PESHAWAR: Health department is planning to implement a law to grant administrative and financial autonomy to district level hospitals on the pattern of Medical Teaching Institutions Reforms Act to improve patients’ care.

The government previously passed Khyber Pakhtunkhwa Regional and District Health Authorities Act from provincial assembly in 2019 but it couldn’t be enforced owing to tough resistance by employees of health department including doctors, nurses and paramedics. Later, the government repealed that law and replaced it with Khyber Pakhtunkhwa Healthcare Facilities Management Act, 2022, which also remained far from being implemented.

The new law has been modeled after Medical Teaching Institutions Reforms Act, 2015, (MTIRA) aiming to run district health system through committees and free them from the district health officers, the directorate-general health services and health secretariat.

Prof Nausherwan Burki, who also played key role in framing MTIRA, confirmed to Dawn that the process to enforce the law was initiated in the province and health department had been tasked to give inputs in that regard.

Officials say the initiative will improve patient care at local level

Officials familiar with the new law said that the legislation, seeking to grant financial and administrative autonomy to local hospitals, was put on hold owing to protests by employees of health department. “Now a new piece of legislation is being implemented. In the new set of law, several amendments have been incorporated to make it acceptable to all stakeholders,” they added.

They said that enforcement of a law similar to MTIRA, which was not fully implemented despite its passage about nine years ago, was a tough task because of the employees’ resistance but the government wanted to implement it to improve patients’ care at district and tehsil level.

They said that the law, which remained in limbo for two years, would be enforced in phased manner. To manage hospitals within districts and divisions, regional health authorities (RHAs) will be established to govern dispensaries, basic health units and types A, B, C and D hospitals. The RHAs will be run by a Board of Governors (BoG). For each region, there will be chief executive officer. Each BoG will be headed by respective chairperson.

Officials said that for district health authorities, there would be chief operating officers. The RHAs will have all financial and administrative powers including recruitment of staff on ad hoc or daily wages basis and their termination as per rules to be framed under the law.

A provincial policy board with health minister as its head will be formed. The chairpersons of RHAs, director-general health services and health secretary will be members of the board.

A search and nomination committee will be constituted with health minister as its head. Director-general health

services, health secretary, representatives of vice-chancellors of Khyber Medical University and University of Peshawar besides representatives of public and private hospitals and civil society members to be nominated by chief minister will be members of the committee. The law also seeks formation of inspection and advisory committees.

Officials said that the law was meant to establish district health authorities to manage health-related affairs in their respective districts. So far, district health officers run district health facilities and report to director general health services.

“Under the new law, the services of civil servants will not get affected and their status would remain unchanged,” they said.

Published in Dawn, August 27th, 2024