Pakistan Bureau of Statistics National Health Accounts
61
Table 35: Federal autonomous bodies/corporations and their employees 2011-12 by Division
S.No
Division
Number
Employees
1
Cabinet
15
19,995
2
Commerce
7
5,241
3
Communications
1
1,212
4
Culture
4
373
5
Defence
2
28,306
6
Defence Production
2
2,784
7
Education
42
10,342
8
Environment
2
176
9
Establishment
8
1,872
10
Finance
10
25,267
11
Food, Agriculture & Livestock
4
4,898
12
Foreign Affairs
3
124
13
Health
11
2,438
14
Housing & Works
3
575
15
Industries Production and Special Initiatives
14
25,599
16
Information & Broadcasting
5
8,264
17
Information Technology and Telecommunications
8
6,094
18
Interior
2
11,064
19
Kashmir Affairs & Northern Areas
1
650
20
Labour & Manpower
3
1,208
21
Law, Justice & Parliamentary Affairs
1
58
22
Livestock & Dairy Development
1
60
23
Minorities Affairs
1
1,059
24
Overseas Pakistanis
1
1,718
25
Petroleum & Natural Resources
10
31,339
26
Planning and Development
1
188
27
Population Welfare
2
100
28
Privatization & Investment
1
84
29
Port & Shipping
6
7,758
30
Religious Affairs, Zakat & Ushar
1
104
31
Science & Technology
18
10,438
32
Sports
1
373
33
States & Frontier Regions
1
196
34
Social Welfare & Special Education
1
1,194
35
Tourism
5
416
36
Textile Industry
2
443
37
Water & Power
6
156,994
38
Prime Minister Secretariat (Public)
1
281
Total
207 369,285 Source: Pakistan Public Administration & Research Centre, Establishment Division
Pakistan Bureau of Statistics National Health Accounts
62
Table 36: Provincial autonomous bodies/corporations
and their employees 2011-12
Province
Number
Employees
Punjab
67
33,576
Sindh
40
46,615
KP
45
19,724
Baluchistan
18
8,773
Total
170
108,688
Source: Respective Provincial Departments/Service & General Administration Departments
5.5
Main findings for federal autonomous bodies/corporations
Census of ABs/C pertaining to federal or provincial governments of Pakistan was conducted for the reference period 2011-12. The purpose of the census was to collect data on the remuneration of health expenditures of the employees of the ABs/C working under the control of the federal government of Paki- stan. Out of 207 federal ABs/C, 92 have provided data through mail which is almost 45% of the total federal ABs/C and covered approximately 82% of employees of the federal ABs/C. It was observed that most of the ABs/C are providing health services to their employees through reimbursement of medical bills. Table 37 gives an overview of the number of ABs/C and their health care service mechanism. Table 37: Federal autonomous bodies/corporations 2011-12 by mechanism of health care provision Mechanism Number % Reimbursement only 53 25.60 Medical Allowance/No Reimbursement 7 3.38 Health Insurance only 3 1.45 Reimbursement & Health Insurance 7 3.38 Reimbursement & Own Health Care Facilities 22 10.63 Non-Response 115 55.56 Total 207 100.00 82/92 reporting federal ABs/C are providing health services to their employees through the reim- bursement of medical bills. The health expenditures incurred by their employees during 2009-2012 were Rs. 3,627 million in 2009-10, Rs.3,977 million in 2010-11 and Rs.4,596 million in 2011-12. 3/92 reporting ABs/C are providing health services to their employees through health insurance only. Virtual University (NPO) paid Rupees 4.5 million, National Trust for Population Welfare, Islamabad paid Rs.0.3 million and COMSAT Institute of Information Technology paid Rs. 24.4 million. Seven out of the 92 reporting ABs/Care providing health services to their employees by co-mech- anism (reimbursement & health insurance). Table 38 gives an overview of the health expenditures incurred by them.
Pakistan Bureau of Statistics National Health Accounts
63
Table 38: Expenditures of federal autonomous bodies/corporations on health via
combination of reimbursement & health insurance 2011-12 (Million Rs.)
Autonomous Body Health Insurance Reimbursement
National Centre of Excellence in Analytical Chemistry, University of
Sindh, Jamshoro 0.018 0.195
National Institute of Historical and Cultural Research,
Centre of Excellence, 0.170 0.300
Pakistan Study Centre, University of Sindh, Jamshoro 0.049 0.386
Pakistan Security Printing Corporation (PSPC) 0.005 0.011
Pakistan Gems and Jewelry Development Company, Karachi 0.476 1.114
Government Holdings (Pvt.) Limited 0.873 0.194
National University of Science & Technology (NUST) 5.167 6.593
Total 6.76 8.79
Twenty-two out of the 92 reporting ABs/ Care providing health services to their employees and
members of their families by two mechanisms: own health care facilities as well as reimbursement of med-
ical bills. These ABs/C are running 28 hospitals/medical centers and 1 34 dispensaries. Out of 28 hospi-
tals/medical centers WAPDA owns 12 hospitals; Pakistan Steel Mills and Capital Development Authority
each have one hospital and Pakistan Mineral Development Corporation own s two hospitals . Pakistan In-
ternational Airlines (PIA) has 5; Oil & Gas Developme nt Company Ltd (OGDCL) has 3 and Civil Aviation
Authority has 2 medical centers for their employees etc. Similarly, out of 163 dispensaries, OGDCL owns
21, WAPDA 30, PIA 13, and Pakistan Steel Mills 11 dispensaries.
The actual data on expenditures on the prescribed questionnaire in respect of WAPDA and Capital
Development Authority (CDA) have been received. The expenditures of the non -responding ABs/C hospi-
tals, medical centers and dispensaries have been estimated on the basis of factor s (health expenditures
per employee incurred by the hospital (Rs. 5,113) and dispensary (Rs.3,918) obtained from the actual data
received from WAPDA and CDA.
The lump sum health e xpenditures of ABs/C with this co -mechanism in the year 20 11-12 were
Rs. 2,887 million for their own healthcare facilities and Rs.2,674 million for their reimbursements. Overall ,
the expenditure totals to Rs.5,561 million.
As mentioned earlier, 82/92 federal ABs/C reported that they are providing health expenditures
through reimburseme nt of medical charges . Their health expenditure per capita of employee (in total
284,009) has been calculated (Rs16,182) in order to raise the number of health expenditures for 115 non-
responding federal ABs/C having 67,683 employees. This results in Rs.1,095 million assuming that they do
not employ other mechanisms than reimbursement. Table 39 summarizes the above results by mechanism.
Pakistan Bureau of Statistics National Health Accounts
64
Table 39: Expenditures of federal autonomous bodies/corporations on health 2011-12 by mechanism Mechanism Number Health Expenditures in million Rs. Reimbursement only 53 1,913 Health insurance only 3 29 Reimbursement & Health insurance 7 15 Reimbursement & Own health care facilities 22 5,562 Non-response (estimated) 115 1,095 Medical Allowance/No Reimbursement 7
Total 207 8,614 5.6 Provincial autonomous bodies/corporations In Census of ABs/C 2011-12,170 bodies working under the administrative jurisdiction of federal and provincial governments. 67 of them were under the control of Punjab, 40 were located in Sindh, 45 in KP and 18 in Baluchistan. The response rates were 66% for Punjab, 40% for Sindh, 42% for KP and 56% for Baluchistan. In Punjab there are 67 bodies and corporations working under the control of Punjab govern- ment, of which 44 have provided data/information which is 66% of the total Punjab ABs/C covering approximately 63% of the employees. The actual reported data in respect of 44/67 ABs/C has been analysed and observed that 22 out of 44 ABs/C are providing health services to their employees through the method of re-imburse- ment of medical charges, 12 out of 44 are providing medical allowance to their employees and one out of 44 ABs/C is providing health services to their employees via reimbursement and health insur- ance. While nine out of 44 ABs/C are providing health services to their employees by co-mechanism (Via reimbursement and own health care facility). Table 40 gives an overview of health expenditures incurred by the employees of 22/67 ABs/C via reimbursement in the period 2009-2012. It also includes the respective figures for the other provinces. Table 40: Expenditures of provincial autonomous bodies/corporations on health via reimbursement of medical charges 2009-10 until 2011-12 (Million Rs.) Province AB / C (reporting) 2009-10 2010-11 2011-12 Punjab 44 27,270 23,335 24,212 Sindh 16 36,911 44,397 44,031 KP 19 20,700 23,394 26,054 Baluchistan 10 8,368 14,289 15,401 Total 89 93,249 105,415 109,698
Pakistan Bureau of Statistics National Health Accounts
65
The per employee health expenditures (Rs. 1,829) based on the reimbursement of medical charges bills has been calculated and raised for the 23 non responding ABs/C employees. Estimation procedure of the health expenditures of the non-responding ABs/C is shown in Table 41. The table includes the respec- tive figures for the other provinces. Table 41: Estimation of health expenditures of the non-responding autonomous bodies/corporations via reimbursement method 2011-12 Province Response (Reimbursement) Non-response Per Capita expenditures (in Rs.) Expendi- tures (In million Rs.)
AB / Cs
Employees
AB / Cs
Employees
Punjab
22
13,236
23
20,340
1,829
61.419
Sindh
6
6,108
23
37,190
7,209
312.123
KP
15
7,670
27
12,054
3,397
67.002
Baluchistan
7
6,453
07
2,320
2,387
20.938
Total
50
33,467
80
71,904
14,822
461.482
According to reported data, one of the Punjab ABs/C (Punjab Education Foundation) is providing
health insurance to their employees in addition to reimbursement of medical bills facility and its health
expenditures via health insurance is Rs.6.997 million. In Sindh, three bodies namely Karachi Fisheries
Harbor Authority, Liaquat University of Medical and Health Sciences, Jamshoro and Dow University of
Health Sciences, Karachi are providing healthcare services to their employees via health insurance only.
The total health expenditures reported by these three bodies through health insurance only are Rs.64 mil-
lion.
Besides the facility of reimbursement of medical bills, 9/44 ABs/C in Punjab are providing health
services to their employees through their own health care facilities as well. For example, University of Pun-
jab has 5 dispensaries, University of Agriculture, Faisalabad and Islamia University, Bahawalpur are run-
ning 2 dispensaries each for the health care of their employees/students etc. The expenditures of the ABs/C
dispensaries have been estimated on the basis of factor (health expenditures per employee incurred by the
dispensary is Rs. 4,176). So, the estimated health expenditures of the Punjab ABs/C own healthcare facil-
ities are amounting to Rs. 77.12 million.
Under KP government the bodies providing health services to their employees through their own
health care facilities are, for example, B.I.S.E Peshawar, and KP Agriculture University has one dispensary
each. University of Peshawar has one child welfare center and one dispensary at the campus for the health
care of students/employees. The expenditures of the KP own healthcare facilities (three dispensaries & one
child welfare center) have been estimated on the basis of factors as mentioned above. Hence the lump
sum expenditures of the KP healthcare facilities are worked out to Rs. 19.45 million. None of the ABs/C (as
reported in the census) under KP government is offering health insurance to their employees.
In Baluchistan, Lasbela University of Agriculture, Water & Marine Science and Baluchistan Univer-
sity of Engineering and Technology, Khuzdar is providing health services to their employees by running its
own dispensary at the premises. Expenditures of the dispensaries are estimated on the basis of the factor
(per employee Expenditures of the dispensary), which is Rs. 2.956 million. None of the ABs/C (as reported
in the census) under the Baluchistan government is offering health insurance to their employees.
Pakistan Bureau of Statistics National Health Accounts
66
Table 42 gives an overview of the total health expenditures and their breakdown by mechanism
incurred by the bodies and corporations of all four provinces in the fiscal year 2011-12.
Table 42: Expenditures of provincial autonomous bodies/corporations on health by
mechanism 2011-12 (Million Rs.)
Province
Mechanism
Total Health
Expenditures
Reimbursement
Own health care facilities
Health insurance
million Rs. million Rs. million Rs. number million Rs. Punjab 106.74 77.118 6.998 67 190.86 Sindh 318.089
93.83 40 411.93 KP 82.713 19.447
46 102.16 Baluchistan 21.043 2.956
18 23.99 Total 528.58 99.52 100.83 171 728.93 5.7 Federal & provincial autonomous bodies/corporations’ expenditure: Extrapolation from 2011-12 to 2019-20. Census ABs/C working under the administrative control of federal & provincial governments was carried out in the year 2013 for the reference period 2009-10 to 2011-12. The purpose of this census was to collect data on remuneration of health expenditures of their employees. Health expenditures of ABs/Care are mainly made either through reimbursement of medical charges, health insurance, or through their own health care facilities. It was observed in the Census that some of the ABs/C (both at federal & provincial levels) are providing cash medical allowances to their employees in salaries. These allowances are not included in the total health expenditures of ABs/C as it is not sure that the medical allowance is spent on the health care. Moreover, the precise estimate of the health care expenditures incurred by the employees out of the cash medical allowances is not possible due to a lack of information or any national-level research on it. Therefore, health expenditures of ABs/C, both at federal & provincial levels, incurred via reimburse- ment of medical charges, health insurances, or through their own health care facilities have been included in the NHA report. The aforesaid census has also provided a frame of health care facilities running primarily for the health care of ABs/C. The following table gives an overview of federal & provincial ABs/C health expenditures by each mechanism for the period 2009-10 to 2019-20. The health expenditures by each mechanism for the period 2011-12 to 2019-20 have been estimated on the basis of actual data obtained via censuses 2007-08 & 2011-12. The health expenditures by each mechanism for the fiscal years 2015- 16 to 2021-22 have been estimated on the basis of the factor (average relative change) observed in the previous fiscal years.