Experts stress national control of health sector after devolution

ISLAMABAD – Eminent health experts and lawmakers here on Tuesday stressed the creation of federal health division to retain national role in health sector after devolution of ministry of health to provinces. They were speaking here on Tuesday in a Legislative forum on ‘Health and the 18th Constitutional Amendment’ organized by PILDAT and Heartfile, two civil society organization. Speaking on the occasion Dr Nadeem Ehsan, MNA, Chairman National Assembly Standing Committee on Health said National Assembly Standing Committee on Health has held several meetings with different stakeholders regarding future role of federal health ministry/division.
He invited participants to submit their suggestions to the committee which will be shared with the Chairman Implementation Commission Senator Raza Rabbani. He stressed that provinces also need fiscal autonomy to effectively run the functions transferred to the provinces under the 18th Constitutional Amendment. Sania Nishter, president Heartfile in her presentation appreciated the 18th Constitutional Amendment which strengthened provincial autonomy. However she believed that certain important issues such as health could only be dealt at national level and therefore national role of health should be retained. She presented the functions which should be under a federal health unit.
She believed that the immediate steps which should be taken for the creation of health division and a definition of its appropriate mandate so it can serve national functions in health. Secondly regulatory prerogatives to the federal level by the provinces under article 144 of the Constitution should be granted. Jalal Mandokhel, secretary Health Balochistan, in his presentation briefed about the programmes running under federal government. He believed that federal government always funded the provincial government for health programme but kept funds under its own control. He said that instead of creating new programmes provincial government would use these funds to strengthen its current health facilities.
While giving an example he said that federal government wants to get rid of Lady Health Workers (LHWs) programme and wants to shift its burden to the provinces, which will become a liability on provinces. He briefed that total cost of these 8 national programmes is Rs 11865 million. He said that federal government should continue the MNCH and LHW programmes and the remaining 6 programmes should be shifted to provinces with the shift of donors support to provinces as well.
KP Director Health Shaheen Afridi was of the view that provinces have the capacity to handle federal projects on their own.
She said the major concern is financial implications for provinces. She said that after 18th amendment, provinces have more defined and clear role. Aftab Shaban Mirani, MNA, former federal minister was of the opinion that devolution would affect every citizen, as 2, 50,000 federal employees are to be sent to provinces, which is a huge task and will take time. Wazir Ahmed Jogezai, former deputy speaker National Assembly believed that private sector is making money out of health and there is no public administration.
Earlier, Ahmed Bilal Mehboob, Executive Director, PILDAT while welcoming the participants said the devolution of health ministry has raised several questions among stakeholders regarding the requirement of smooth delivery of health services and may need to be addressed before complete delegation of health department to the provinces.