Lady Reading Hospital (LRH) Peshawar which is one of the oldest and largest tertiary care hospital of Khyber Pukhtoonkhwa (KP) is facing a crisis like situation due to resignation and leave of senior doctors. 5 senior doctors of LRH has reportedly taken long leave while one of them has submitted resignation due to the appointment of a blue-eyed person on a vital administrative position.
LRH is facing severe crises from the past 5 years after the introduction of Medical and Teaching Institution Act (MTI) by the previous PTI lead govt. The appointment of junior doctors on the key administrative positions have further aggravated the condition and annoyed the senior doctors to the extent that they have refused to serve the people in the 90 years old prestigious institutions.
Doctors who quit LRH due to the appointment of junior on administrative positions include
Name of the Doctor
Prof Dr Imran Khalil
Prof Dr AmjadTaqweem
Prof Dr Intekhab ALam
Medical specialist and Head of Medicine department
Prof Dr Muzaffar Ud din Sadiq
Prof Dr Mumtaz Ali
Head Neuro surgery department
Prof Kifayat Khan
All of the above-mentioned doctors have taken long leave due to this situation. The sources further said that another senior doctor Dr Javid Iqbal Farooq has taken an extreme step and has submitted resignation 5 years before his retirement.
Several other doctors, Dr Zahir Shah Afridi, Dr Aizaz, Dr Bakht Jamal and Dr Yousaf are also likely to quit LRH in coming days either by taking long leave or by submitting resignations. Prof Javed Iqbal Farooqi, a senior Gastroenterologist is also said to have applied for long leave but his application has not yet been accepted.
It is reported that the Board of Governor (BOG) of LRH has recently appointed a junior doctor as chairman of medicine and allied departments of the hospital and ignored all senior doctors presently working in LRH in BPS 19 and BPS 20. Dr Salman (Rheumatologist) who returned from UK and joined LRH two years ago is presently working in BPS 18 as an assistant professor and is junior to almost the majority of the doctors.
The reason behind the appointment of a junior doctor is said to be the difference of senior doctors with the Board of Governor (BOG). The senior doctors are against the undue interference of BOG in the internal affairs of various departments in LRH. Dr Nausherwan Burki who is the cousin of Prime Minister Imran Khan and head of BOG is behind all such decisions which are creating unrest among the doctor’s community. He has taken several controversial decisions without the fear of accountability due to his close relations with Imran Khan.
No one in the doctor’s community as well as in the civil services has the courage to resists his decision and those who raised objection against his decision are shown the doors. Abid Majeed, former secretary health KP who is an energetic, dedicated and honest officer is just one example in this regard.
On the other hand, the hospital administration is of the opinion that after the promulgation of MTI act by the previous PTI led government no one can be appointed on administrative position and departmental head if he/she doesn’t opted for institutional-based practice (IBP).
Various organizations of doctors community including Provincial doctors association (PDA) has also resented the decision of BOG and demanded that an impartial inquiry should be conducted in this regard. They said that institutions can’t be run without their senior and experienced members.
If such trend prevails and the brain drain of senior doctor is not prevented then it would be devastating for the ailing people, health community and the medical profession as well. PDA is of the opinion that it would be a great injustice if the failure of the government in reforming the health sectors is put on the doctor’s community.
The reports about the differences between the professors of the cardiovascular department and the administration of LRH has also been surfaced in print and electron media. The tug of war between these two departments has finally led to the suspension of cardiac surgeries in the hospital. Like other departments of Lady Reading Hospital, the cardiovascular department also has a serious conflict with the administration of the hospital which has further added to the vows of the patients.
The sources said that this conflict started at a time when the cardiovascular department of LRH has demanded 46 cardiac-related items, workforce and specialized equipment but the administration failed to provide the same due to which the professors decided not to perform the cardiac surgeries. They were of the opinion that without the provision of basic facilities the risk of performing cardiac surgeries cannot be taken.
The administration of the hospital is of the opinion that the demands of the doctors for cardiac surgeries are not according to the requirements. The items demanded by the doctors will be sent to the third party for verification. The administration of the hospital has accused the doctors of deliberately increasing the financial burden on the hospital, by demanding unnecessary items just to fail the system of Institutional Based Practice (IBP) as the majority of doctors are not in favour of it.
The medical director of the LRH has issued new directives for the requisitioning of items which annoyed the professors to extent that they have finally decided not to perform the surgeries.
The ultimate loser in this tussle of two giants are the poor patients who come to government hospitals for getting treatment at affordable prices. It is a known fact that majority of the people cannot afford the hefty prices of private hospitals and they prefer to get treatment in govt hospitals.
There are dozens of patients on the operation list of LRH. Some of them even waited for months for their turn but when the time of their operation reaches some unnecessary conflicts come in front of them.
The government must come forward and such a prestigious institution of the state shall not be left at the mercy of few people. The issues shall be resolved as soon as possible so that the lives of poor people can be saved and they took a sigh of relief in this difficult time.
Justice Qaisar Rasheed of Peshawar High court also resented the MTI Act during a hearing of a case. The Justice said that after the promulgation of MTI act the senior and competent doctors of the province are being forced to resign and the juniors are appointed on their vacant positions. He was hearing the case of a professor Dr Muhammad Jehagir of Nowshera Hospital.
The lawyer of the petitioner, Qazi Jawad Ihsan Ullah informed the court that his client was appointed as a medical director of the said hospital on 21st March 2019, for the period of 5 years under the MTI Act but he was removed from the said post on 25 March 2019. The reason for his removal is said to be the difference between the Chairman and the member of BOG.
The lawyer informed the honourable court that as per MTI Act a director once appointed cannot be removed from service, before the expiry of the prescribed period until he resigns or his credential found illegal. He further stated that as per the MTI Act no person can be appointed from other institutions in case a doctor having the same qualification and experience is present in the hospital. As the newly appointed medical direction is an employee of Bach Khan Medical colleges, therefore, his appointment is illegal and against the rules and regulations.
The two-member bench comprised of Justice Muhammad Ghazanffar and Justice Qasar Rasheed has directed the KP secretary health to personally appear and brief the court about the issue. The bench also remarked that several senior doctors resigned from govt hospitals due to the MTI act which is badly affecting the performance of these hospitals.
They further stated that it is not clear that whether the govt wants to facilitate the public in the health care sector or creating problems for them by appointing junior most people on the administrative positions and compelling the seniors to resign from the hospitals under the disguise of MTI Act.
As it is not a hidden fact that the problems among the government, doctors and hospital administration started when the previous PTI led provincial government has started health sectors reforms in KP. The most important reform in this regard was the introduction of Medical and Teaching Institution (MTI) Act.
The doctor’s community resisted this move of the government with full force and staged protest demonstrations, held rallies and boycotted duties throughout the big hospitals of the province. On the other hand, the govt also showed its resolve to bring reforms, will not succumb to pressure from any sector and the traditional old system will be changed at any cost.
Imran Khan who was in opposition at that time in the national assembly held a press conference in Peshawar in which he categorically stated that I can even cost my govt on the issues of reforms. He further stated that if the system remains the same and PTI failed in reforming the yearly old traditional system then there is no need for this political party.
After the introduction of the MTI Act by the previous KP govt, the option of doing private practice in hospitals was left open for doctors. They were given the opportunity to serve the people in private clinics outside the hospitals, in the evening as well as they had the option to select Institution Based Practice (IBP) in the hospitals in which they are doing their government jobs. Few senior professors in the govt hospitals and a large number of junior doctors opted for IBP and issue resolved amicably.
After sweeping the 2018 general elections and securing the 2/3rd majority in the KP provincial assembly by the Pakistan TehreekInsaf (PTI) their resolve to bring reforms further strengthened. This time the government has decided to introduce amendments in the existing MTI Act and to make it more convenient for the general public and tough for doctors.
The main amendment in the said act is said to be putting a complete ban on the doctor’s private practice out the side of the hospitals. The option of choosing between IBP and private practice outside the hospitals will not be there for the doctors and they will have to opt for IBP. This clause of the amendments is considered to be the main bone of contention between the stakeholders.
As there is a 2/3rd majority of PTI in the provincial assembly they will have no problems while passing the said amendment from the assembly. Even the opposition in the KP assembly is also not able to put considerable pressure on PTI to introduce their desired amendments in any act presented in the assembly. In such a situation no other option is left with the doctors serving in govt hospitals. They will either opt for the IBP or will have to resign in case they wanted to continue their private practice. In the extreme case, they will resort to protest and boycott their duties.