LARKANA: The Secretary Health Department, Government of Sindh, Dr Muhammad Usman Chachar, has expressed his grave concern on overall lack of management and control, in a letter sent to all District Officers (DHOs) and Medical Superintendents (MSs) of the province. He said in the letter that “irony is that even the matters which do not have financial implications such as adopting simple measures like cleanliness of premises (proper garbage disposal / placement of dustbins), cleanliness and conduct of staff (clothing, uniform, identity badges or nameplates, dealing with patients), process and procedures (waiting queue lines, token numbering for OPD patients, storage stock register with transport disbursement of medicines, sign / direction boards) were seen missing during his visits to various health facilities recently. Moreover, simple repairs, change of linen were not undertaken timely, he added.” Chachar states in his letter, “Most importantly the performance of duties by staff, their timely arrival, and attendance neglected. Any Absenteeism, absconding from government duties of any staff is to be checked by the MS or head of the health facility and personally ensured by him/her. In case anyone is not attending duties or absconding from duty the same is to be proceeded against/reported to the Health Department and salaries stopped otherwise MS/Head of Health Facilities concerned will be deemed to be in connivance with such absconders who do not perform their duties and only draws government salaries”. It was also noted, the letter added, that “local budget is not properly spent and local purchase budget is spent arbitrarily. Instead of necessary items for health service delivery, maintenance etc. unnecessary expenditure is made. This practice should be stopped and expenditure made as per priority for improving health service delivery. Due diligence is to be exercised otherwise MS/Incharge/Health will be held personally responsible”. The letter further added that “all MSs/Incharge/Head of the Health Facilities are required to ensure strict necessary action on above lines and the supervising officers from Director General Health Services Sindh and Directorates regularly visit and monitor health facilities within their domain who will also be held accountable on the same account”. Copies of this letter have also been sent to all Commissioners of the province, DG Health, Director, Health Services of all the division including Karachi, Hyderabad, Mirpurkhas, Nawabshah, Larkana and Sukkur, quoting the letter of SGA&CD dated: 09th July 2018. In this connection, it is reliably learnt that over 150 employees are absent from their duties in Chandka Medical College Hospital who are enjoying the support of accounts office as they have never stopped their monthly salaries despite knowledge. Mismanagement is at its peak in this largest 1500-bed capacity Teaching Hospital of Rural Sindh as lower grade officials were promoted previously in sheer violation of apex court orders who continue to work on lucrative posts for which they were never appointed as their cadres have been changed illegally. Provincial Health Department must enforce the directives of the Supreme Court for good governance, and ensure meritocracy, otherwise poor will continue to suffer for no fault of theirs at all. Published in Daily Times, July 14th 2018.