The federal government has decided, in principle, to hand over four hospitals to Sindh and Punjab governments due to acute shortage of financial resources. This decision was taken by the cabinet in its meeting held on July 2, 2019 with Prime Minister, Imran Khan in the chair.
Ministry of National Health and Services Regulation Division informed the Cabinet that the Supreme Court of Pakistan in its judgment of January 17, 2019 in civil appeal number 125-KL to 131-A and CM appeal number 1254-A and number 8973 or 2018 and civil petition number 23121 of 2018, declared the transfer of the following institutions/departments to the provincial government as unconstitutional and without lawful authority: (i) Sheikh Zayed Postgraduate Medical Institute, Lahore; (ii) Jinnah Postgraduate Medical Centre, Karachi, (JPMC); (iii) National Institute of Cardiovascular Diseases, Karachi; and (iv) National Institute of Child Health, Karachi(NICH) .
It was directed by the Supreme Court that within 90 days of the judgment, federal and provincial governments will complete necessary steps relating to return of the institutions from respective provincial governments to federation and to restore them to their original status.
In this context, the federal cabinet in its meeting held on May 28, 2019 considered a summary on this issue and took the following decisions: (i) Minister for Law and Justice to approach the Supreme Court to seek permission to divert the requisite financial resources from provinces to Federal Government for effective management and smooth running of these institutions, and a report will be presented within two weeks; and (ii) a committee was constituted under the Special Assistant to the Prime Minister on Health to the Prime Minister on Health, comprising Secretaries of Finance, National Health Services, Regulations' & Coordination and Law Division. The committee will negotiate with the provincial governments and work out an efficient mechanism for management of these hospitals.
The committee held its meeting on June 2, 2019 and suggested the following recommendations: (i) federal government can have management contract with provincial governments on mutually agreed terms encompassing all financial and governance related aspects ensuring efficiency, accountability and transparency; (ii) Ministry of NHSR&C in consultation with Law Division and Attorney General of Pakistan may file an application before the Supreme Court seeking more time, approximately six months, to fully take over these hospitals from the provinces. The notifications earlier issued for taking over these hospitals will indicate the positive intent of the Federal Government in implementing the judgment of Supreme Court; (iii) the Federal Government, may also, through the office of Attorney General, get the review applications filed by both the provinces and fixed for hearing to determine the finality of the case giving provinces another chance to argue their case before the Supreme Court. If the review is decided, whatever way, it will help considerably bring down the political temperature on the issue; and ( iv) Ministry of NHSR&C will engage with both the provincial governments to assess the budget requirement for each of these four hospitals both on current and development side .
During discussion, it was pointed out that federal government is facing acute shortage of resources and may not have enough fiscal space to run these hospitals. Hence it is not advisable to keep the control of these units without sufficient budgetary cover, which in the current scenario is not possible.
After detailed discussion, the federal cabinet decided, in principle, to hand over the four hospitals to respective provincial governments with their consent. A report in this regard, with full justification including current financial constraints for the Federal Government, will be submitted by NHSR&C before the Supreme Court in order to avoid any adverse order of the court.