FAFEN hospital appraisal: Over 50 district hospitals overstaffed, says report

To prepare the report, Fafen’s governance monitors visited 55 DHQs across the country in September: 22 in Punjab, 12 in Khyber-Pakhtunkhwa (K-P), 11 in Balochistan, nine in Sindh and one in Kurram Agency.

The report observed that nine appointments were made over and above the 98 posts sanctioned for clerks in Punjab, four in KP and three in Balochistan, while 13 senior medical officers were appointed against a sanctioned strength of 12 in Balochistan DHQs. Additional 100 sanitary workers were hired above a limit of 418 in 20 DHQs in Punjab, the report added.

Appointments made for senior storekeepers, peons, watchmen and gardeners also exceeded the sanctioned posts, between one to six appointments, across Punjab, Sindh, K-P and Balochistan. No cases of overstaffing were noted in the DHQ monitored in Kurram Agency.

The report also assessed the availability of specialist medical services at the DHQs, revealing that a majority of the DHQs had most of the required specialist medical services.


Conditions for infrastructure and essential medical facilities were met well by most of the 55 DHQs monitored nationwide.

The report said all monitored DHQs were approachable by a proper road, and had both electricity and fans. All but two DHQs had boundary walls and 49 were housed in buildings which were in good condition. However, the report said that as many as 13 DHQs were not clean and 24 DHQs did not have Sui gas connections.

Except for two DHQs in Balochistan, the rest had telephone landline connections, while 51 had proper shaded waiting areas for patients. Forty-seven DHQs had washrooms with running water while 13 did not have clean drinking water arrangements for patients.

The report said in the July-September 2011 quarter, disciplinary action was taken against 91 personnel, including 27 medical staff, 36 paramedics, seven technicians and 21 administrative staff. Disciplinary actions involved warnings, terminations, and non-payment of salaries, show cause notices and explanations. These actions were taken for absence from duty and unpunctuality.

Fafen’s governance monitors interviewed up to three patients at each DHQ to assess the level of satisfaction with regard to presence and behaviour of doctors and staff. More than a quarter of 157 interviewed patients felt they had not been given enough time by doctors; 25 were not satisfied with the behaviour of doctors, while doctors’ absence was noted by 12 patients.

Twenty-four per cent patients complained about the support and guidance offered by the support staff. Fifty-seven reported they did not get free medicines from the in-house pharmacy as per doctors’ prescriptions. Four patients in Punjab and one in K-P reported demands for illegal payments at the DHQs.

Published in The Express Tribune, November 24^th, 2011.