Friday, September 18, 2009

What the Previous Minister of Health Can Do?

The minister of health of Kurdistan Regional Government (KRG), complained in a recent media appearance in Hawlati newspaper of "corruption" and "Limits on his Power". He attributed his unwillingness to continue serving as the Minister of Health in the new KRG cabinet to those two main reasons.
The minister hit the bull's eyes when he identified corruption as one of the main ailments that is crippling our health care system in Kurdistan. This problem is rooted into the minute structures of public health care services. During my one year tenure, directing a health care center in a suburb of Erbil City, only 20% of our employees were actually working in the center. The remaining was just appearing to get their salaries or their wages were taken to their homes for them. Most of those "Masked Employees" were family members of prominent governmental officials who the administration staff at my center were seeking favor to them by employing their family members without necessary the latter having anything to do with health care. This is just one example of the crippling effects of corruption on the financing, quality and administration of the health care services in the KRG. Working as a Minister of Health, Dr. Abdulrahman needs to stay a fervent advocate to fight corruption in the health care sector even if after he leaves the Ministry. He doesn’t necessary has to serve in a higher position, as many are proposing for him, to be able to advocate on behalf of the Kurdish people, on the contrary, he may even be more effective, working at a grass root level given his experience in the health care system. However, this proposed move in part of the Minister would be unthinkable given the trend of the overall political system in the KRG, where the system is modified to accommodate the desires of its bureaucrats. The opposite should be done; the official of KRG should accommodate the needs and necessities of the system.
As right as the Minister was with regard to diagnosing corruption, which shouldn’t have taken him so long to get, he was wrong with the limits on his power as a reason for him to quit. The Minister should understand that we are a Federal Region, and one of the main characteristics of Federalism is decentralization. When The Minister refers to limits on his power, he obviously means the Directorates of Health in Erbil and Dohuk that are under the political control of Kurdistan Democratic Party, the rival of his own party; Patriotic Union of Kurdistan (PUK). Regardless of political rivalry and its influence on health care services, the ability of the Directorates of Health to gain some independence from the power of the Ministry of Health could serve well the prospect of decentralization in the KRG.
When it comes to routine administrative procedures, the Directorates of health in the KRG should be given more autonomy and greater power. The Ministry of Health doesn’t need to get involved in every detail of procedural and administrative issues that can be easily implemented by the directorates. This would help achieve two goals; the Ministry of Health will be more dedicated to health promotion and disease prevention at the regional level, and the directorates will be more responsive to the needs of their respective governorates.
While it is a personal choice to quit or continue working in a governmental position, we would like to see the Minister continue serving possibly in a lower position, may be the director of one of the directorates of health. This would provide him a better opportunity to apply the knowledge and skills he acquired during his tenure in the Ministry of Health.

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