PESHAWAR: The long delay in appointments to top positions in the ofHces of the provincial director general (health services), including district health ofñcers, is taking a toll on patient care in Khyber Pakhtunkhwa, the relevant officials insist.

The officials told Dawn that the post of director-general health services, which by the virtue ofthe designation was the chief technical adviser to the provincial government on healthcare, had been lying vacant for around one month.

They said the DG was the top implementer of the government`s policies at the health secretariat for the benefit of patients.

The officials said a summary for the promotion of senior management cadre doctors recently promoted from grade 19 to 20, DHOs, ADHOs, medical superintendents etc., was rejected by the establishment department thrice on the plea that some general cadre doctors had been recommended for administrative positions against the relevant rules.

They said a total of 46 doctors had been awaiting appointments for one to six months, while the retirement of many of those recently promoted to BPS20 were at hand.

The officials said the health department had explained the position regarding the need for the desired postings insisting until there was a DG, the health department couldn`t execute its plans.

They said the department was short of administrative cadre personnel.

The officials said the people with proven competen-cies had been selected ignoring the fact that they`re about to reach the age of superannuation to retire.

They said the Swat DHO, who was retiring in the next couple of months, could still be the best choice for the 1(ey post due to good reputation in the department, but his appointment was unlikely to take place anytime soon.

The officials said the 26 doctors promoted in August by the provincial selection board were also among those awaiting appointments.

Among them, 20 are to be promoted to BPS-19 and six to BPS-20.

The officials said the objections raised by the executive director were genuine but the department didn`t have the number of some administrative doctors to be posted in the prescribed grade.

They said the government recently changed the grade of the post of the medical superintendent of the Naseerullah Babar Teaching Hospital from BPS-20 to BPS-19 but the relevant person was waiting for his positing.

The officials said few appointments were of routine nature but the vacant positions in administrative cadre had been adversely affecting patient care.

They said the post of DG (health services), who was in the driving seat of the health department and put the government`s policies and decisions to action through administrative staff members, fell vacant on Oct 14 and therefore, important decisions couldn`t be taken.

The officials said the delay also led to the manipulation as the doctors who came to know about their transfer from favourite positions made the utmost effort to stop the move.

They said the doctors maneuvered and got delayed the health department`s summaries on their transfer.

The ofñcials said the observations were of microlevel and shouldn`t be the reason for the rejection of summaries but under the Civil Servant Act, the powers to make postings and transfers in light of the rules was the job of the ED.

They added that theadministrative decisions regarding procurement of medical supplies and equipment, and hiring of staff members had suffered at both provincial and district levels in the absence of permanent DG (health services), DHOs and hospital chiefs.

On Friday, Chief Minister Pervez Khattak had declared malnourishment in children under the age of five years an emergency.

However, the officials felt the implementation of necessary actions to address the problem as well as the other government directives on better patient care required a full-fle dge d administrative structure.