Law passed two years back: Federal health regulator not yet set up

ISLAMABAD: A principal health regulator, created for the federal capital by an act of parliament two years back, has still not been set up with its top guns, having no office, no salary, no requisite personnel or paraphernalia, beseeching authorities to provide them at least the seed money to start with.

A law enacted in May 2018 to establish the Islamabad Healthcare Regulatory Authority (IHRA) on the pattern of similar provincial forums provided that the federal body would be established within one month. It has been armed with sweeping powers and functions, which would have been helpful in the fight against COVID-19 as well, if it would have been operational.

“Had the IHRA been working, it would have specified the standard operating procedures (SOPs), protocols and quality of healthcare in the battle against coronavirus,” IHRA Board Chairman Dr Syed Fazle Hadi told The News, when contacted.

He said the board was constituted and Dr Syed Ali Hussain Naqvi appointed the chief executive officer (CEO) in end-2019 but the CEO is working from home, getting no salary, having no office or staff.

Dr Hadi said to begin with the IHRA needs Rs270m as the seed money and Special Assistant to the Prime Minister on Health Dr Zafar Mirza has promised to provide Rs150 million instead. Dr Mirza, Dr Hadi said, attended the board meeting last week on his own, which was welcomed because they wanted to bring to his notice the dire issues faced in making the IHRA functional.

The board chairman said that the regulator needs around 50 personnel, including directors, inspectors and others. “We have worked out job descriptions of the new appointments.”

He said that the IHRA would monitor, check and register the working and functioning of thousands of private clinics, hospitals, nursing homes, laboratories, all the public sectors medical facilities and health professionals and receive complaints from the general public against them to decide.

Dr Hadi said that a search committee had picked up the members of the board, who elected him its chairman. All of them have three-year tenure under the law. He stressed that the federal capital urgently needs the creation of fully functional IHRA so that the medical profession could be regulated.

According to the law, the IHRA will have the powers and functions to maintain register of all healthcare establishments, set standards for registration and licensing of healthcare establishments; register all healthcare establishments, health professionals and equipment, and issue licence for defining scope and extent of healthcare services to be provided by a healthcare establishment.

The IHRA will also enforce minimum standards of safety for patients, healthcare professionals and other staff in a healthcare establishment; regulate healthcare establishments in accordance with standards and notified practices; prepare and issue notified practices as a guiding document for service provision in healthcare establishments; inquire and investigate into violation of any of the provisions of this law by any healthcare facility.

The law says no healthcare establishment will render any healthcare services unless it is registered with the registration board subject to the terms and conditions as the board may determine on case to case basis at the time of registration. No such establishment will render any healthcare services for which it is not licensed.

No healthcare professional will render healthcare services in a healthcare establishment unless he has a prior registration. A healthcare professional will get himself registered with the IHRA for rendering services in a healthcare establishment and no healthcare professional will render services in a field in which he is not registered.

The IHRA will investigate the complaints relating to healthcare establishments, healthcare professionals, healthcare services and medical negligence. It will define the kinds of complaints, categories of different kinds of medical negligence and mal-administration, malpractice and failure in provision of healthcare services. The recognised and known complications of a medical or surgical treatment will not be considered medical negligence.

The regulator will ensure compliance and implementation of provisions of this act, rules and regulations and notified standards by arranging periodical inspections and surprise visits by an inspecting committee; provide guidelines to the registration board for grant, renewal, suspension or cancellation of registration of healthcare establishments, its healthcare professionals and equipment; advise the federal government to prescribe rates of fee for various registrations or licensing, renewals, restoration or suspension of registrations or licensing or restoration of lapsed registration or licensing; issue standing orders to ensure provision of quality healthcare services by healthcare establishments; and take steps for coordination with healthcare establishments for implementation of various health improvement, disease prevention, curative, rehabilitative and palliative programmes.

The IHRA will develop and put in place various policies and measures to ensure elimination of quackery; establish committees for assistance and advice to the IHRA in relation to the performance of its functions; determine the membership, remuneration of members and terms of reference of each committee; prepare and issue regulations, guidelines, instructions and directives to ensure implementation of this law and notified practices; and collaborate with international and national institutions, organizations and companies to secure their assistance, cooperation and support for improvement of healthcare establishments for provision of healthcare services.