Will health ministry adhocism continue in Naya Pakistan?

Islamabad : Though new health services and regulation minister Aamir Mehmood Kiani has ordered the immediate expenditure audit for national health programmes and organisations on suspicion of corruption and mismanagement, adhocism plaguing the ministry has yet to attract his attention.

Eighteenth Amendment to the Constitution had decentralised healthcare in 2011 but the 2013 interim government had revived the federal health ministry though with new name and mandate.

Tasked with improving health systems governance in the centre, the ‘ministry of health services, regulation and coordination’ had got the administrative control of all national health organisations and programmes, which were overseen by various ministries and divisions in the post-devolution regime. However, the ministry’s adhoc approach to the management of these organisations led to the initiative’s failure to come up with the goods during the last five years of the democratically-elected PML-N government.

Now as the PTI has taken up the reins of government in the centre, officials wonder whether adhocism at the ministry will end in the ‘Naya (new) Pakistan’, whose creation through institutional reforms and rule of law and merit, was promised by the ruling party in its election campaign.

While many cross their fingers, the others are pessimistic about their minister’s ability to pull rank on ‘powerful, smart’ bureaucracy to remove the well-connected deputationists from health organisations and programmes, ensure right job for the right persons from within the respective organisations, and end the widespread practice of one man holding more than one posts for good governance.

They however, agree until the tendency of accepting adhocism as a replacement for policy moves isn’t done away with, the idea of reforming health institutions will continue to be a pipe dream. According to the officials, the ministry has given away top positions of some of its key organisations and programmes, including foreign-funded ones, to own officials or deputationists as a ‘stop-gap arrangement’ instead of filling them on permanent basis.

Most of these appointments understood to be politically-motivated were made during the last PML-N government. Many of these appointees have got their contracts extended over the years against the rules to continue claiming fat salary and fringe benefits.

On top among them is ‘deputationist’ executive director of the National Institute of Health Dr Brigadier Aamir Ikram, who secured the key post in July 21, 2017, for one year but got extension in his deputation period for two more years under mysterious circumstances weeks before the last government completed term in office.

Involved in multi-disciplinary public health-related activities like diagnostic services, research and production of biologicals for more than 40 years, the institute has been awaiting a permanent head for eight years exposing the ministry’s approach of adhocism towards its affairs. Similarly, the Drug Regulatory Authority of Pakistan (DRAP) has seen only one permanent head since its creation in 2012. Instead of filling the top vacancy over the years for one reason or the other, the ministry has made either own or DRAP officials the interim CEO of the drug regulator.

Things are no different at the Pakistan Medical and Dental Council (PMDC), the watchdog for medical and dental education and practice in the country.

An interim committee has been managing its affairs since January this year when the Council was dissolved on the Supreme Court’s orders over the lapse of a presidential ordinance promulgated for its creation. Though the panel headed by former Supreme Court judge Shakirullah Jan is to stay put until the government replaces it with a nominated or elected Council as ruled by the court, an official word on adhocism at the PMDC has long been awaited from the ministry, which oversees it.

Also, the ministry is managing the affairs of the country’s premier autonomous health research agency on adhoc basis.

For many months, additional secretary of the ministry Muhammad Ali Shahzada has been provisionally holding the office of the executive director of the Pakistan Health Research Council (PHRC), which was created in 1962 to ‘promote, organise and coordinate’ medical research in the country.

Adhocism has also been reported in the ministry’s Coordination/Common Unit created last year to manage the Global Fund-financed national TB, AIDS and malaria programmes, as well as the Nutrition Wing.

Officials also insist that while the ministry’s many top officials hold more than two offices at the same time and thus, availing themselves of the respective monetary and fringe benefits, some deputationists from the provincial governments have got themselves absorbed into the ministry using strong political and bureaucratic connections over the years. The health services minister didn’t answer this correspondent’s repeated phone calls and text messages on the matter.