PESHAWAR: The Khyber Pakhtunkhwa government has started giving incentives to the doctors recruited under Medical Teaching Institutions Reforms Act, 2015 to strengthen institution-based practice in the teaching hospitals.

The teaching hospitals had the services of consultants, doctors, nurses, paramedics and other staff prior to the implementation of MTIRA. They would work under the provincial government.

Following the extension of the new law to teaching hospitals, the staff was asked to opt for becoming employee of the respective medical teaching institution but most of them preferred to stay as civil servants under the provincial government.

Under the law, the government wanted to woo all consultants to do institution-based practice (IBP) inside the MTIs instead of running private clinics in the evening but they didn’t respond positively and continued their private practice. As government servants, the consultants and other staff were free to work at private places after performing their duty in the hospitals from morning to evening.

Incentives being given to doctors recruited under MTI law

However, the situation completely changed after the ruling PTI won second consecutive elections in the province. Now government has started aggressive implementation of MTIRA 2015 with special focus on strengthening IBP.

The newly-recruited consultants in line with MTIRA 2015 do compulsory IBP along with their morning duties in the medical teaching institutions.

The law was passed during the first tenure of PTI in Khyber Pakhtunkhwa but it couldn’t be enforced due to court’s wrangling, lack of interest by the bureaucracy as well the staff of the teaching hospitals where the law was enforced.

MTIRA 2015 is aimed at doing away with the old system under which the teaching hospitals were managed by the health secretary and giving administrative and financial powers to the institutions to improve their performance.

The government initially implemented the law in three teaching hospitals in Peshawar and one in Abbottabad in 2015 but faced resistance from doctors, nurses, paramedics and other employees, who saw the new system as a plan of outsourcing the tertiary care hospitals and converting their regular services into contractual jobs.

However, the government continued to release budget to all the 10 hospitals and their affiliated medical colleges covered under the law so far. Architects of the law also failed to take strict action against the stakeholders, who resisted the reforms process since 2014 to 2018. However, since the PTI’s victory in 2018, the efforts to enforce the law have been escalated.

Senior consultants, who worked as civil servants before the enforcement of MTIRA 2015, have been removed from their positions as chairpersons of different departments and replaced with junior consultants recruited under the new law in the MTIs.

In the process, several senior consultants have quit jobs in the MTIs due to which some very established medical specialties have suffered.

Meanwhile, the IBP consultants enjoy senior positions but they can be terminated anytime as per their contract signed with the respective MTIs.

The MTIs have aggressively started transferring out the civil servants to the provincial government as they have been recruited under Government Servants Rules, 1974 and no action can be taken against them under MTIRA 2015, which empowers the institutions to do away with the services of the employees whenever they want.

Prof Nausherwan Barki, chairman of the MTIs Policy Board, told Dawn that the new law was meant to strengthen IBP, an important component of MTIRA 2015.

He said that senior consultants were leaving MTIs but more qualified and experienced doctors were joining the teaching hospitals. “We have developed new specialties over the past few years and MTIs have been asked to fully enforce the law,” he said. He added that many of the civil servants were still chairpersons of their departments because they opted to do IBP.

Published in Dawn, July 28th, 2021