By. Dr, Abdul Razak Shaikh

Doctors in Sindh always getting benefit from PPP government for their issues but some time they feel embracement in many problems. On 6th September 2018 , Health Department Government of Sindh issued the Press release by the Directive of Honourable Minister Health Dr. Azra Pecuho to conduct the competency test for BPS-19 and 20 qualifying for the post of Director General Health (DG) , Medical Superintendent (MS) of tertiary care , Major Hospitals, civil surgeons and District Health Officers (DHO) . The Doctors community feeling not well for this tact’s using to appear in the test. The Doctors of General Cader of BPS1-9 and BPS-20 were advised to register themselves before the Dow University for appearing in the test. Later on, another letter was issued by the Health department Dated 22nd October 2018 to Vice Chancellor Dow University asking him for conducting the test.
On 26th October 2018 again one another Circular issued that all the secretariat Side officers of cader and non-cadre are also eligible to appear in the test for these posts of Doctors Community. Supreme Court of Pakistan in Petition No. 89/2011 has summarized the post of cader and non-cadre than why Health department disobeys the Hon. Supreme court of Pakistan.
All the post of Director General Health, Medical Superintendent, and District Health Officers are purely related to doctors and that is the technical job. How possible that non-technical person of the Secretarial group will be DHO or MS. On the pressure from doctor’s community, the authority has withdrawn the letter regarding the appearance of secretariat group.
Presently all above posts are occupied by doctors of BPS-20/19, having more than 30 years of service experience and promoted after complete Annual Confidential Reports (ACRs) make them eligible for next grade and posting. When any Doctor reaching in BPS-20 after complete all the formalities of ACRs and having no any disciplinary action against him that is eligible for promotion under the Chair of Chief Minister Sindh of Provincial Board I and for BPS-19 under the Chair of Chief Secretary Sindh Provincial board II. There are no any criteria of test for posting on the Administrative job in any department, whereas we have very less number of Doctors in BPS-20 and ratio of retirement is more. Seniority must be considered and Management cader may be created. In Sindh Health department lot of doctors are highly qualified to have a postgraduate qualification in Management cader. These were trained by both public sectors through their preventive programs funds or own expenses in the different institution of Pakistan. Presently these qualified Doctors are not posted in right places due to the nonexistence of management cadre in the health department. These qualified doctors working with donor agencies or posted on non-management posts. Whereas doctors having no management degrees are posted on decision making positions and utilizing resources ineffectively.
The National Health Policy 2001 and National Health Conference 2004 recommended for removing professional and Managerial deficiencies in the District Health System. The main deficiencies have been identified as an ineffective of District Health Officer due to lack of essential qualification and Management skills.

USAID-JSI health experts have developed a document in consultation with the Department of Health for the creation of Health management Cadre during 2014
Sindh Health Sector Strategy 2012 – 2020 has also recommended developing a trained Administrative Cadre to improve the efficiency of Health Administration at District and Provincial level.
In the light of the Situation, the effectiveness of our programs is not up to mark and the target could not achieve. Quality of health services is poor. Health department Sindh has to improve their performance by effective management of resources and grasp the available opportunities in the health sector. The health department has to recognize their management skill and make a separate management cadre of those positions which are related to management of health services. This management cadre is properly working in other provinces to improve health services for poor community living in urban and rural areas.
Now it is need of time for our province Sindh that we should get the benefit of our postgraduate qualified DPH, MPH, MSPH, MBA, MAS, Msc, persons after creating Management cadre.
Doctors are socialized to respect and reproduce hierarchy from the start of medical college, where they learn not to challenge authority but it will be un- justification if they were asked to appear in the test for occupying the Administrative post of Health delivery system. Doctor’s community in Sindh is intact and they will resist the move to appear in the test.

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