Peshawar [Pakistan], May 15 : The administrative cadre established in Khyber Pakhtunkhwa's health department to manage key managerial positions is rapidly losing relevance due to the absence of fresh inductions over the past several years, according to officials familiar with the matter.
The cadre, introduced in 2009, was originally designed to place doctors trained in health administration in top administrative roles such as district health officers, medical superintendents, and directors, as reported by Dawn.
According to Dawn, the health department consists of three groups: general cadre, specialist cadre, and management cadre. While general and specialist doctors are primarily responsible for patient care, the management cadre was specifically created to oversee administrative and financial affairs within hospitals and health institutions.
Policy changes introduced by a previous provincial government allowed general cadre doctors to occupy administrative posts, severely weakening the position of trained management professionals.
As a result, many qualified doctors holding degrees in health administration, including foreign qualifications, remain sidelined while less experienced officials handle critical posts. Officials claimed that several junior doctors are currently serving in senior positions such as DHO, regional director, deputy medical superintendent, and director-level offices, despite lacking specialised administrative training. These posts are considered highly significant because they involve coordination with international organisations, including the World Health Organization and UNICEF.
The report further stated that many administrative cadre doctors are being declared officers on special duty (OSD), leaving them with reduced salaries and suspended allowances until reassignment. Sources stated that the growing trend of outsourcing public hospitals is accelerating the decline of the cadre. Around 25 hospitals have reportedly already been outsourced, while dozens more are expected to follow, as highlighted by Dawn.
Medical teaching institutions are also contributing to the problem because administrative cadre doctors, being civil servants, are required to resign before joining such institutions, which largely prefer contractual appointments from the private market, as reported by Dawn.
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