MTI budget surges amid audit concerns

Financial autonomy raises transparency concerns as health experts demand accountability

PESHAWAR/SWAT:

The budget for Medical Teaching Institutions (MTIs) in Khyber-Pakhtunkhwa has surged to Rs80 billion for the fiscal year 2026-27, marking a nearly 22 per cent increase from the previous allocation of Rs65.7 billion. However, despite the massive outlay, no comprehensive external audit of these institutions has been conducted, raising serious questions about financial transparency and accountability.

According to sources, the provincial government has substantially boosted funding for MTIs in the new budget, but health experts have voiced alarm over the lack of independent oversight of their revenues and expenditures. These institutions not only receive hefty government allocations but also generate billions of rupees through the Health Card Plus programme, Institution-Based Practice (IBP), and patient charges. Yet, unlike other public sector entities, their financial activities remain largely unscrutinised.

Leading MTIs, including Lady Reading Hospital, Khyber Teaching Hospital, Hayatabad Medical Complex, Peshawar Institute of Cardiology, and facilities in Mardan, Bannu, Dera Ismail Khan, and Swabi, have been consistently receiving funds from Health Card and IBP streams. However, no independent review has been made public detailing how these sums are utilised. The government has also failed to conduct a full external audit of these institutions, a standard practice for other departments.

Health experts point out that under the MTI Reforms Act 2025, these institutions were granted administrative and financial autonomy, with Boards of Governors drawn from the private sector, and direct oversight by the health and finance departments significantly curtailed.

While autonomy is commendable, they argue, public institutions handling taxpayer money must be subject to rigorous financial monitoring.

Data reveals that since 2016, approximately Rs150 billion have been spent on the Health Card programme, of which nearly Rs50 billion went to MTIs. In the last fiscal year alone, Rs35 billion were disbursed under Health Card, with over Rs15 billion allocated to MTIs. For the new fiscal year, the Health Card budget has been increased to Rs46.7 billion, a 33.4 per cent rise, and it is estimated that nearly half of this amount will again flow to MTIs.

Experts insist that as MTIs continue to receive substantial funds from government budgets, Health Card, IBP, and other sources, and as doctors and staff draw government salaries, the reasons behind the annual budget increases must be clearly justified. "To maintain public trust in the healthcare sector, financial accountability is non-negotiable," said a senior health analyst.

However, health department officials disagree with this critical view.