PESHAWAR: Various medical teaching institutions (MTIs) in Khyber Pakhtunkhwa have been applying different formulas for distribution of the income generated through Sehat Card Plus unlike district headquarters hospitals, which follow the guidelines approved by the provincial cabinet.
All district headquarters (DHQs) hospitals across the province have been following the “fund retention and utilisation formula” for distribution and utilisation of funds generated through the free health initiative programme of the provincial government approved by the cabinet in 2020. However, MTIs are not applying the same, causing issues for patients.
“In many MTIs, consultants are giving long waiting dates to patients seeking medical services on Sehat Card Plus (SCP) because of their less share in the income. They accord priority to those patients, who want to get treatment in institutional based practice (IBP) due to sizeable income,” senior doctors told this scribe.
According to them, MTIs are run by their boards of governors that have devised different formulas for share in distribution of the income generated through SCP, though health department has devised a formula for all public sector hospitals.
DHQ hospitals have uniform govt-approved mechanism for the purpose
“Recently, some consultants have resigned against this discrimination as they want the government-approved strategy. Those, who resigned against lesser share in the income, readily got jobs in private hospitals. They get more salary in private hospitals than that of MTIs from which they have resigned,” said doctors.
They said that MTI-Policy Board, which was required to ensure uniform policy in all 11 MTIs, should implement the formula on pattern of DHQ hospitals to remove unrest among consultants.
The approved formula says that 25 per cent of the SCP’s income should be used for improvement in quality of services including minor repairs and maintenance of respective health facilities while 20 per cent will go to consumables and 30 per cent to other doctors including surgeons, physicians, anaesthetists, pathologists, radiologists and medical officers etc involved in provision of services to patients.
According to it, 15 per cent of the income will be given to nursing and paramedical staff and 10 per cent to administrative and auxiliary staff. This formula is in place in DHQ hospitals but not in MTIs, which generate more income from the free health insurance scheme.
The government has been spending Rs41 billion on the free medical treatment of more than 10.8 million families (34 million people) of Khyber Pakhtunkhwa at 172 empanelled hospitals. The number of designated hospital is 1,000 nationwide in all provinces and regions where residents of KP possessing national identity cards are entitled to cashless diagnostic and treatment services.
Each family of KP is eligible to get services up to Rs1 million per year under the scheme.
The programme, started in 2015 with coverage of small number of population in four districts, was gradually extended to the entire province. The government enhanced budget for the initiative to Rs41 billion in 2026-27 up from Rs35 billion in the last financial year with a view to ensure fast-track services to patients. However, officials said that patients were opting for private hospitals where they got rapid services on SCP.
Consultants and other staff want MTIs to adopt the formula so that they can get share in SCP’s income at par with that of DHQ hospitals and patients could benefit properly from the programme. “Especially during nights, MTIs don’t have proper arrangements to facilitate patients on SCP because of the staff’s concern about smaller amount of share,” said doctors.
They said that all the MTIs wanted to show to the policy board that their revenue had been increasing, so they cut the share of doctors and staff and as a result patients suffered. “In some hospitals, patients are getting dates for surgeries in 2027 to 2029 but they get the same services in IBP, the same day because they pay for the procedures there,” they said.
Prof Nausherwan Burki, the chairman of Policy Board, told Dawn that all MTIs were re-informed of a uniform formula. According to him, Policy Board will ensure that people benefit from the free healthcare scheme.
Published in Dawn, September 11th, 2026
