Punjab to outsource health facilities in 10 districts

LAHORE
THE Punjab government has decided to hand over management of health facilities in 10 districts of Punjab to external parties under Punjab Health Reforms Roadmap with effect from November 1, 2015 with the objective to improve the health status of people and overall health indicators in the province.
The Punjab government has planned to eventually replicate the ‘successful model’ of these outsourced curative health facilities in all 36 districts of Punjab.
The chief minister has approved the plan of outsourcing curative health facilities in all districts of Punjab, which initially will be implemented in 10 districts in the first phase not later than October 31, 2015. Similarly, the Punjab government will also select one or two model districts for outsourcing of preventive healthcare as well.
The lowest-performing districts on health front such as Nankana Sahib, Narowal, Muzaffargarh, etc., will be among those 10 districts, where all facilities, including Basic Health Units (BHUs), Rural Health Centres (RHCs), Tehsil Headquarters (THQ) Hospitals and District Headquarters (DHQ) Hospitals will be contracted out to external providers to achieve optimum functioning to get the desired results of provision of quality healthcare services to the patients without putting any financial burden on them. The Punjab government was, particularly, perturbed over abysmal performance in health sector vis-à-vis achieving MDGs targets 4, 5 and 6 relating to child mortality, maternal health, and combating HIV/AIDS, malaria and other diseases within stipulated period i.e. before the end of 2015 and had to extend deadline to achieve the targets before 2018.
The Punjab government will outsource health facilities to local and international social sector NGOs, local private health providers and local private for-profit companies. The ten districts will be selected on the basis of terrible primary health services with good secondary healthcare or vice versa.
It is learnt that after outsourcing of health facilities to external parties, the Punjab government will be responsible for allocating funds for medicines, salaries, etc.; make transfers and postings of doctors and staff; while the infrastructure and equipment would remain property of the government. The service providing agencies will just take over the management and have their say in recommending transfers and postings of doctors and ancillary staff in the health facilities.
The KP government is successfully running a model after outsourcing management of health facilities in five districts, including Batagram, Buner, Bannu, Kohistan and Karak. Similarly, the Sindh government is also likely to sign agreement with an external party to outsource health facilities in two districts of Thatta and Badin.
In this regard, Punjab’s health authorities, on Monday, held a session with external agencies, including Merlin, Save The Children Pakistan, DFID, TRF+, World Bank, Punjab Rural Support Programme, Akhuwat, Al-Shifa and others to roll-out the plan to contract out health facilities from 1st November, 2015. The representatives of participating agencies floated different proposals to make the programme successful and also desired to outsource BHUs along with outreach service delivery as well. “The outsourcing of BHUs in isolation without outreach programme will be a waste of money,” said one participant on the basis of his agency’s experience in KP.
Punjab Health Department has identified that the functioning of BHUs, RHCs, THQs and DHQs was low despite a huge spending on these health facilities e.g. posting of Medical Officers in Nankana Sahib and Narowal was dismally low. Therefore, it desired the providers to improve the functioning to optimum level by posting of staff, ensuring doctors and auxiliary staff’s presence, supply of medicines and infrastructure to give quality by implementing administrative, hygienic and clinical protocols to achieve maximum customer’s satisfaction. It aims at increasing equity by selecting the marginalised and improve service provision through better management. The contracting out of health facilities will fix the chronic issues like absenteeism of doctors and other staff, pilferage of medicines and corruption.
Punjab Health Department will conduct monitoring through Monitoring and Evaluation Assistants (MEAs).
Talking to The News, Secretary Health Jawad Rafiq Malik, while confirming the Punjab government’s plan to outsource health facilities in Punjab, said that the successful model of outsourced facilities in 10 districts would eventually be replicated in all the 36 districts in the province. He said the programme was aimed at achieving the optimum functioning of health facilities without burdening the poor. “The patients will continue to be provided free treatment even after outsourcing of health facilities,” he added.
To a question about outsourcing of tertiary care hospitals in future, he said that tertiary care hospitals were already autonomous under Punjab Autonomous Medical Institutions Act. However, Punjab Health Department will take measures to improve the functioning of mega teaching hospitals in the province as well.