KP health department’s administrative cadre dwindles amid years without inductions

PESHAWAR: The administrative cadre created in the Khyber Pakhtunkhwa health department to fill management posts is gradually disappearing because no fresh inductions have been made in recent years.

They said the cadre was established in 2009 to place doctors with qualifications in health administration in managerial roles, including directors, district health officers, and medical superintendents. According to the sources, when the cadre was introduced, a number of senior doctors already serving in administrative positions obtained health administration degrees from private institutes so they could continue in those posts.

Sources said the health department has three cadres: general, specialist and management. They said doctors in the general and specialist cadres are meant to treat patients, while those in the management cadre are supposed to handle administrative responsibilities.

According to the sources, the previous government in Khyber Pakhtunkhwa amended the rules and permitted doctors from the general cadre to serve in administrative positions. They said that decision severely weakened the administrative cadre.

General cadre doctors occupying management posts

Sources said there is now an acute shortage of administrative cadre officers, with general cadre doctors currently serving in positions such as district health officer, medical superintendent, deputy medical superintendent and director. They said that while doctors with health administration qualifications, including some trained abroad, remain without postings, important management offices continue to be assigned to general cadre doctors.

“As the government continues to post general cadre doctors to administrative positions, scores of doctors with qualification from abroad in health administration are sitting idle. As a result, those holding important managerial positions cannot deliver to a desired level due to lack of experience,” said sources.

They added that several key posts are presently being held by junior doctors even though those positions were intended for senior administrative cadre officers. According to the sources, important offices at the directorate general (health services) are also occupied by junior officers, despite the significance of those roles in coordination with Unicef, WHO and international donor organisations.

“The situation regarding the posts of DHO is the same as many junior doctors have been holding these positions of BPS-20,” sources told this scribe.

Sources said appointing general cadre doctors to administrative posts has not only denied management cadre officers their due role but has also affected the department’s performance. They said junior and general cadre doctors cannot replace officers who possess the relevant qualifications and experience for such assignments.

“The positions of regional directors are held by BPS-19 doctors contrary to the requirement of BPS-20 officers,” said sources.

They said the administrative cadre had originally been created to address hospitals’ financial and administrative matters, resolve employee issues, and improve patient care at the local level by reducing the burden on the directorate general (health services), which also deals with provincial affairs as well as international donors and UN agencies.

“The important positions of DHOs are held by junior doctors and most of them have no qualification in administration. Some of them have additional charge of medical superintendent too,” they said.

According to the sources, the policy shift allowing general cadre doctors to take up administrative assignments has also discouraged doctors from pursuing qualifications in health administration, further contributing to the decline of the cadre.

“Not only this, but the administrative cadre doctors are often made OSD and during this period they get half salaries. OSDs are also deprived of health professional allowance and their salaries and allowances are restored when they get posted,” said sources.

Sources further said the cadre is also shrinking because the government is outsourcing hospitals. They said contractors appoint their own people from the market to administrative positions in outsourced facilities. According to them, 25 hospitals have already been outsourced, while 72 more are in the pipeline.

“Administrative cadre doctors have no place in medical teaching institutions (MTIs) because being civil servants, they are asked to resign in case they are selected there. MTIs hire people from the market on contractual basis and therefore indications are that administrative cadre will disappear,” said sources.