K-P plans outsourcing of 32 more hospitals

The Khyber-Pakhtunkhwa government has decided to outsource another 32 underperforming public-sector hospitals to private organisations, with the new phase of the process scheduled to be completed by August 24.

Eight private organisations have been shortlisted to manage 21 Category-D hospitals, five Rural Health Centres and six Category-B and C hospitals. Before final agreements are signed, the Khyber Health Foundation is assessing the organisations' financial strength, technical capacity and ability to manage healthcare facilities. A third-party audit is also under way to evaluate their suitability.

Officials said hospitals from different districts had been included in the latest outsourcing phase. Under the new strategy, a private organisation will not be assigned only relatively better-performing or urban hospitals. Instead, it will be required to manage facilities in both developed and remote areas. For example, an organisation awarded a hospital in Abbottabad may also be given responsibility for a hospital in the merged tribal districts.

A total of 34 hospitals have been advertised for outsourcing, while the province has been divided into four regions to streamline the process. Private operators will be accountable to district administrations, district health officers and the Health Department for the performance of the facilities entrusted to them. Action may be taken against organisations showing poor performance.

Officials said private partners would receive quarterly budgets for running the hospitals, but the release of funds would be linked to performance assessments. Their performance will be monitored through reports prepared by district administrations and health authorities, with strict action possible in case of unsatisfactory service delivery.

The outsourcing agreements will also require private operators to ensure the availability of specialist doctors, diagnostic facilities and emergency services. Specialists, including physicians, surgeons, ophthalmologists, ENT specialists and gynaecologists, will be required at the hospitals.

Private partners will also be responsible for promptly repairing faulty medical equipment, ensuring timely supplies of medicines and maintaining uninterrupted emergency services.

The Khyber Health Foundation has been outsourcing underperforming government hospitals to private organisations with healthcare expertise since 2017. So far, 18 public hospitals have been handed over to private operators, most of them located in the merged tribal districts. Once the latest phase involving 32 hospitals is completed, the number of government hospitals operating under private management will rise to 50.

Officials attribute the outsourcing policy primarily to inadequate facilities, staff absenteeism and poor diagnostic services, including deficiencies in X-ray and pathology facilities. The Health Foundation says improvements in patient care and service delivery were observed at hospitals outsourced during the first phase, prompting the government to expand the policy.

However, doctors' organisations have strongly opposed the decision. The Provincial Doctors Association has been staging peaceful protests at hospitals for the past four days, with doctors and medical staff wearing black armbands.

Doctors argue that the government is effectively privatising public hospitals, which could create difficulties for patients seeking free healthcare and cause problems for medical staff, including issues related to promotions and salaries. They also warn that inadequate funding can lead to delays or stoppages in staff salaries, adversely affecting both employees and patients.

Doctors' organisations have demanded that the government withdraw its decision to outsource the public hospitals.