KATHMANDU, April 6: Health Minister Gagan Thapa, who assumed  office on August 26, 2016, has succeeded in bringing about changes in policy-making but has yet to implement all these changes in full and ensure efficient service delivery to the public.

To date, Thapa has worked on formulating more than five dozens  policies, rules and regulations and guidelines as well as taking various decisions, according to the Ministry of Health (MoH). “He has done better than other health ministers when it comes to initiatives  for  improving the health sector,” said  MoH officials.

The initiatives include regulations to limit the funds provided for the treatment of VVIPs to under Rs 1.5 million, free dialysis and kidney transplants for the needy, OPD services from 9AM to 5 PM at all government hospitals, bringing of unregistered clinics into the formal system, rules requiring government health workers to take permission before working in private institutions, directives on the running of ambulances and laboratories, additional facilities for health workers, the Medical Council Act and Health Insurance Act, legislation on quality assurance, regulations on the use and sale of tobacco and alcohol, hiring of doctors from the private sector for working in the districts, and providing 10 percent free services at private hospitals.

However,  some of the attempts by Minister Thapa to reform the health sector remain challenging. “Many of them were easily implemented, but some are a bit more difficult,” he said adding. “I had a bitter experience in my attempts to purchase the services of health workers from the private sector.”
Shortage of health workers, lack of infrastructure and facilities at hospitals and proper management of human resources are said to be the major hurdles. 

More than 20,000 health staff positions are still vacant, over 1,800 health posts are without proper buildings, about three dozens hospitals are without the numbers of beds sanctioned, and many health facilities are not delivering the basic services.

I have plans to hire 3,300 doctors and 800 MDGPs, procure hospital equipment worth Rs 40 billion and invest an additional Rs 14 billion annually for developing this sector,” Thapa said. “I am working under a master plan to achieve these goals in seven years.”

Lack of policy coherence, planning and vision and failure in implementation of the plans and monitoring were major lapses, said Thapa. 

 
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