After devolution: Medicines, salaries and deputations worry hospital staff

Staff worried about salaries after federally run hospitals devolved ahead of Ramazan.

KARACHI:

It is a state of limbo for the former federally-run hospitals in the city. Since the orders for the implementation of the 18th amendment were received by the administrations of the city’s three largest hospitals staffers and contractual workers have been running helter-skelter in search for answers. Due to the sensitive, uncertain and delicate nature of the situation none of the officials privy to matter were willing to speak on the record for this report.

Among the prominent and urgent issues that need to be addressed are the salaries of about 3,500 staffers belonging to the three hospitals - Jinnah hospital (JPMC), the National Institute of Child Health (NICH) and the National Institute for Cardio-Vascular Diseases (NICVD).

“Ramazan is around the corner and we have no funds to pay salaries,” said a doctor associated with JPMC. “Suddenly these institutions have become so irrelevant that they have been chucked aside.”

“These issues are critical and cannot be delayed. Also, there is maintenance and repair work and since we cannot hire private contractors and do not know our status we have nowhere to go,” an NICH official explained. Contractors differ for federal and provincial institutions.

“It is so easy for any one of us to get a heart attack when faced with such anxiety and uncertain circumstances,” says a doctor at JPMC on condition of anonymity. “They have just thrown us aside. People don’t even treat their animals like this. These are centres of education where doctors and medical staff are trained and they do not deserve to be treated like this... suddenly become so irrelevant.”

While the administrations of the hospital concerned met the newly inducted Sindh Secretary for Health Rizwan Ahmed on Monday, nothing conclusive seems to have come from the meeting. “The secretary has promised to resolve the issue but I don’t think even he is aware of what exactly is going on,” commented a member of NICH’s administration who was part of the meeting.

Medicine stocks

Medication and the crucial supply of oxygen and carbon dioxide are falling short. “Budgets have been prepared and tenders finalised for the supply of medication for JPMC but without the release of the funds our hands are tied,” an official said. “Generally there is a shortfall of medicine in the hospital - the Accident and Emergency (A&E) ward is stocked to last about a fortnight but beyond that we really don’t know,” another official added. The total budget for JPMC is estimated at Rs1.14 billion while medicines cost around Rs230 million.

However, a doctor at the hospital admits JPMC’s lack of planning compounded the issue. “They [the JPMC administration] were unwilling to accept that they would be devolved so they didn’t even prepare for it.”

For its part, NICH has stocked its medicine cabinets for the next three months. “We knew something like this would happen and since we had some extra funds left over from the last budget we put it towards buying medical supplies and lab equipment to last us about three months,” a member of NICH’s administration told The Express Tribune. NICH has, however, about 650 staffers while JPMC has around 2,500. The total budget for NICH last year was Rs255 million while the allocation for medicines etc. was Rs37 million. This year the hospital’s administration has asked for Rs100 million for medical supplies but the request has not been approved so far.

The hospital gas supplies are also under threat. “We cannot pay for gas in advance. We are billed as per consumption so money for that needs to be paid on a regular basis for uninterrupted service.”

Deputations

The notification sent to the three hospitals reads that its employees have been sent on deputation to the Sindh government. “When a person is sent on deputation the Lien is maintained with the parent department [in this case the Centre],” explained constitutional law expert Barrister Farogh Naseem. “During the time the person is on deputation (s)he draws their salary from the temporary department [in this case the Sindh government] not the parent.”

If a deputation is time-bound the rules differ. “Sometimes it is till further orders [are given] for perhaps three, six or nine months,” he said. If it is “till further orders” then, technically speaking the person can be recalled the next day. Even if the deputation is time-bound, since the Lien is maintained by the parent department, they can be recalled at any time. “However, this rarely happens,” he added.

A day after about 150 contractual workers were relieved from their duties at JPMC, the situation grew more complex. “There has been a great deal of talk that orders have been sent to regularise contract workers but we have yet to receive them. And till we do not get a formal notification we cannot say or do anything,” an official in JPMC’s administration said.

Published in The Express Tribune, July 6^th, 2011.