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> PILDAT Legislative Forum on Health and the 18th Constitutional Amendment

Federal health division should be created to retain national role in health: Experts

PILDAT Legislative Forum
April 19, 2011

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Islamabad; April 19, In a PILDAT and Heartfile Legislative Forum on Health and the 18th Constitutional Amendment, experts believed that a Federal health division should be created to retain national role in health after devolution of health to provinces. Provinces should be given fiscal autonomy as well to effectively implement its powers after devolution.


Dr. Nadeem Ehsan, MNA, Chairman National Assembly Standing Committee on Health was the chief guest on the occasion while other speakers include Dr. Sania Nishter, President, Heartfile, Mr. Jalal Mandokhel, Secretary Health Balochistan, Ms. Shaheen Afiridi, Director Health, KPK, Mr. Aftab Shaban Mirani, MNA, former Federal Minister, Mr. Wazir Ahmed Jogezai, former deputy Speaker, National Assembly and Mr. Ahmed Bilal Mehboob, Executive Director, PILDAT.


Speaking on the occasion Dr. Nadeem Ehsan said that the Implementation Commission is still working on the issues regarding 18th amendment. He shared that National Assembly Standing Committee on Health has held several meetings with different stakeholders regarding future role of federal health ministry/division and invited participants to submit their suggestions to the committee as well which the committee will share 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.


Dr. Sania Nishter in her presentation appreciated the 18th Constitutional Amendment which strengthened provincial autonomy. However she believed that there certain important issues such as health could only be dealt at national level and therefore national role of health should be retained. She presented in detail the functions which should be under a federal health unit. She believed that the immediate steps which should be taken are creation of health division and 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.


Mr. Jalal Mandokhel 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 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.


Ms. Shaheen Afiridi was of the view that provinces have the capacity to handle Federal projects on its own. She said the major concern is financial implications for Provinces. She said that after 18th amendment, provinces have more defined and clear role. She proposed a Federal license authority which could handle the federal issues regarding health.


Mr. Aftab Shaban Mirani was of the opinion that affects every citizen, so it is very important subject to discuss in detail. He believed that in rules there is always room for amendments. He said that 2, 10%,000 federal employees are to be sent to provinces, which is a huge task and will take time.


Mr. Wazir Ahmed Jogezai appreciated PILDAT for arranging forum on such an important issue. He believed that private sector is making money out of health and there is no public administration.


Earlier, Mr. Ahmed Bilal Mehboob, Executive Director, PILDAT while welcoming the participants said that with the passage of the 18th Constitutional Amendment, Health has become a provincial subject and, according to the Constitutional requirements, all the departments under the Federal Health Ministry are to be absorbed gradually in the Provincial Health administrations. He said that this devolution 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.