PESHAWAR: A tug-of-war between the Khyber Pakhtunkhwa government and bureaucracy has deepened over government affairs. Severe differences have arisen between the provincial ministers and secretaries in running the government affairs.
In the last year of the PTI government, bureaucrats are using delaying tactics in the implementation of the provincial cabinet’s decisions. The powerful lobby of the Baboos has refused to sign important projects and summaries under red-tapism.
One of the ministers told this correspondent on condition of anonymity that a few bureaucrats are creating hurdles in the implementation of government policies.
The chief secretary was time and again informed but he was reluctant to take any action. When asked why the secretaries were not transferred, he said they had a powerful lobby and the CS was the competent authority to write their ACRs.
The first controversy erupted between the government and the secretary transport when he refused to implement the government decision to make the transport department daily wagers permanent.
The provincial assembly had approved a bill to regularise the employees working in the transport department. However, incumbent secretary Amir Latif raised some observations due to which the regularisation and increase in the salaries of employees could not materialise.
The provincial members moved a privilege motion against the secretary and the standing committee decided to remove the secretary transport from his post for frustrating the Regularization of Employees Act 2022 and hindering the implementation of the law.
The meeting of the Standing Committee on Rules, Privileges, and Implementation of Government Assurances concurred to remove the secretary for confronting the Act, but ironically he was not removed from the post.
Another controversy arose between the health department and KP Health Foundation over the outsourcing of MRI services in eight hospitals of the province. Due to the objections, the investment of 8 billion rupees in eight hospitals in the province has been put at risk. The MRI services were proposed in public and private partnerships in Charsadda, Batkhela, Saidu, Kohat, Timergara, Bannu, Haripur and Mansehra.
The health department has made an illogical comparison between 1.5 Tesla MRI machines with 0.4 Tesla machines after the tendering formalities. Two years ago, it was decided to provide modern medical facilities with MRI machines to 130 million people in eight cities of KP. The health department prepared the project and after approval from various forums, it was sent to the Health Foundation for tendering and award of contract. But after completing all the formalities, the health secretary raised objections to the project. In a letter, the health secretary declared the project as expensive and unworkable.
The secretary health says negotiations between the health foundation and the private party appear to have forsaken the government interest and neglected the provincial prospects.
“Why the proposed Rs11 billion deal with high service costs, with no provision for public revenue generation and little impact on per capita MRI density is justified. Therefore, re-examine the agreement draft,” the secretary says.
While the KP Health Foundation has sent a reply to the secretary health regarding the outsourcing of MRI services, the Health Foundation took considerable time to ensure that the model for MRI services outsourcing is reflective of the latest trends in MRI services. The foundation undertook an extensive review process with the technical and advisory committees and with the board of governors of the foundation. The Foundation also took guidance from relevant technical experts. The Foundation has also ensured that the procurement process is competitive and that it attracts credible vendors. It took all measures to ensure that the procurement process is KPPRA compliant in all manners.
The letter says the health department has compared 0.4 and 0.3 Tesla MRI machines installed at Qazi Hussain Ahmed Medical Complex (QHAMC) and Mufti Mehmood Memorial Teaching Hospital (MMMTH) with the 1.5 Tesla MRI machines.
A 1.5 Tesla MRI machine is far superior to a 0.4 or 0.3 Tesla MRI machine due to its high image resolution, high number of tests, etc. Moreover, the MRI machines at QHAMC and MMMTH are refurbished MRIs. The outsourcing process by comparison was for new machines. Therefore, the comparison, erroneously made by the Health Department, is akin to comparing a 70CC motorcycle with a Honda Civic car. The 1.5 Tesla MRI machine provides three times higher resolution and better-quality image. It provides three times the number of tests (67 tests by 1.5 Tesla against 21 tests for 0.4 Tesla machines).
The Foundation said the key consideration was to design the model in such a manner that competitive bids from credible vendors and operators are received. Although, the bidders were given both choices, none of the bidders submitted a bid for the option of non-guaranteed load. They could have chosen to do so by simply raising their prices. However, this confirmed that no bidder was interested in taking on the entire process risk given the investment they would have had to make.
The letter said the proposed initiative would cost the provincial exchequer Rs3.5 billion over the next 5 years. Providing the same services through the traditional mode of procuring MRI machines and maintaining and operating the same would cost Rs6 billion over the next 5 years. Moreover, the rates quoted by the winning bidder for all districts are lower than the rates of comparable MRI services provided by reputable hospitals of KP and outside.
The Foundation believes that MRI outsourcing is an initiative that has the potential of greatest impact on service delivery and can ease the lives of 13 million people in the selected 8 districts and several million more in nearby districts. This office did its best to ensure fairness, transparency, and efficiency in the entire bidding process while designing the model in such a way that it would ensure effective service delivery in the most efficient way possible.
The Minister for Finance and Health, Taimur Khan Jhagra, told this correspondent that the government has worked innovatively on its PPP agenda in health with outstanding results, and the credit for this goes to the Health Foundation and the outstanding civil servants in the department.
He said there was a dearth of MRI services in the province, and the objective was to provide such service in 8 major districts across the province. Since such services have usually failed to deliver in the public sector, the idea was to outsource the MRI services to accountable providers, a model that has worked well both here in other areas, and in Punjab.
“We would get capital expenditure worth Rs5 billion for free effectively and massively improve the healthcare delivery,” he said
Taimur said retendering in an environment where the rupee had devalued would also significantly increase the cost, so failure of this contracting process could not only cost billions to the exchequer, but would also miss an opportunity to massively improve the healthcare services.