KARACHI: After the passage of a year to the order notifying bifurcation of the Sindh health department, the government has finally decided to implement it at a time when the department is being overseen by the coalition partner, the Muttahida Qaumi Movement, which is visibly not happy about its splitting for a host of reasons, it emerged on Sunday.
The provincial government of the Pakistan Peoples Party had notified the bifurcation of the health department — one for the primary healthcare and the other for secondary healthcare — in July last year on the grounds that it could improve the department’s performance as per its claim that health topped among its prioritised sectors.
The implementation on the notification, however, failed to kick off for a variety of reasons with resource constraints, internal tussles and assessment of future political consequences topping them all.
The government had merged many departments and split education and health departments to reduce their overall number from 46 to 39.
Officials cited the provision in the 18th Amendment to Constitution, which permits that the total strength of a cabinet shall not exceed 15 members or 11 per cent of the total membership of a provincial assembly, whichever is higher.
The provincial government departments such as rural development, public heath engineering, housing and town planning were merged with the local government department; Auqaf and religious affairs had been merged with the Zakat and Ushr department; supply and prices was merged with the agriculture department; relief and land utilisation were merged with the revenue department; the narcotics department was merged with the excise and taxation; fisheries had been merged with the livestock department; etc.
It split the education and health departments into higher and technical education, school education (up to matriculation), as well as primary health and secondary health departments; for which the government cited the reason that it was according to its policy to put education and health on top of its priorities.
Sources in the health department said that initially the health department had been bifurcated more of a political manoeuvre than administrative concerns as the ruling Pakistan Peoples Party had received off and on response from the top opposition party, the Muttahida Qaumi Movement, about its offer to make a coalition in the province.
know more MQM joins Sindh govt, two ministers take oath
Sources said that now when the MQM had already joined the government and presided over the department, the PPP government found it high time to share the fortune when a notification was already in effect.
The MQM, sources said, saw the bifurcation as a measure which would disconnect the present networked system and would waste huge money on administrative matters. Besides, it would be an encroachment on the share agreed upon between the two parties when they consented to form a coalition.
The MQM had been heading the health department for a couple of decades whenever it became part of the provincial coalition. The department had been given to the party in a previous coalition during president Gen Pervez Musharraf’s regime and it stuck to tradition during the previous PPP-led government in Sindh.
However, since its bifurcation, the scenario changed when along with several other lucrative departments, the health ministry also went to Syed Owais Muzaffar, who was said be at close terms with former president Asif Zardari.
The PPP experienced serious internal differences over Mr Muzaffar’s alleged interference in the affairs of his party fellows, including the chief minister, and it exacerbated to the level that Chief Minister Syed Qaim Ali Shah and several other ministers forming the party’s elite were summoned to the UAE during Mr Zardari’s stay there last year to sort out the issue.
Mr Shah, however, got away with his move to strip Mr Muzaffar of health ministry. Stakes are too high for the ruling party to go with its agenda to split the department into two as it had been notified.
“The health department is lucrative if it remains one big department that could lure a coalition partner to stick to its loyalty. Even it attracts a party minister less if its fortunes are divided,” said a senior official.
The officials said in the event of a formal bifurcation, most of the budgetary allocations for this fiscal would go to the secondary health care department and it could be highly impracticable to run the primary healthcare department for peanuts that it could eventually grab. Besides, the authorities require huge funds for stationery, bifurcation of staffs, etc. Initially, it was said the bifurcation of the health department into the primary health and the secondary health services might take at least a couple of months to properly divide the services and job specifications of thousands of employees who see an unclear future for themselves.
The sources said the pressure from employees also forced the government to staunch furthering its plans for a year.
The provincial government is already facing a vague situation in the face of three main hospitals it got from the federal government after devolution of power four years ago, where the employees have moved the court to insist on their status to be associated with Islamabad.
“The division of employees in two ministries requires consent from all stakeholders and that is a gigantic task to attain,” said a senior official.
At present, the government is mulling over keeping doctors and paramedics, who are working in rural health centres (RHCs), basic health units (BHUs) and vertical programmes on the same posts. However, it is possible that some employees could move court against their postings as the same was done by the Jinnah Postgraduate Medical Centre, National Institute of Child Health and National Institute Of Cardiovascular Diseases employees, who have got a stay order from court.
According to the notification, the primary health department will take care of the RHCs, BHUs and a dozen of vertical programmes, including the enhanced programme on immunisation, hepatitis, tuberculosis, HIV/Aids control and malaria. Furthermore, all tertiary and teaching hospitals will be handed over to the new secondary health services.
Critics, on the other hand, said the bifurcation of the department could only increase ambiguity and replicate many previous attempts of the government in which it had opted for ‘failed experiments’ at heavier costs only to dump them in future.
Published in Dawn, July 14th, 2014