PESHAWAR: The Khyber Pakhtunkhwa government continues to increase budget of medical teaching institutions without conducting external audit of their revenues and expenditures, according to health experts.

They say that the upcoming fiscal is no exception as 22 per cent increase has been announced in the budgetary allocations of medical teaching institutions (MTIs).

Experts in healthcare financing told Dawn that besides financial boost in their budget, there was no audit of MTIs regarding their revenues generated through Sehat Card Plus (SCP), institution-based practice (IBP) and users’ charges.

The allocation of funds for provision of medicines to 2,600 health facilities, being operated by health department, is Rs14.3 billion showing an increase of 20.2 per cent from Rs11.9 billion in 2025-26.

District headquarters and primary health facilities struggling to provide medicines to patients

Lady Reading Hospital, Khyber Teaching Hospital, Hayatabad Medical Complex and Peshawar Institute of Cardiology in Peshawar and in MTIs in Mardan, Dera Ismail Khan, Bannu and Swabi continue to generate revenue from SCP and IBP but the government is yet to carry out their audit like other departments and hospitals to check where that amount is spent.

“Non-MTIs are subjected to regular audit by the government,” experts said.

The provincial government enforced Medical Teaching Institutions Reforms Act in 2025 under which hospitals and their affiliated medical and dental colleges were given administrative and financial autonomy and governed through respective Board of Governors (BoG). The members of BoG are selected from private sector.

“BoGs take all administrative and financial decisions of MTIs with no control of health or finance departments,” said experts.

Since 2016, the government has spent Rs150 billion on free treatment of patients under SCP scheme of which about Rs50 billion has gone to MTIs. Only in 2025-26, the government spent Rs35 billion on SCP patients with over Rs15 billion going to MTIs. “Instead of carrying out financial accountability, the government continues to increase budget of MTIs,” they said.

For the year 2026-27, fund allocation for MTIs is Rs80 billion, up from Rs65.7 billion of last year. It is the largest single-line budget to be used by the respective MTIs as per their needs without government involvement.

“Showing an increase of 21.8 per cent, there are no financial statements to suggest volume of their own receipts from SCP, IBP and users’ charges,” said experts.

During the past two years, Policy Board, an oversight body for all MTIs, has thwarted government’s attempts to conduct their audit, arguing that they had autonomous managements aiming to improve tertiary healthcare facilities and had their own internal audit mechanism.

The allocation for SCP has also been increased from Rs35 billion in 2025-26 to Rs46.7 billion in 2026-27 and indicators show that half of the amount will go MTIs. There has been an increase of 33.4 per cent in SCP’s allocation than previous financial year.

Officials in health department said that SCP was very good initiative appreciated by all international organisations as it ensured universal health coverage and enabled people to seek healthcare easily and without expenditure from their pockets.

“However, it is a fact that doctors and other staff take regular salaries from government along with revenues generated through SCP and IBP then why the budget of MTIs continues to rise,” they questioned.

On the other hand, non-MTIs were struggling to provide medicines to patients at district headquarters and primary health facilities, they said.

Health experts pointed out that substantial enhancement in SCP budget underscored government’s resolve to extend universal health coverage to vulnerable segments of population but at the same time MTIs should be held accountable like other hospitals.

“MTIs have actually completed external audits. I am awaiting results,” the chairman of MTI-Policy Board, Dr Nausherwan Burki told Dawn.

Published in Dawn, June 24th, 2026