Islamabad: Days after the PIMS nursery fire killed 14 newborns, the Islamabad Healthcare Regulatory Authority (IHRA) board has sought an administrative review of former chief Dr Muhammad Zaeem Zia, now acting DG Health, while the federal health ministry has asked the Auditor-General of Pakistan to audit the regulator’s performance and finances for two financial years.
The parallel requests have exposed a dispute between the regulator and ministry at a time when IHRA faces questions over oversight of public hospitals and enforcement of safety standards in Islamabad.
In an August 29 letter, issued after its 59th meeting on August 27, the board asked the Ministry of National Health Services, Regulations and Coordination to review Dr Zaeem’s conduct and decisions while he was chief executive officer on additional charge.
It said concerns were based on official records and board decisions, not personal considerations. The board termed his performance unsatisfactory, alleging disregard for rules, failure to place important matters before the statutory forum, and delayed or non-implementation of board decisions.
It alleged inadequate attention to IHRA’s core regulatory responsibilities and discrepancies between information reportedly provided to the ministry and parliamentary forums and its official record, particularly on registered healthcare establishments and inspections. It sought reconciliation of the figures through official records.
The board disputed attribution to Dr Zaeem of the HFAT app, online registration and licensing, waste and complaint portals, chatbot, Report a Quack system and podcast studio, saying these were board-directed projects carried out by IHRA directorates.
It cited appointments from the District Health Officer’s office without approval and alleged that decisions on internships, expenditure, official vehicles, fuel and key administrative documents were not placed before the competent forum.
Referring to an extortion complaint, the board said an inquiry committee held three external persons responsible, but its findings and subsequent board directions were not implemented. It also alleged imprudent petty-cash spending, vehicle and fuel irregularities, and unsupported claims that activities had ministry or ministerial approval.
It said IHRA’s budget was forwarded without statutory approval, while service rules withheld because of pending litigation were circulated without prior board consideration and approval.
Dr Zaeem, a BS-19 ministry director, was given additional charge of the BS-20 DG Health post on August 17 for three months or until a regular appointment. The ministry earlier assigned him a third spell as IHRA CEO despite the board’s objection, maintaining it was a fresh order after a gap.
Responding to the allegations, Dr Zaeem rejected any suggestion of procedural violations or failure on his part, saying everything during his tenure as acting CEO was conducted in accordance with the prescribed rules and procedures and proactive steps were taken towards licensing.
He said a performance review would be a better way to assess IHRA’s functioning, proposing that the authority’s performance from January 2025 to January 26, 2026 be compared with his tenure from late January to July 2026.
The board also complained of what it termed inappropriate news coverage after the PIMS tragedy, fearing the deaths were being used to create mistrust of IHRA. It said the request did not challenge federal authority but sought decisions made with full knowledge of its assessment.
IHRA says Section 28 of the Islamabad Healthcare Regulation Act, 2018, deems federal healthcare establishments registered, but requires the government to certify their compliance with minimum standards. Such facilities must seek licences for their services.
IHRA officials say PIMS never applied for a licence, raising questions over whether it was directed to do so and what action followed.
In a separate August 30 letter, the ministry asked the Auditor-General to conduct performance and financial audits of IHRA for 2024-25 and 2025-26. It said it was reiterating a June 11 request for an audit for 2024-25.
Citing Section 40 of the Act, the ministry said audits were required within 90 days after each financial year. It said the 2024-25 audit had not been conducted and sought priority completion for both years.
A senior ministry official said the performance and regulatory audit would determine whether any shortcoming or maladministration had occurred, including during 2024-25 and 2025-26 when Dr Zaeem was at the helm of IHRA’s affairs.