ISLAMABAD: Contrary to the past practice, the Ministry of National Health Services (NHS) has asked the executive director (ED) of the Pakistan Institute of Medical Sciences (Pims) to take decisions on his own.

Because of the decision, it will become possible for the head of the hospital to get out of order machines repaired or replace them without getting written approval from the ministry.

In the past, it used to take weeks and months to get such an approval.

“ED is a Category I officer and has unlimited powers. He does not need to get an approval from the ministry for everything. It is unfortunate that in the past EDs were not allowed to take decisions despite the fact that they also had powers.

“But I have given full confidence to the Pims head, Dr Ansar Maxood, to take decisions to smoothly run the hospital.

In the past, the ministry’s approval was mandatory

Even if Basic Pay Scale 20 officers are not allowed to take decisions, I don’t know when they would become capable of taking decisions,” NHS Secretary Dr Allah Bakhsh Malik told Dawn.

The decision is also appreciated by the employees of the hospital who have been criticising the ministry of NHS for its proposal to convert the hospital into a medical teaching institution (MTI).

Dr Asfandyar Khan of All Employees Pims Restoration Movement (AEPRM) said the decision would meet all the requirements which were to be implemented through MTI.

The government is considering promulgating a MTI ordinance under which the hospital would be run through a board of governors (BoG).

The board will be empowered to take decisions such as hiring and sacking employees, increasing salaries, expanding the hospital besides increasing lab test charges.

However, the Pims employees have shown their concerns saying it was a plan to privatise the hospital due to which both staff and patients would be suffering.

They had announced a strike from Aug 26 but last week the secretary NHS visited the hospital and after holding talks with the employees convinced them to withdraw the strike call.

Dr Malik told Dawn that he wished machines in hospital never remained out of order even for a single day.

“Head of the hospital should be aware of the status of all equipment and should take steps to ensure that no machine remains out of order even for a single day. That is why the head of a hospital is appointed,” he said.

About the MTI, Dr Malik said it was a new concept which stressed better service conditions for doctors and patients.

“It is a concept and will be discussed with all stakeholders. There are misconceptions about it. It would have a better salary and service structure,” he told.

On Aug 18, Special Assistant to Prime Minister Dr Zafar Mirza claimed that the government was moving towards converting Pims into MTI.

During an event at Pims, he said across the globe decisions in hospitals were taken by their respective heads and the hospitals were run on the basis of autonomy.

“But in Pakistan, medical superintendents and executive directors have no powers to take decisions. They cannot purchase medicine, start new facilities and even cannot hire staff.

“However, under the MTI a board of governors would be established and a chief executive officer (CEO) would be appointed on a market based salary.

“ The CEO would hire his own team to ensure service quality. Private practice would also be allowed in the hospital,” he said.

Dr Mirza also said the employees would be given the option of opting for contractual jobs. They will also have the option of continuing as government servants till the age of superannuation.

“However, employees refusing to opt for a contractual job can be transferred to any other public sector hospital. MTI is the best system and would not only improve the service delivery but would also allow hospitals to generate revenue,” he said.

Dr Asfandyar Khan said the health ministry should empower the ED rather than going for MTI.

“We not only appreciate the decision but will also support Dr Mirza to implement it. It is a fact that a number of functions of the hospital get stuck just because of bureaucratic hurdles or due to a delay in getting approvals from the ministry. If ED is empowered to take decisions, most of the issues of the hospital would be addressed without any delay,” he said.

“SAPM not only understands issues but is also a man of his words such as he said the issue of pending promotions of the employees would be addressed and just after a few days of his commitment we were informed that a meeting of the Departmental Promotion Committee (DPC) would be held on Sept 19. Moreover, he had promised that 1,370 vacant posts in the hospital would be filled and I have heard that efforts are underway regarding this,” he said

But Dr Khan said employees would not accept any move to privatise the hospital and convert it into MTI.

“Rather than running the hospital through a BoG, the ED should be empowered so that he would take all the decisions. Moreover, we have been making efforts to ensure that the MTI ordinance is not passed by parliament. We will convince parliamentarians not to support such a move,” he said.

When contacted, Pims Joint Executive Director Dr Ijaz Qadeer said a number of issues of the hospital would be addressed because of the latest decision.

“In the past it used to take years to get approval of different matters. For almost one decade recruitment could not be made in the hospital and contractual employees could not be regularised. I believe that ED should have the power to give approval for purchasing equipment and hiring staff,” he said.

Published in Dawn, August 31st, 2019