PESHAWAR: Significant disparities in salaries and employment benefits for senior executives across Khyber Pakhtunkhwa’s Medical Teaching Institutions (MTIs) have raised questions about the absence of uniform compensation standards in one of the province’s most autonomous public healthcare systems.
An investigation by The News has found that while each MTI operates under its own Board of Governors (BoG), with the authority to determine contractual appointments and remuneration, the resulting pay structures for comparable positions vary considerably from one institution to another.
Official documents available with The News show that the BoG of Hayatabad Medical Complex (HMC), through Agenda Item No. 2 of its 48th meeting held on April 2 this year, approved the appointment of the institution’s Director Finance on a monthly salary of Rs800,000.
Less than two weeks after assuming charge, the director submitted a written request to the BoG chairman seeking the allocation of an official vehicle, a monthly fuel entitlement of 250 litres, and the inclusion of an annual increment clause in his employment contract.
In the letter, dated April 12, the officer argued that the responsibilities attached to the office required extensive official travel and coordination across the hospital and its allied institutions.He stated that the position was comparable to those of other members of the hospital’s senior leadership and requested benefits that, according to him, would ensure parity and consistency with practices followed in his previous assignments.
The letter pointed out that his current contract did not explicitly provide for an annual increment and requested that the board incorporate a performance-linked annual increase, stating that similar provisions had existed in his previous MTI appointments.
Information collected by The News from multiple MTIs indicates that remuneration for Directors Finance differs substantially across institutions despite broadly comparable responsibilities.
According to officials familiar with the respective appointments, the Director Finance at Bacha Khan Medical Complex, Swabi, receives approximately Rs300,000 to Rs400,000 per month, while the corresponding position at Mardan Medical Complex falls within the same range of Rs300,000 to Rs400,000.
Officials said remuneration packages at other MTIs also vary, reflecting the discretion exercised by individual BoGs.The findings have revived the debate over whether the province should introduce benchmark salary guidelines for senior MTI executives while preserving institutional autonomy under the MTI framework.
Former secretary to the BoGs, Kamran Khan, confirmed to The News that the letter requesting the additional facilities was genuine and had been received during his tenure. He said he had processed the communication in his official capacity and placed it before the board for consideration before his contract expired on June 30, 2026.
When contacted, Khyber Pakhtunkhwa Health Secretary Shahidullah Khan, who was recently elected chairman of the MTI Tribunal, described the matter as an issue warranting attention.The MTI model was introduced to grant administrative and financial autonomy to public teaching hospitals through independent BoGs.
While supporters argue that institutional autonomy enables hospitals to recruit skilled professionals on competitive terms, critics maintain that the absence of province-wide benchmarks has resulted in considerable variation in salaries and benefits for similar positions.
Health policy experts say the issue extends beyond a single appointment and reflects the broader challenge of balancing institutional independence with transparency, fiscal responsibility, and public accountability in the management of taxpayer-funded healthcare institutions. This correspondent contacted the Director Finance concerned and the chairman of the BoG for comment. Their responses were not available by the time this report was filed.
