Public welfare off government's priority list

Despite declaring a health and education emergency in Khyber-Pakhtunkhwa, the provincial government is aiming to outsource dozens of hospitals and colleges to the private sector on the grounds that such a step will improve institutional performance.

Since the past several years, educational outcomes across the province have been bleak. While government schools produced dismal matriculation results, colleges too showed poor performance. The health sector fared no better. With frequent doctor protests and a lack of timely medical services, thousands of patients were left without critical care.

According to official documents obtained by The Express Tribune, the K-P government has decided to outsource 72 hospitals, which currently cost the provincial exchequer Rs7.9 billion annually. Once outsourced, the costs are projected to rise to Rs9.6 billion. This move follows earlier outsourcing phases under the Khyber-Pakhtunkhwa Health Foundation Act, 2016.

In the first phase in 2020, eight hospitals from districts such as South Waziristan, Mohmand, Orakzai, Kurram, FR Dera Ismail Khan, Upper Chitral, and Lower Chitral were outsourced. The second phase in 2022 added 11 more hospitals, including those in South and North Waziristan, Bajaur, Khyber, Orakzai, Kurram, and Upper Kohistan.

For the latest phase, the government has devised 16 performance indicators covering population served, OPD and IPD patient loads, emergency care, surgeries, lab facilities, staffing, infrastructure, housing, and security, collectively carrying a total score of 70. Any hospital scoring below 37 was shortlisted for outsourcing.

However, many medical professionals are not in favour of the outsourcing drive. Professor Dr Muhammad Hussain, a pediatric specialist at the Lady Reading Hospital and a member of the Pakistan Pediatric Association, opined that privatization would burden patients rather than benefit them. "Health systems are meant to ease the suffering of the public. Instead of outsourcing, the government should invest in strengthening public facilities, as is the case in other countries," implored Dr Hussain.

Addressing the backlash, the provincial health adviser, Ehtesham Khan, defended the decision, claiming that it was necessary to improve healthcare delivery in underserved areas and address shortages of human resources.

Meanwhile, in the education sector, the government is pursuing a similar course. After privatizing 1,500 schools earlier this year, preparations are underway to outsource 55 public colleges across K-P. The Higher Education Department has released the list, which includes the highest number of colleges from Chief Minister Ali Amin Gandapur and Governor Faisal Karim Kundi's home district, Dera Ismail Khan.

Other districts on the list include Swabi (six colleges), South Waziristan and Karak (five each), Bannu (four), Batagram and Orakzai (three each), and Abbottabad, Haripur, Mansehra, Nowshera, Kurram, Shangla, and Kohistan (two each). Peshawar, Hangu, Lower Dir, Malakand, North Waziristan, and FR Tank have one college each set for outsourcing.

The move has triggered strong opposition from teachers. Abdul Hameed Afridi, President of the K-P Professors, Lecturers, and Librarians Association (KAPLA), revealed that the association had unanimously resolved to block college privatization.

"Instead of destroying the existing system, the government should focus on addressing missing facilities. Many colleges remain closed due to past military operations and ongoing security concerns. The province faces a shortage of more than 3,000 teachers, making it unrealistic to expect improved results without filling vacancies and providing basic facilities," noted Afridi.

Conversely, K-P's Higher Education Secretary, Kamran Afridi, clarified that teachers would not lose their jobs. "We face a shortage of 6,000 faculty members in the province. Teachers from the outsourced colleges will be adjusted in nearby institutions. The department is awaiting cabinet approval to recruit 3,086 vacant sanctioned posts. Outsourcing will enhance performance and ensure better resource utilization," said the secretary.