ISLAMABAD: In the name of rightsizing, the government is going to repeat a failed experiment by devolving five hospitals and other health facilities in the federal capital.

However, health experts have suggested establishing a regulatory authority such as the Federal Directorate of Education (FDE) to run the health facilities rather than placing them under the Ministry of Interior, Metropolitan Corporation Islamabad (MCI) or some other division.

They said while the world was dealing with Mpox and polio had become a headache it would become a matter of embarrassment for Pakistan if MCI was mandated to deal with global diseases. They warned that it will also become difficult to get foreign aid for the health sector.

However, Secretary National Health Services Nadeem Mehbub said there was no such plan or decision except rightsizing.

According to documents of the Prime Minister Office dated August 19 signed by Additional Secretary Sara Aslam and available with Dawn, a transition plan shall be chalked out to devolve the institutions to the relevant organisations/entities within a month.

Health experts warn govt against repeating failed experiment and suggest setting up a regulatory authority to run facilities

According to documents, Pakistan Institute of Medical Sciences (Pims), Federal Government Services Hospital (Polyclinic), National Institute of Rehabilitative Medicines (NIRM), Federal General Hospital (FGH), the Health Department (DHO-ICT), Directorate of Malaria Control and the primary healthcare facilities such as Basic Health Units (BHUs), Rural Health Centres (RHCs) will be placed under one department.

It added that Coordinator to the Prime Minster on Health Dr Malik Mukhtar and Secretary Nadeem Mehbub will further review the entities operating under the administrative control of the Ministry of National Health Services to make the structure more lean and efficient.

A senior doctor at Pims, who attended a meeting held a few days ago, said the government was repeating the experiment which had already proved wrong and failed.

In 2011, Capital Administration and Development Division (CADD) had been established after the 18th Amendment [2010] and it was claimed that all departments can be controlled by one ministry or division. However, the experiment failed and had to be withdrawn.

“The idea behind CADD was to focus on solving the capital’s problems ranging from water scarcity to health issues and a significant rise in population due to migrations from Khyber Pakhtunkhwa and tribal areas which was becoming a reason for terrorism.

However, it became impossible for the minister to deal with all the issues as 24 sectors had been kept under his domain, including education, health, social and population welfare as well as the Capital Development Authority (CDA),“ the doctor said.

He said as there was only one ministry, it was not possible for it to get budgets for all the departments. It had to sacrifice one sector to get funds for another from the government.

“At that time, Pims and Polyclinic faced severe financial constraints despite being two major hospitals of the federal capital. The project of extension of Polyclinic could not be implemented because there was no ministry to take up the issue seriously,” the doctor said.

He said health was a global issue as in the recent past the world dealt with Covid-19. Currently, World Health Organisation (WHO) is dealing with Mpox and polio has become an embarrassment for Pakistan. It would be difficult to deal with such issues from the platform of MCI.

“Moreover, we get foreign aid for health-related issues. Global bodies prefer to deal with the health ministry regarding issues of funding rather than with municipal departments,” he said.

A senior doctor of Polyclinic, requesting anonymity, said it was unfortunate that a decision was being made without taking stakeholders into the confidence.

“Currently, Polyclinic has dispensaries and staff in Presidency/colony, PM House/colony, Supreme Court, Parliament House and many other offices. We provide medical cover for VIP movement and to heads of state during their visits. Even the food checking, as per the green book, in the Presidency is done by the Polyclinic. We are offering postgraduate degrees in over 10 disciplines, so how so many things can be devolved to an existing ministry,” he said.

The doctor suggested that if it was necessary to abolish the health ministry, the government should establish a regulatory authority, such as the FDE which deals with education departments, to deal with health facilities.

“It is unfortunate that the government is going to repeat a failed experiment and forcing employees of the health sector to start protests and go on strikes. There are over 15,000 employees in these institutions,” he said.

It may be noted that in March 2011, Nazar Mohammad Gondal was appointed as the first head of CAD ministry by the then PPP government after its establishment. Later, he was replaced by Barrister Usman Ibrahim.

On August 4 2017, with the reorganisation of CAD ministry into CAD Division, the then prime minister Nawaz Sharif appointed MNA Dr Tariq Fazal Chaudhry as the state minister for CADD. However, during the PML-N tenure, a cabinet committee recommended abolishing CADD and placing the departments working under it under line ministries.

A senior faculty member at Pims said if it was necessary to devolve the ministry, Pims and Federal Medical College (FMC) should be placed under Shaheed Zulfikar Ali Bhutto Medical University (SZABMU).

“The best way forward to improve Pims is to keep it under its teaching university — SZABMU — like the model adopted for Dow Hospital Karachi or Rawalpindi Medical University (RMU). The employees shall remain civil servants posted at Pims under ICT whereas faculty should be under SZABMU,” he said.

“Similarly, FMC faculty should also come under SZABMU for best educational output. Being the university hospital, Pims will become a model hospital in the region,” he claimed.

Published in Dawn, August 26th, 2024