The total cost of the proposed restructuring is Rs944.5 million.
The proposed draft points out a number of governance flaws in the present system, which it says lacks appropriate structure, and aims to make the healthcare system more integrated and effective.
The draft states that functional components at the district level do not employ an appropriate mechanism, which in turn results in disparity in standardisation, supervisory control, monitoring and evaluation. The proposal aims to improve coordination among districts, so that healthcare service for the community can be improved at the grassroots level.
The total cost of the proposed restructuring is Rs944.5 million. Of this, Rs249.7 million is a one-time cost for purchasing vehicles and other equipment. The amount also includes Rs259 million worth of incentives to attract and retain experts. Salaries amount to Rs439.8 million.
For 2011-12, the budget allocated for the Health Secretariat and Director General Office was Rs225.87 million, while Rs289.53 was allocated for provincially funded projects and programmes, taking the total figure up to Rs515.4 million.
According to the proposed summary, if the once-off expenditure and incentives components are left out, the new structure will require Rs75 million less than the one in place at present.
“Deficient structures and missing functions have resulted into mushrooming of projects and temporary interventions through government and non-governmental funding. Although these interventions consume a huge chunk of resources, majority of them have failed to deliver the desired results,” reads the text of the draft.
The draft further states that the ever rising number of these projects and programmes, and their continuation for an indefinite period of time, is proof of the failure of the current structure of the Health Department.
The proposed organisational structure empowers the health secretariat to handle strategic affairs, control overall performance, monitor healthcare system. It also calls for autonomous institutions and bodies.
The secretariat will have four wings: policy, planning and reforms; knowledge management; quality management; and coordination wing.
Every district will have its own set up to provide support, supervision, monitoring, evaluation and reporting of preventive, curative and rehabilitative services at the community level.
“After the 18th Amendment, health functions were totally devolved to the provincial government and the health department’s old structure was not addressing the needs of the people,” newly appointed Special Secretary Health Dr Akbar Khan told The Express Tribune.
Khan said the proposed structuring will help provide better service to patients and assign specific duties to previously overburdened health officials.
“The current buildings of the health department and health secretariat meet the standards, but we will appoint some new staff because of increased activities. We will focus on every problem of the province.”
The 73-page draft titled ‘Restructuring of Health Department, government of Khyber-Pakhtunkhwa’ has been sent to the Establishment Department, which has expressed some reservations over it. The proposal will then be sent to the Law and Parliamentary Affairs Department and onwards to the chief minister for a final approval.
Published in The Express Tribune, January 2nd, 2013.
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