Health Diary: Does KMU need a medical college with private partnership?

PESHAWAR: The Khyber Medical University (KMU)’s plan to sign a memorandum of understanding (MoU) with a newly-established private healthcare facility to set up a joint medical college has generated controversy, with senior doctors raising questions why KMU is not taking over public sector hospitals if it wants to build a medical college.

Also, according to senior government officials, a former governor had allegedly played an instrumental role in helping sign the MoU between KMU and the private hospital. The private hospital is a joint venture of wealthy serving and retired doctors and some businessmen in Hayatabad Peshawar.

“There are some powerful people behind this project as the plan was kept completely secret, particularly from the media. Initially, former Governor Ghulam Ali chaired the KMU senate meeting convened to discuss the plan and a sub-committee was formed to handle this issue on a priority basis,” a senior government official privy to the details told The News.

Pleading anonymity, he said there was “unprecedented” pressure on the subcommittee to approve the MoU. In this regard, another meeting was held in the civil secretariat to review the MoU plan but they decided to discuss it in the next session.

The KMU is the lone public-sector medical university in Khyber Pakhtunkhwa. It had vehemently opposed when the then caretaker prime minister Anwarul Haq Kakar and caretaker chief minister Syed Arshad Hussain announced upgrading of Khyber Pakhtunkhwa’s first and historic medical college, Khyber Medical College (KMC) into a medical university.

When contacted, KMU Vice-Chancellor Prof Dr Ziaul Haq initially termed it an old story, saying it had already been disbanded. “This is an old story and we had closed this chapter,” he insisted.Prof Dr Ziaul Haq said they had preferred the public sector hospital, particularly the Lady Reading Hospital (LRH), and in this regard, several meetings were held with the LRH administration but in vain.

“Then representatives of the private hospital came to us with a proposal, but we took it to the senate and then decided that since KMU has a good number of teachers of basic sciences, therefore, we will advertise it and let’s see whoever applied to it,” said the KMU vice-chancellor.

Dr Zia said it was the second version that was discussed a few weeks ago, saying they were working on the third version which they will share in a couple of days as they’ve removed “private” partner but joint venture, public or private.

However, when he was informed about the senate meeting held with the governor in the chair and then another meeting held on Tuesday at the Civil Secretariat, Dr Ziaul Haq endorsed the information, saying that the meeting was convened to discuss ways and

options of how to proceed with the available facilities for establishing a medical college.

He said he himself attended the meeting.“What we are trying to do is to get this plan done through a transparent process of bidding. And let’s see whoever gets it through a bidding,” he added.

The question is does Khyber Medical University need a medical college? The short answer is “no”, certainly not as a public private partnership with an entity that is yet to celebrate its first birthday.

It is certainly in the interest of a group of individuals owning and running a recently established private hospital in Hayatabad, Peshawar as opposed to the public interest.For the hospital to be recognized as a health institution and to have its own medical/dental college, it requires a building for the medical/dental college, fully equipped basic sciences labs, in addition to faculty in basic and clinical sciences.

The MoU of this kind may help this group in financial and material terms at the cost of KMU. From KMU’s point of view, it would be a financial disaster, both in the short and long term.Further, it is important to have an authentic report on the financial strength of the private hospital before even considering the possibility of such an MoU.

The provision of building, basic sciences labs and faculty in basic sciences are resource intensive and this MoU puts all onus on KMU with no share by the private group.Responsibility of recognition by the regulating body (Pakistan Medical and Dental Council) has also been given to KMU, which requires a lot of resources to meet the required standards.

The little share of revenue generated through tuition fees, etc, would not be enough to maintain the infrastructure KMU has to offer through this MoU. The private group would be free to collect money through clinical practice and services in addition to sharing through the MoU.

This MoU is silent over the due share of KMU in clinical practice and procedures conducted by clinical faculty and share from revenue generated through support services including but not limited to labs, radiology, physiotherapy, etc. The MoU is also silent over the real-time record of all revenue generating segments of the private group and the proposed medical/dental college.

It is also important to note that the MoU does not mention authentic mechanisms to confirm and reflect actual earnings through various segments, mechanisms for curtailing expenditure, financial risks involved, mitigation of risks and exit strategy.

In short, there is no need for the KMU to get involved in such a venture unless vested interest, on both sides, dictates otherwise. It has a constituent medical/dental college at Kohat. If KMU needs to have another constituent medical/dental college, being a public sector entity, it should take over a well-equipped and Khyber Pakhtunkhwa’s oldest and largest hospital, Lady Reading Hospital (LRH), or DHQs Hospital in Jamrud in the Khyber tribal district, or the Naseerullah Babar Memorial Teaching Hospital in Peshawar, so that all entities are public sector with no conflict of interest.

It will help develop services and serve the greater public interest. The revenue so generated can be used for research and development of these hospitals instead of supporting a private sector entity.