Health Diary: MTI Act — contradicting perspectives

By Bureau report
March 20, 2023

PESHAWAR: The Medical Teaching Institution Reforms Act 2015 introduced in Khyber Pakhtunkhwa has been a subject of much debate of late.


It is intriguing to see the provincial caretaker government trying to overstep its mandate by derailing the system that promised autonomy to health institutes and sought to do away with red-tapism and political control.

Some MTIs had issues particularly with regard to recruitment and procurement as members of their Boards of Governors were largely appointed by the political leaders of Pakistan Tehreek-e-Insaf to serve their interests.

It is largely believed that except for the Lady Reading Hospital and Hayatabad Medical Complex in Peshawar, the remaining MTIs were always in headlines for certain reasons.

Some of the MTIs such as the Qazi Hussain Ahmad Medical Complex in Nowshera, Mardan Medical Complex, Ayub Teaching Hospital Abbottabad, Khyber Teaching Hospital Peshawar, Peshawar Institute of Cardiology, Peshawar, and the two other hospitals, in Bannu and Dera Ismail Khan, the doctor community had been complaining about violations of merit in recruitment.

In Mardan, the doctors raised the issue after the BoG authorised the purchase of a new car for the secretary to the hospital BoG.

Advisor to Caretaker Chief Minister on Health Prof Dr Abid Jameel stopped the process of interviews for the applicants shortlisted for the hospital director’s position in Abbottabad but the same advisor remained silent when the BoG in Mardan reinstated former Hospital Director Dr Tariq Mahmood.

Chairman BoG Attaullah Toru defended Dr Tariq Mahmood’s reinstatement, saying they restored his services on the direction of the Service Tribunal, but failed to argue that being a civil servant, the person in question would have to first resign from civil service and then apply for the position of the hospital director.

Dr Tariq Mahmood was not shortlisted for the position when the BoG advertised it.

Prominent figures of the Health Department including three former director generals of health services Dr Ayub Rose, Dr Arshad Khan, Dr Mohammad Ali Chohan, and Dr Khalid Mahsud, who served as HD in the LRH, Bacha Khan Medical Complex Swabi and Pakistan Institute of Medical Sciences Islamabad were shortlisted for the position.

These are the reasons that prompted the government to dismantle all the BoGs, believing that all of them were involved in illegal activities.

Dr Abid Jameel said nobody had brought the alleged illegal reinstatement of Dr Tariq Mahmood into his knowledge.

It will open a Pandora’s Box as realising their inability to deliver a fatal blow to the system due to the legal protection offered by the relevant act, the caretaker cabinet decided to disband the boards of these institutes without offering any substantial explanation for their dissolution.

The reforms that came in the form of MTI Act in the province can be seen as one of the few success stories of the PTI government as despite shortcomings, the new system helped improve services and staff attendance.

Some of the institutes particularly LRH and HMC certainly showed signs of improvement.

The infrastructure and equipment were upgraded and more importantly the patients found standard diagnostic and therapeutic facilities on the premises of public sector hospitals.

The teaching and training opportunities for budding doctors and other paramedical staff found a structured system translating into competent human resources.

Building on the public confidence in these hospitals the government introduced the sehat card insurance scheme, which offered relief to the poor patients but certain affluent and privileged members of the community are trying to make this facility controversial.

No doubt, like any other system, there is room for improvement in the MTI system as well but to revert to the old system or experiment with yet another model will only push this financially strived province into new depths of despair at the cost of public health, which may be seen as a dark blot on the reputation of the caretaker chief minister.

It is unfortunate that the subject of public health is being used for gaining political mileage by a select few who have their own scores to settle.

Perhaps they want to have boards of their choice to promote their agendas and targeting those who never heeded to their illegal requests and efforts to hold the system hostage to their will.

Dissolving or changing the KP MTI policy board and institutional boards merely on allegations of corruption and mismanagement without any concrete evidence of wrongdoing will equal to a complete disregard to the mandate the caretaker government has.

Condemning unheard certain members of the boards is not only illogical and against the spirit of law but depicts a biased approach by those at the helm of affairs.

It will take at least six months for the new boards to come to terms with the dynamics of the provincial health system and respective teaching institutes - a timeframe far beyond their proposed stay in office.