A tale of inordinate delays and bureaucratic hurdles

By Mushtaq Yusufzai
August 04, 2021

PESHAWAR: If there was any yardstick to measure the performance of the Health Department in Khyber Pakhtunkhwa, the Health Foundation could be the best example that concluded the affiliation process of private medical training institutions in two years.

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The Health Foundation took two years to issue letters to allow the private medical colleges to use the public sector hospitals in certain districts.

After approval of the Board of Governors (BoG), the Health Foundation allowed four private medical colleges to start activities in the four district headquarters hospitals.

Zia Medical College (ZMC) was allotted the District Headquarters Hospital (DHQ) Mardan for teaching purposes, Jinnah Medical College (JMC) in Peshawar will use the DHQ Charsadda while the DHQ Hospital in Timergara in Lower Dir was declared as a teaching institution for Zaib Medical College (ZMC).

Though the Jinnah Medical College had already established its building, it suffered a lot due to bureaucratic hurdles.

The college could not enroll students in the last two years as it lacked a teaching hospital, thanks to the Health Foundation that delayed the process for two years. The long delay in the affiliation process frustrated the investors, who regretted having made the investment.

The agreements were signed with nine medical colleges, 83 nursing institutes and 181 paramedical institutes for diploma and BS programmes for affiliation with the public sector hospitals.

The medical colleges included Frontier Medical College in Abbottabad, Women Medical College Abbottabad, Abbottabad International Medical College, Jinnah Medical College in Peshawar, Al-Baironi Medical College Peshawar, Zia Medical College Mardan, Zaib Medical College in Lower Dir, and Windsor Medical College in Haripur.

Apart from these new medical colleges, five other medical colleges had already signed agreements with the Health Foundation but could not start classes due to the failure of the new BoG to approve the agreements signed by the previous one.

Only four medical colleges were allotted hospitals and it is not clear when the other colleges would be given permission to start teaching activities.

Also, the Health Foundation is silent on the agreements with nursing and paramedical institutions.

The process started in June 2019 and concluded on July 28, 2021, that too after repeated complaints and requests by the private sector that had signed agreements with the Health Foundation.

The Health Foundation was declared as an autonomous body when the previous Pakistan Tehreek-e-Insaf-led government initiated its much-publicized health reforms. It had passed two laws from the provincial assembly to introduce health reforms in the public sector.

They included the Medical and Teaching Institution Reforms Act 2015 and Health Care Commission Act 2015.

The government constituted a board of governors for each medical and teaching institution.

The Health Foundation was neither a medical nor a teaching institution so the government brought it under a separate board of governors (BoG).

It was a sad story how the board handled this important health body and discouraged the basic aim behind the establishment of the Health Foundation, which was supposed to promote public-private partnership.

However, the ones wishing to invest in the health sector would think twice keeping in view the treatment meted out to investors by the BoG and its incumbent managing director.

In 2019, the provincial government decided to strengthen health services in some of the district headquarters hospitals and announced a public-private partnership programme.

It wanted the private sector to contribute to the public sector hospitals.

As per the initiative, the government wanted to allow the private sector to establish medical colleges in districts and use the DHQs as tertiary care hospitals for teaching purposes.

But the efficiency of the Health Foundation and its BoG could be gauged from the fact that the affiliation process for private medical training institutions began in June 2019 and agreements with the shortlisted parties were signed in July 2020.

It was a misfortune of the investors as the tenure of the BoG that had signed agreements with the private sector expired in October 2019.

The government constituted the new board in November 2020 when the issue was highlighted in the media.

Sadly, the new board was not aware of the agreements the Health Foundation had signed with the private sector.

The private sector was told that no government official had attended the ceremony, where the agreements were signed.

But the truth is that besides the health minister, special secretary of the Health Department and several other high-ranking government officials had participated in the ceremony in Peshawar.

The inordinate delay and other hurdles embarrassed the government and Chairman BoG Javed Hashmat was subsequently removed.

Dr Amanullah was chosen as the new chairman BoG but being based in Saudi Arabia, he could not spare time for the affairs of the Health Foundation.

On May 10, 2021, the BoG approved the agreements and directed the managing director of the Health Foundation to allot hospitals to the private in respective districts.

The managing director took three months to issue letters to the private sector medical colleges.

According to the provisional agreement, the private parties would affiliate themselves with the Pakistan Medical Commission in two years and the agreement would be extended for 10 years.

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