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Health Diary Of tough MTI rules and long overdue promotions

December 11, 2023

PESHAWAR: Despite judgement of the Appellate Tribunal, the Board of Governors (BoGs) of most of the Medical Teaching Institutions (MTIs) in Khyber Pakhtunkhwa are denying overdue promotions to senior doctors though they meet criteria.

“There are nine tertiary care hospitals in Khyber Pakhtunkhwa that were declared as MTIs in 2015, which have different rules for the promotion of faculty members. The toughest rules were enforced in the Lady Reading Hospital (LRH), where Dr Nausherwan Burki was chairman of the hospital’s BoG and its Policy Board,” a senior faculty member of LRH told The News.

The Lady Reading Hospital (LRH) Peshawar building can be seen in this picture released on September 23, 2022. — Facebook/Lady Reading Hospital Peshawar
The Lady Reading Hospital (LRH) Peshawar building can be seen in this picture released on September 23, 2022. — Facebook/Lady Reading Hospital Peshawar

The News has obtained a copy of the notification about the promotion of the faculty members. It has mentioned the Basic Pay Scale in all other MTIs except the promotion notification of MTI LRH. The Health Department and Policy Board are supposed to make the procedure uniform.

Pleading anonymity, the faculty member said that there were three categories of faculty members serving in the hospitals, including civil servants, institutional employees and the MTI employees.

Most of the civil servants had either retired or were nearing retirement age. But the institutional employees are said to be the most affected. They were people who offered quality services to the patients.

After promulgation of the MTI Act, the doctors were asked to opt for the Institution-Based Private Practice (IBP) and it was only meant for the institutional employees as those recruited under the MTI Act were bound to practice within the institutions.

The previous board of governors made a huge blunder by hiring fresh FCPS doctors, who had no experience of working as senior registrars, but were appointed as assistant professors in MTIs.

Almost all junior doctors serving as assistant professors opted for IBP for better incentives. They were made heads or chairpersons of their respective departments to dictate their professors and associate professors.

Some senior doctors got discouraged due to the attitude of the BoGs and quit. Other doctors, particularly the institutional employees, continued working, but were sidelined and were made to work under their trainees. They were never included in the decision-making process. Some institutional employees were ignored in promotions despite meeting the criteria.

The criteria are tough compared to PMDC rules. Most of them have fulfilled MTI criteria, but they are required to sign an affidavit for joining IBP or practicing within the institution after promotion.

The faculty members in LRH publicly celebrated when Dr Nausherwan Burki was removed as chairman BoG and Policy Board. A former faculty member and head of Dermatology Department LRH, Prof Dr Zubair Khan was made chairman BoG while senior ophthalmologist Prof Dr Ziaul Islam was appointed chairman Policy Board.

Prof Zubair Khan started promotion of the doctors which were long overdue and even replaced a previous promotion committee. The new committee is headed by a senior gynaecologist Dr Gul Rukh. She and other members of the committee accelerated the promotion process, sending a message of hope and encouragement to the community.

Promoting some of the doctors sent a positive message to the faculty who until felt demoralised. Dr Inam Khan, orthopaedic specialist, Dr Farooq Azam, neurosurgery department, Dr Zahid, Dr Zafar Iqbal were promoted in the initial phase.

However, the LRH administration has asked them to submit an affidavit that they will join IBP after promotion. They were informed that former chairman Policy Board, Dr Burki had decided in January 2023 that all institutional employees would have to submit an affidavit to join IBP after promotion.

Associate Professor Dr Inam Khan challenged this decision in the Appellate Tribunal. Most of the doctors hired under MTI Act on high salaries and incentives started quitting jobs apparently due to suspension of Sehat Card Programme. They used to make huge profits in the IBP from Sehat Card patients.

The Appellate Tribunal in its verdict turned down the IBP’s condition as illegal. The court observed promotion of the faculty was not an initial recruitment to ask them for IBP. The LRH administration did follow the court verdict only in the case of Dr Inam Khan and exempted him from an affidavit and IBP.

However, the hospital administration has been asking every institutional employee to submit an affidavit to join IBP following promotion. All institutional employees, who were promoted recently, were asked to submit affidavits to join IBP and almost all of them decided to challenge it in the court.

In the Khyber Teaching Hospital (KTH), the BoG recently appointed all senior doctors as heads of their respective departments that not only improved patient care but also maintained discipline at the departments. They were not bound to join IBP. The same decision is expected of BoG in HMC and LRH to appoint the senior most faculty member as HOD to improve patient care and proper training of FCPS trainees.

The Policy Board was expected to overrule this ‘controversial’ decision of Dr Burki but since the government couldn’t appoint three members of the Policy Board, therefore it never convened its meeting to discuss the issue.

The Policy Board held its only meeting in September 2023 and the newly appointed three members, Prof Ziaul Islam, chairman, Dr Hafizullah and Dr Azar Rasheed attended it. The remaining old members, affiliated with Dr Burki didn’t join the meeting, due to reasons best known to them.

When reached, chairman BoG LRH, Prof Dr Zubair Khan told The News that he had already started promoting the deserving faculty members. He said since Dr Burki as chairman Policy Board had decided that all doctors would have to submit an affidavit to join IBP after promotion, therefore, the new chairman Policy Board, Dr Ziaul Islam would overrule that decision.

“I think the doctors should apply for promotion if they deserve it, and the situation will improve in future,” said Prof Zubair Khan. Prof Ziaul Islam said that they can’t call a meeting of the Policy Board until the government appointed three more members to fill the vacant seats.

The News has obtained a list of senior faculty members of LRH who are avoiding to apply for promotion despite serving for the last seven and eight years in the same position due to the illegal order of condition of IBP. These senior most doctors are Dr Mohammad Hussain, Dr Mohsin, Dr Irshad Khan, Dr Abdur Rahman, Dr Anwar Shah, Dr Bilal Awan, Dr Zafar Ali, Dr Ikram Ud Din, Dr Musharaf Kamal, Dr Ikram Akhunzada, Dr Umar, Dr Fawad Pervez, Dr Hashmat, Dr Kamran Hassan, Dr Ibrar, Dr Junaid Sethi, Dr Raheel, Dr Nuzhat, Dr Majid Paracha, Dr Mukhtarul Haq, Dr Nadeemullah, Dr Naeemulallah, Dr Noor Mohammad, Dr Mohammad Adil, Dr Sher Bahadur, Dr Saad, Dr Zafar Ali, Dr Abdur Rahman, Dr Ikramuddin, Dr Shahida, Dr Adil Bangash, Dr Shad Mohammad, Dr Sumaira, Dr Inayatullah, Dr Ilyas Siddiqi, Dr Younas, Dr Naveed Iqbal and Dr Zahoor.

Some of the junior doctors, who left LRH as assistant professors and joined private hospitals, have now become professors as they were eligible as per rules and regulations of the Pakistan Medical and Dental Council.

The doctors are now looking to caretaker Chief Minister Syed Arshad Hussain Shah to appoint the remaining members of the Policy Board so they continue working. This scribe in a recent interaction with the chief minister raised this issue with him and he promised to look into it.