Much-publicised health reforms in KP losing significance

PESHAWAR: The much-publicised health reforms initiated by the previous Pakistan Tehreek-e-Insaf(PTI) government in Khyber Pakhtunkhwa have started losing significance apparently due to lack of interest by the present PTI government and failing to honour merit in key appointments, senior government officials told The News.

“The Khyber Pakhtunkhwa Healthcare Commission (KPHCC) is the latest example of how this important regulating body became irrelevant owing to negligence of the present government. It had come into being due to series of brainstorming sessions of medical experts,” recalled a senior medical expert.

He and some other experts had spent months to develop standards for the regulatory body years before the PTI came into power.

Senior government officials said it was stated to be the flagship project of the PTI government but it lost its importance due to neglect by the government, particularly Health Minister Dr Hisham Inamullah Khan.

“It used to be the Health Regulatory Authority at that time, but had nothing to do with health standards. Most of the staff was accused of making money as they were not professional and knew nothing about health,” he recalled. He said majority of HRA staff, about 60 to 70, were employed by government officials in the past without following merit. “We had conducted two inquires and found nothing in HRA done as per law. All the people were employed in sheer violation of merit. They had strong roots in the bureaucracy and used to make enough money to keep their masters happy,” a former member of BoG told The News.

This was the reason the previous PTI government decided to introduce reforms. It passed the Khyber Pakhtunkhwa Healthcare Commission Act 2015 (KPHCC) and Khyber Medical Teaching Institution Reforms Act 2015 (MTI) from the provincial assembly.

The prime aim of PKHCC was to regulate public and private healthcare establishments in KP.

Some of its responsibilities included training and capacity building of healthcare providers, patient rights, registration of healthcare establishments, clinical governance, inspection of health facilities, accreditation, complaints management and licensing.

A senior Health Department official said that despite limited resources and insufficient manpower, the KPHCC achieved some goals, but couldn’t accomplish the targets due to lack of ownership by the government.

“Currently there is complete administrative vacuum in KPHCC. It has stopped its operations,” said an official at provincial health department. “Four members of the BoG, including its chairman had quit due to negative attitude of the health minister,” said the government official.

The KPHCC chief executive and three other senior officers also left the regulatory body after completion of their three-year tenure two weeks ago.

The contract of the management officers was extendable subject to their performance, which was not evaluated in last three years. The commission (board) had called a meeting to review KPHCC performance on October 14, 2019 but it could not be convened due to lack of quorum.

It was rescheduled for October 18, 2019 and was postponed due to the resignation of the chairman KPHCC.

“In the last three years, the government and particularly the health minister didn’t bother to convene a single meeting of KPHCC and learn about its achievements and the problems it had been facing,” a former BoG member complained. According to government officials, the health minister himself had chosen the board members and called them the best available professionals. “But he later felt uncomfortable with them and called them part of the mafia,” said the government official.

Three ex-BoG members on condition of anonymity told The News that they quit after realising that the health minister would not let them work independently and follow merit. “The problem began when the minister wanted us to hire his people on key positions without merit. It was not possible for us as we planned to make HCC the most effective regulatory body. When we felt that our presence will not make any difference we decided to resign,” one of the BoG members said.

Also, he said the HRA employees in the very beginning didn’t accept the HCC staff as they were qualified people and appointed on merit.

“Actually, the chief executive was very honest and the directors were thoroughly professional. The chief executive started enforcement of the law and stopped means of corruption. The corrupt elements started propaganda against the chief executive and other HCC staff,” said the BoG member.

He added that they waited if Chief Minister Mahmood Khan and Dr Nausherwan Burki, the architect of the health reforms in KP, would take note of the situation but they didn’t.

He said they were upset when the health minister claimed he had dissolved the previous board after taking charge and alleged that mafia was sitting in the HCC management.

According to former members of the board, the BoG was supposed to work independently and make decisions on merit.

They claimed the issue started when they advertised some positions in the commission and the minister wanted his nominees to be given these jobs.

“We advertised the positions and collected Rs800,000 as application fee from the applicants. How could we hire people without merit?” said the BoG member.

He said the health minister had never sought briefing of the board regarding “real” and “genuine” issues and “started keeping a distance when he realised that they would not appoint his people.”

“When we started hiring the staff purely on merit, the minister stopped us, though legally he could not prevent us from recruitment,” the BoG member said.

Health Minister Dr Hisham Inamullah Khan neither answered phone calls of this correspondent nor replied to the text messages sent to his phone. In the past, he had denied these charges against him and said that he never preferred recruiting his people. “I felt that the criteria and prerequisites for the new employment need to be changed and the ToRs need to be redefined so we employ professionals and qualified people who have the know-how of the field of medicine and have the capacity and knowledge to judge what is wrong in terms of quality of healthcare. Does it mean that I want to recruit my people?” he had said in his previous comment.