Health experts at a legislative forum suggested the creation of a federal health division to retain a national scope for the health sector in Pakistan after the devolution of Ministry of Health. The ministry is expected to be devolved to the provinces under the 18th constitutional amendment.
They were speaking at a discussion on Health and the 18th Constitutional Amendment, which was organised by Institute of Legislative Development and Transparency (PILDAT) on Tuesday. Experts including, Dr Nadeem Ehsan, MNA, Chairman National Assembly Standing Committee on Health, Dr Sania Nishter, President Heartfile and others spoke at the event. The participants were of the view that provinces should be given fiscal autonomy as well to effectively play their role after the devolution.
Dr Sania Nishtar urged for immediate steps to be taken for the creation of a health division and definition of its appropriate mandate so it can serve national functions.
Secondly, regulatory prerogatives to the federal level by the provinces under article 144 of the Constitution should also be granted, she added.
While appreciating the 18th constitutional amendment she said it will strengthen the provincial autonomy.
Jalal Mandokhel, Secretary Health Balochistan, while giving a presentation on the programmes being carried out in his area, said the federal government always funded the provincial government for health programmes but kept funds under its own control.
“Instead of creating new programmes, provincial government shoud use these funds to strengthen its current health facilities,” he said.
Mandokhel was of the view that federal government was trying to get rid of the Lady Health Workers (LHWs) programmes and wanted to shift its burden from the centre, which will become a liability on provinces.
He added that the total cost of these eight national programmes was around Rs12 billion and suggested that federal government should continue them. The remaining six programmes should be shifted to provinces and the shift of the donors should also be ensured.
Another speaker, Shaheen Afiridi, Director Health Khyber-Pakhtunkhwa, was of the view that provinces have the capacity to handle federal projects on their own. However, major concern in the implementing of the 18th amendment was the financial implications for provinces.
She proposed a federal license authority which could handle the federal issues regarding health.
Aftab Shaban Mirani, member National Assembly (NA), said that 250,000 federal employees are to be sent to provinces, which is a huge task and will take time. Moreover, Wazir Ahmed Jogezai, former deputy speaker NA believed that private sector was minting money from the health sector and there was no mechanism to keep a check on them.
Speaking on the occasion, Dr Nadeem Ehsan said that the Implementation Commission is still working on the issues pertaining to the execution of the amendment.
He shared that National Assembly Standing Committee on Health had held several meetings with different stakeholders regarding future role of federal health ministry/division and invited participants to submit their suggestions to the committee as well, which the committee will share with the Chairman Implementation Commission Senator Raza Rabbani.
He stressed that provinces also need fiscal autonomy to effectively run the functions transferred to the provinces under the 18th constitutional amendment.
Published in The Express Tribune, April 20th, 2011.
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