SHC orders single line budget for all govt tertiary care hospitals by October

The Sindh High Court (SHC) has directed the finance secretary to ensure the implementation of a single line budget for all tertiary care government hospitals starting October so that the health facilities may directly receive their entitled funds.

Hearing petitions with regard to health care facilities and teaching hospitals in the province, an SHC division bench comprising Justice Salahuddin Panhwar and Justice Adnanul Karim Memon ordered the health department to upgrade all government-run hospitals to district and Taluka levels, notified as district headquarter (DHQ) and Taluka hospitals.

The court said that the reappropriation of hospital funds would be made within the spirit of the health department’s proposal, and that the medical boards constituted by the government would be competent to re-examine the same, while the post of finance director would be filled within three months.

The bench said that the administration director and any member nominated by the board would be cosignatory of the budget with the medical superintendent as interim measures, and they would be answerable before the board for ensuring transparency in the entire process.

The health secretary said that the Sindh government was going to launch an ambulance service by providing a toll free number to enable the people to reach the hospital in time. He said that the process was under way and it was expected that the same would be completed within a year.

The court said that big cities also need to be given their due, but at the same time, the small towns and cities are also to be assured of their rights, which include basic health facilities. The court added that basic health facilities cannot satisfy their meaning if patients cannot reach the hospital in cases of emergencies.

The health secretary said that the Sindh chief minister had also approved the constitution of a medical board with regard to all tertiary care government and provincial teaching hospitals under the Sindh Teaching Hospitals (Establishment of Management Board) Act 2020.

The bench said that the constitution of the board or the notification thereof alone will not satisfy the objective unless it becomes functional and is updated by continuing periodical meetings so as to know the outputs of the decisions of the meetings as well as the objectives of its constitution.

The bench directed the chairperson of the board to ensure the meeting of the board, and that they would take over all the responsibilities. The court said that the medical superintendent of hospitals would be completely responsible before the board.

The court was informed that 36 health department officials who were working on higher grades had been removed from different posts. The bench directed the health secretary to ensure that specific directives in this regard were not infringed in future, and if so, the same would leave room for legal action against the delinquent.

Replying to the court’s query whether or not the post of the health director general is filled by a grade 20 officer, the health secretary said that a grade 19 officer was at present the acting incharge of the health DG post.

The bench ordered that all junior officers working on own pay scale, acting incharges and allowed to work officers would be removed, including the health DG.

The court said that in case at any stage the statement of the health secretary was found improper or wrong, the health secretary would be liable to be charged under the contempt of court act as well as the beneficiaries posted at higher grade offices.

The bench said that the health department was directed to form committees and invite the public to open courts in accordance with population to deal with health facilities at district level, revised schedules of new expenditure of all hospitals from district headquarter unit level to district hospitals and tertiaries.

Besides, the court said that the health secretary was to submit the details of hospitals that were designated or notified as DHQ hospitals and Taluka hospitals but their summaries were not yet approved.

The bench directed the health secretary to complete the exercise within a month on a war footing. The court said that the upgrade would be completed preferably within two years, but at least six DHQs and 12 Taluka headquarter hospitals would be upgraded as required within a year.

The health secretary said that a mechanism as applied in teaching hospitals was required to be applied in DHQ hospitals, and at least one in Taluka in a district, and by creating different posts of different cadre on market-based recruitment through contract to deal with the heavy flow of patients.

The bench said that there was a heavy flow of patients in every Taluka, so DHQ hospitals would be regulated like teaching hospitals, ordering that the exercise would be completed within a month.

The court said that a summary as prepared by the health department in this regard would be floated to the CM, and thereafter, would be placed before the cabinet.