PESHAWAR: The Khyber Pakhtunkhwa government seems unable to implement the Health Reforms Act to do away with the “rotten” health delivery system in teaching hospitals because the old administrators want to maintain status quo, according to sources.

The government has appointed medical and hospital directors on interim basis in four teaching hospitals of the province to enforce the law as stopgap arrangement till recruitment of permanent officials on these posts.

Four professors have been appointed as acting medical directors, who have taken numerous steps to work on clinical side and improve patients’ care, but the health officials already working there as medical superintendent, deputy medical superintendents or resident medical officers have also been allowed to continue their work as hospital directors.

Sources say that it means the government seeks complete overhaul of the existing health delivery system in public sector hospitals. However, they say that hope for any positive change in Khyber Teaching Hospital, Lady Reading Hospital and Hayatabad Medical Complex, Peshawar and Ayub Teaching Hospital Abbottabad in the presence of old administrators is misplaced.

The old administrators of teaching hospitals want to maintain status quo

Being associated with the old system, they don’t want to make any change happen, they say. The hospitals are still run by those people, who did so before the new law was put in practice, they add.

Sources say that unwillingness on the part of these administrators has hampered the implementation of major decisions, especially about employees’ option regarding becoming institutional employee or staying as civil servant. A simple matter has become complicated as the interim administrators, who were part and parcel of the old system, don’t want and change, they add.

The snail’s pace approach to implement the law could face failure. Except LRH, all the teaching hospitals are yet to advertise posts of medical and hospital directors.

There is less coordination among the members of the Board of Governors and the administrators of the respective hospitals. Each of the hospitals has a 10-member Board of Governors, which is supposed to run the respective institution through hospital and medical directors.

The government’s inability to hire fresh officials to launch the new system has been creating suspicion among the employees, who are under misconception that their services are being made private. The government has asked the civil servants of these hospitals to become institutional employees of their respective hospitals as part of the policy of change.

There is unrest among the employees, including paramedics, nurses and Class-IV staff. The new system is aimed at granting financial and administrative autonomy to the hospitals with enhanced benefits to the workers.

However, rumours are doing rounds these days that the hospitals are being sold to private contractors.

The existing administrators want to stick with the old system. They don’t explain to the employees about their privileges in the new system but rather instigate the low-ranked employees against the system, sources say.

The employees are yet to be told categorically that they will work in competitive environments with more opportunities of academic and professional development.

There is no one to explain the government’s position to the employees and win their support to be able to make it run.

Some 4,500 employees of KTH, LRH and HMC who happened to be civil servants are required to become institutional employees. In KTH, about 70 health workers have already opted in its favour but there are no efforts by administration to perform the task.

Instead of convincing employees to opt for it, there are deliberate attempts to spread rumours about the new system and ask the employees to stay away from giving option in favour of institutions.

The matter is very simple as 50 per cent of the staffers of these hospitals are employees of the institutions. All employees of ATH, Abbottabad belong to institution since its establishment in 1979. It means there is no harm in giving up status of the civil servants and switching over to the institutions.

In LRH and HMC, the employees are yet to be formally approached by administrators to get their consent because no one represents the government.

Much of the crisis prevails in LRH these days.

The chairman of BoG of LRH is abroad. But the chairpersons of HMC and KTH BoGs live in Peshawar and Lahore who remain in touch with medical directors via telephone and emails etc. But the first step before launching the system is the employees’ support, which cannot be fulfilled in interim setup.

The employees are preparing to start series of strikes against the decision.

Recently, LRH hospital director was removed. He was restored by court but how a person can be expected to toe the government’s line when he is on collision path with health department, sources say.

Sources say that as soon as the permanent hospital directors are appointed the present lot will go, then why they should be willing to allow the new system to operate which will deprive them of their jobs?

However, interim medical directors, who are medical professors, have helped the government in transitional phase of the new system by introducing new measures in line with the government’s agenda. These professors are not interested to be posted as permanent medical directors, therefore, they have acted professionally.

Sources say that the government needs to appoint fresh people on these posts.

The administrators, who are supposed to implement the new system, are part and parcel of the old system and a change will mean slipping away of their powers.

Published in Dawn, July 2nd, 2015

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