Patients of KP’s three MTIs suffer due to lack of funds

PESHAWAR: The authorities of the three Medical Teaching Institutions (MTIs) in Khyber Pakhtunkhwa complained about lack of funds, fearing they may not be able to entertain the patients accordingly if funds were not provided to them immediately.

There are three MTIs in the provincial capital city, including KP’s oldest and largest health facility Lady Reading Hospital (LRH), Khyber Teaching Hospital (KTH) and Hayatabad Medical Complex (HMC). They are governed by their separate Board of Governors (BoGs).

The basic concept of much-publicised health reforms of the previous Pakistan Tehreek-e-Insaf government and introduction of the MTIs system in 2015 was to grant financial and administrative autonomy to the tertiary care hospitals by enabling them to generate their own resources and spend as per their requirements. However, none of these MTIs had been able to achieve financial sustainability in the past eight years.

They got full independence from the government but the provincial bureaucracy was quite critical of these MTIs, saying they were fully independent to spend funds but there had been no independent audit of these institutions. “They always behaved as if they were neither answerable nor accountable to the government. But they forget that they are funded by the government,” said a senior official of the health department.

The hospital authorities started complaining of fund shortages a few days later after the caretaker government was installed in the province. Since the caretaker government is dominated by Maulana Fazlur Rahman’s Jamiat Ulema-e-Islam, an arch-political rival of the PTI, it is widely portrayed as if the government was intentionally trying to create problems for the MTIs and the boards, nominated by the previous government.

However, the authorities of the three hospitals in Peshawar said they had nothing to do with any political party and their agenda, their mandate was serving patients no matter which party was ruling the province.

“It is an open secret that being the largest health facility in the province, LRH has been receiving the highest number of patients from across the province. The funds shortage has badly affected our ability to manage the flow of patients and I am afraid it could deteriorate if funds were not made available to the hospital within a few days,” Mohammad Asim, a media manager of the hospital, told The News.

The same is the case with the two other major hospitals in Peshawar, KTH and HMC. Asim said the hospital was having Rs7 billion annual budget and they never faced any problems in the past in terms of funding.

The LRH used to get Rs1.5 billion quarterly from the government, but after the new government took over, it reduced its funding. “The government is supposed to pay us Rs4 billion, including Rs2.5 billion operational budget which is very important as it is directly related to the patient care to look after around 3,000 emergency patients as they are given each and every service free of cost. These services include passing stents to cardiac patients, neurosurgery procedures and similar gynaecology treatments,” the LRH spokesman explained.

Besides emergency care, he said they had to offer free services to around 1,300-1,500 indoor patients, which cost them heavy expenses, and if the government stopped their payments, it would have adverse effects on the patients. LRH is having around 4,000 employees, 1,000 of them faculty members.

Despite the high rise in budget and faculty and other staff members, LRH had reduced the number of patients from 5,000 to 2,500 in the outpatient departments (OPDs). Before being declared an MTI, LRH used to cater to 5,000 patients in OPDs.

The hospital spokesman argued they never reduced their OPD patients but introduced filtration clinics, where patients are referred to their relevant consultants and patients suffering from common illnesses are treated in the same place. “Prof Dr Nausherwan Burki’s vision is that every patient should be given at least 30 minutes in the OPD,” he said. He said he had never stated that the hospital had defaulted but would not hide the fact that they would not be able to continue with their present operations if funds were not provided to them.

The LRH had the largest number of beds for mass trauma in its Accident And Emergency Department and it has been LRH that handled all the major traumas of the province, including bomb explosions, suicide attacks, drone strikes and road traffic accidents.

The latest suicide attack was in the Peshawar Police Lines mosque, and according to Mohammad Asim, they had received 170 injured in the devastating attack and all of them were professionally handled. He said they had spent Rs2.5 million from their own budget on the first day of the incident and some of the injured remained admitted for several days and were given free medical care.

Some of the hospitals, particularly LRH, had heavily spent funds on the procurement of equipment, some of them were unnecessary and hardly used. Sajjad Khan, a spokesman for KTH, also confirmed that the government was required to pay them Rs2 billion in funds, which had been stopped for some time, affecting their routine operations. “Obviously, it would have adverse effects on our operations, though we may not pay salaries to our employees but can’t afford to stop services to patients,” he said.

HMC is another major hospital and is stated to be one of the best among the 10 MTIs for the quality of patient care and the standards it had developed. The government needs to make more than Rs1 billion payment. “Certainly, it will have a negative impact if funds were not made available in time. We have to cut down on equipment purchase and development work to ensure payment of salaries and utilities. Moreover, because of the shortage of funds and issues with LCs, availability of certain essential drugs and surgical disposables is also adversely affected,” an official of the hospital said.

When reached, Secretary Health Mahmood Aslam told The News they had written to the finance department and informed them about the financial problems of the hospitals. “The health department has nothing to do with financial matters of the hospitals. We have informed the finance department and requested them to release funds for the hospitals,” Mahmood Aslam said.