Ahmad Ali
Its almost been a month that fourteen newborns died in the PIMS fire in Islamabad. The cause was known within hours: no alarm, no sprinklers, blocked exits, and oxygen feeding the blaze. The federal government responded immediately with suspensions and orders for criminal proceedings.
It was not justice, but it was accountability in motion. Preserve the record. Fix responsibility. Set a deadline. Tell the public.
Khyber Pakhtunkhwa now needs to apply that same test to its own hospitals. Because our files are already full of warnings.
We do not lack audits. We lack follow-up.
In December 2020, seven patients died at Khyber Teaching Hospital when oxygen failed. The Board of Governors resigned after an inquiry. It should have been a turning point for the whole province. It wasn’t.
At Lady Reading Hospital, the Auditor General’s 2020-21 report reportedly flagged Rs3.3 billion in objections — on equipment, construction, and the hiring of 630 people. The hospital said it would reply to the DAC. The public is still waiting to see what the DAC decided.
The Rs4.44 billion medicine procurement scandal is worse. Departmental and anti-corruption inquiries in 2024 found ignored tenders and estimated a loss of Rs1.9 billion. Responsibility was fixed on 16 officials. The findings were contested. So in August 2026, the Chief Minister ordered a new inquiry because the first one was flawed. Two years later, we are investigating the investigation.
Two recent internal KTH reports explain the cost of inaction. A 2025 lab audit found 135,332 more tests were done between Jan 2022 and July 2025 than were invoiced. Most entries were made by staff, not doctors. The committee could not assign blame because logs were missing. Yet lab revenue had doubled in two months. The solution is obvious: a forensic audit, barcoding, and a system no one can switch off.
An A&E pharmacy report was starker. On Sept 19, 2025, the hospital did a local purchase of Rs7 million for 11,000 IV cannulas — a “three-day need.” A week later, with controls, it bought 600 for Rs402,000. Tender price for a cannula: Rs78.90. Local purchase price: Rs620. The report blamed procedural collapse and Rs82.21 million in unpaid vendor bills that forced emergency buying. Scandals don’t start at the cash counter. They start when finance fails and creates the emergency.
The clearest test is Dera Ismail Khan.
Arshad Ustrana chaired the MTI Board of Governors there. In June 2021 the government dissolved the board over allegations of illegal appointments and tenders. NAB took the records.
On June 20, 2024, NAB wrote to the Chief Secretary. It said its inquiry established 303 illegal senior appointments made without quorum, 53 excess Class IV hires, and 20 more made without advertisement. NAB closed its case and asked the Health Department to take corrective action within two months.
The letter does not convict Mr Ustrana personally. But the irregularities happened under board meetings he chaired. So the questions are simple: What action was taken? Which appointments were cancelled? Was money recovered?
That question matters more because Mr Ustrana continues to hold public office. A KPEZDMC Social Media posts shows him chairing HR Committee meeting — right after NAB’s deadline expired.
Rumours are that Mr. Arshad Ustrana is protected by an Additional Secretary of the department on the instructions of the son of the sitting Advisor to the CM. Whether true or not, the government must answer it by publishing the file. Silence only feeds speculation.
The MTI system is under strain everywhere. In July 2026, ACE opened an inquiry into HMC. In June, the Health Department itself wrote about irregular MTI appointments. In March, 24 hospitals were asked to explain Rs1.355 billion in unauthorized spending.
Autonomy cannot mean immunity.
Before the 30th day after PIMS, the KP government should publish a Hospital Accountability Register. For every audit, NAB referral, and inquiry since 2021, it must state: the allegation, the finding, the officer responsible, the deadline, and the action taken.
KTH needs an external forensic audit. Every MTI must publish board attendance, quorum, and how senior appointments are made. Emergency purchases must trigger automatic price alerts.
Inquiries find facts. Disciplinary forums punish. Courts convict. When we mix them, the guilty hide and the innocent suffer.
Hospital disasters start long before the smoke. They start when a warning is filed and forgotten. KP has twenty days to prove that the warnings in its own files will finally lead to action.
