placing them under IMCs.

Officials said they had framed new rules in line with the amended Act to bind CEs to begin eight hours shift in their respective teaching hospitals and use infrastructure, high-tech equipment and trained personnel for maximising their income by better marketing.

They said performance of CEs would be evaluated every six months and the respective IMCs would be superior to CEs unlike these days.

According to the amended Act, the new CEs of these teaching hospitals may get up to Rs400,000 salary a month but they will also be shown the door if they fail to achieve the performance goals specified in their contracts even before their expiry.

Officials said amendments to the Act would enable these hospitals to use expertise of the staff working in their affiliated colleges for better health delivery system.

“For example, the pharmacy department of the Khyber Medical College will look into drug-related affairs of KTH and Girls Medical College will supervise the HMC’s pharmacy section.

“Similarly, medical superintendent and deputy medical superintendent, who are presently recruited from among the government’s employed doctors, will be hired from the market for a period of three years,” an official said.

He said against the current setup in which many DMS worked in a hospital, there would be only two DMS, one for overseeing services like OPD, wards, operation theatres etc, and the other ensuring attendance of staff.

“Under the existing system, improvement of health delivery system is not possible as CEs of teaching hospitals have failed to check presence of senior consultants in OPDs, operation and wards etc. The amendments to the Act have empowered members of IMCs to initiate action against employees for shirking duties,” he said.

Officials said currently, teaching hospitals were run by the acting CEs because those appointed three years ago had completed their tenure and the health department was awaiting the passage of act from the assembly.

“We cannot appoint permanent CEs because we have to apply new rules that will be applicable only after the enactment of the amended Act,” another official said.

He said appointing new CEs at this stage would be counterproductive because under amendments to the law, rules were different and their jobs had been linked to performance.

“The current rules are vague and therefore, the government can’t hold the CE responsible for mismanagement,” the official said.