PESHAWAR: The institution-based practice at medical teaching institutions is yet to take off to a desired level owing to defiance of consultants and inability of authorities concerned to initiate action against the medics, who violate the law.

As per law, the MTI consultants are bound not to run private clinics but many of them are doing private practice. The Khyber Pakhtunkhwa government passed Medical Teaching Institutions Reforms Act in 2015 to bring reforms in health sector and improve patient care.

The Act was gradually extended to the teaching hospitals. Presently there are 11 hospitals and affiliated medical colleges covered under the law but its main component, the institution-based practice (IBP), is yet to be enforced in letter and spirit.

Under the IBP, the MTIs are required to start private practice of the consultants in the evening and provide quality services to the patients and generate revenue for the hospitals.

Prof Burki says MTIs need to take action against consultants over private practice

However, many consultants, who have been recruited in line with the MTIRA on lucrative salaries, are not willing to start it in the hospitals and continue to run their private clinics.

“We have asked the MTI consultants to return to the hospital premises for IBP and abandon their clinics. Except four, all have come back to the hospital but many of them sneak out and go to their private clinics,” said dean of one of the MTIs.

According to him, these consultants have been hired on contractual basis at Rs200,000 per month salary and IBP is mandatory for them. However, most of them have started private clinics in violation of their contractual agreement, which makes it binding upon them to do IBP.

“We are in the process to take action against all those, who are not doing IBP, because it is part of the MTIRA that they would do private practice in the hospitals,” he said.

The dean said that situation in all 11 MTIs is more or less the same where the consultants ran private clinics instead of IBP. The MTI Policy Board has recently instructed all the hospitals to ensure that the consultants sit in IBP.

Before the implementation of MTIRA, the consultants, who had been recruited by the health department, used to perform their duty in OPD, wards, operation theatre, colleges and diagnostics centres in their respective hospitals and would run their private clinics in the evening.

They were civil servants and didn’t come under the new law. Therefore, they couldn’t be forced into doing IBP. The MTI recruited new consultants to run IBP but despite the recruitment of more than 600 consultants, the MTIs are yet to start full-fledged IBP services and as a result the patients continue to rely on the private clinics.

In Lady Reading Hospital, Khyber Teaching Hospital and Hayatabad Medical Complex Peshawar, the IBP lacks specialist doctors because those hired for the purpose aren’t complying with the directives.

The dean of a Peshawar-based MTI told Dawn that the consultants would soon face action because the government was giving them high salaries and had authorised them to admit patients and conduct operations as private and earn money for themselves and the institutions in addition to taking care of patients freely in morning shift. But many of them were using the MTIs and ran their private clinics, he added.

The MTI consultants said that they had been promised good environment for IBP but the facilities promised with them were missing due to which they focused on the private clinics.

They conceded that it was illegal because they got double of the salaries given to their counterparts in civil services. However, they requested for provision of well-furnished clinics and equipment for all investigation in MTIs to run the IBP successfully.

Prof Nausherwan Burki, the chairman of Policy Board, told Dawn that the respective MTIs were required to take action against the consultants doing private practice instead of IBP. Under the law, their services could be terminated by the Board of Governors of the MTI concerned, he added.

Prof Shehzad Akbar Khan, medical director Hayatabad Medical Complex, said that they had got services of all MTIs consultants for the IBP. “We don’t have enough space due to Covid but we are making arrangements to house all in the IBP,” he said.

Published in Dawn, October 4th, 2021