The federal government has decided that premium of secondary care treatment in additional 11 districts for Prime Minister National Health Programme would be catered by the provincial governments. The original PC-I for Phase-I covering 23 districts has been revised for further expansion of the programme from 23 to 34 districts.
A copy of the minutes of the Central Department Working Party (CDWP) presided over by Minister for Planning, Development and Reforms Ahsan Iqbal revealed that the secretary Planning and Development, Government of Punjab, sought a clarification about the premium contribution for secondary healthcare services in the additional districts.
The secretary National Health Services informed that premium was the same, ie Rs 1,000, for secondary healthcare services to be catered by the provincial government and Rs 300 top-up premium to be catered by the federal government. The secretary P&D observed that provincial consultations should have been undertaken while considering for expansion in the programme as incurring of huge resources to the tune Rs 400 million per year are involved. However, the federal secretary National Health Services responded that National Steering Committee (NSC) consists of provincial representatives.
The secretary Planning and Development of Punjab stated that there is a need to actively involve the provincial health, planning and development and finance departments as well as private healthcare providers. The Chief Economic Appraisal observed that premium of Rs 1,000 had been finalised after successful bidding while Rs 770 were required to materialise the premium related services.
He pointed out that delivery cost per beneficiary amounting to Rs 770 was very high. He suggested that premium related additional cost must be looked into after successful bidding. He also pointed out that the original project was approved with the nomenclature "Prime Minister National Health Insurance Programme" and inquired from the sponsor of reasons for omitting the word "insurance" from nomenclature of the project.
The secretary National Health Service and Regulation and Co-ordination (NHSR&C) responded that word insurance was removed in order to give the impression that the scheme was interest-free. He further explained that Benazir Income Support Programme scales were required to ensure placement of competent human resource for execution of the project. Minister for Planning, Development and Reforms Ahsan Iqbal suggested that the programme must be run as company on corporate style, which was endorsed by the secretary NHSR&C and who committed that the same would be considered.
He also suggested that a study should be commissioned to survey gaps in the coverage within a period of three months before expansion of the project all over the country. The secretary Ministry of Planning, Development and Reforms responded that Prime Minister National Health Programme (Revised) was submitted at revised cost of Rs 8,179.092 million without Foreign Exchange Component (FEC) for implementation in 34 districts throughout Pakistan.
The project would be executed by Ministry of National Health Services, Regulation and Co-ordination through project management units (PMU) and provincial and regional governments and State Life Insurance of Pakistan in 36 months.
A central management information system and special pay scale on the analogy of Benazir Income Support Programme have been proposed in the revised project. The revision of the project was made due to availability of funds and account of successful bidding at lower rates compared to those anticipated in the original project, he further explained.