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June 8, 2018

Though some doctors celebrate end of BoGs, MTI Reforms Act is not yet over


June 8, 2018

PESHAWAR: A group of doctors opposing health reforms initiated by the Pakistan Tehreek-e-Insaf-led government started ‘victory’ celebrations soon after Chief Justice Mian Saqib Nisar dissolved all boards of governors appointed under the Khyber Pakhtunkhwa Medical and Teaching Institutions Reforms Act 2015 (MTI Reforms Act) to run the affairs of the state-run medical and teaching institutions.

It seems the anti-MTI elements believe that nobody will now dare to make them accountable for their failure to follow rules and regulations, particularly during duty hours.

Perhaps Justice Saqib Nisar did not know that three years ago when the PTI government introduced the health reforms, some doctors launched a campaign against it.

They locked down the public sector hospitals by suspending health services for poor patients for many days and challenged the reforms in the Peshawar High Court.

Lengthy litigation delayed implementation of the reforms as the government was unable to make key appointments required under the new system.

Also, nobody informed the honourable chief justice about the fund collected by owners of private medical and surgical centres in Peshawar’s Dabgari Gardens locality nto hire the best lawyers and stop the reforms from being implemented.

?Soon after Justice Saqib Nisar announced the verdict to dissolve the boards during a hearing in the Peshawar registry of Supreme Court, the doctors took to the social media ?and began celebrations.

Some claimed to have taken an important wicket of PTI Chairman Imran Khan while others boasted they buried the health reforms.

They referred to Dr Nausherwan Burki, the cousin of PTI chairman Imran Khan and architect of health reforms, as an important wicket that fell.

?From the celebrations, it seemed as if the chief justice has overthrown the entire MTI Act 2015, though it is not the case.

The cabinet of previous government through a clandestine decision had given three-year extension to the existing boards of governors (BoGs) formed three years ago for running the administrative and financial affairs of public sector tertiary care hospitals.

The ?BoGs of four tertiary care hospitals - Lady Reading Hospital (LRH), Khyber Teaching Hospital (KTH) and Hayatabad Medical Complex (HMC) in Peshawar and Ayub Teaching Hospital (ATH) in Abbottabad completed their three years tenure in May this year.

?As the PTI government was inexperienced some of the party men recommended their close relatives to the search and nomination council to appoint them in BoGs of different hospitals. People having no hospital experience were accommodated in the boards.

Some bureaucrats appointed their relatives. There is the famous case of former special secretary health who got his wife and maternal uncle accommodated as BoG members of one hospital in Peshawar.

Those opposing the much-publicised health reforms used to often refer to the lady, saying a “beauty parlour was also made member of the board.”

However, unlike members of the institutional management committees (IMCs) appointed by the previous ANP-PPP coalition government, majority members of the BoGs in PTI rule were well-educated and known for their services and contribution in their respective departments. They served free of cost.

The IMC members were accused of corruption, nepotism and favouritism by allegedly getting kickbacks in purchase of equipment.

There is now confusion as it isn’t clear whether the chief justice dissolved all the boards or only overruled decision of the previous government for approving three years extension to the BoGs of four hospitals.

The boards of Mardan Medical Complex, Nowshera Medical College - though dissolved by former chief minister Pervez Khattak allegedly to recruit his people without merit -, Bannu Medical College and Gomal Medical College in Dera Ismail Khan have yet to complete the three years tenure.

One wished the chief justice had taken suo moto notice of the 15-year old, incomplete Peshawar Institute of Cardiology.

Certain powerful elements succeeded in delaying PIC as it is likely to damage business of private hospitals in the provincial capital.

It was only a few weeks ago when the BoG, headed by Dr Nausherwan Burki, started recruitment for the cardiac hospital and placed orders for purchase of equipment.

?All eyes are on equipment worth over Rs2 billion to be purchased for the PIC.

?In LRH, where the previous government faced tough resistance in implementing health reforms, doctors were seen distributing sweets for getting rid of Dr Burki and his team.

One senior faculty member said majority of professors stopped attending OPDs after learning that Dr Burki was being removed.

“Unfortunately most doctors opposing reforms never performed duty during official hours,” said a faculty member on condition of anonymity.

?The search and nomination council will now recommend names to the government for BoGs in three weeks. The present BoGs will continue until then.

It’s not clear if the caretaker government will appoint BoGs or it will be left for the coming government.

?The present system replaced the previous administrative set-up of chief executives and medical superintendents with medical directors and hospitals, respectively.

Unlike the previous system, all powers were transferred to the BoGs. However, an audit and evaluation survey conducted by a third party identified numerous deficiencies and shortcomings in the health delivery system of the MTIs in KP.

One major reason the doctors opposed the present system was that it made them accountable. Another important feature of the MTI law was conducting clinical audit of the doctors, who opposed it.

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