Lawmakers have sharply criticized the Islamabad Healthcare Regulatory Authority (IHRA), highlighting severe governance failures and conflicts of interest within its board, and have set a one-month deadline for sweeping reforms. During a recent session of the National Assembly’s Sub-Committee on Health, officials demanded immediate implementation of structural and procedural overhauls to end IHRA’s paralysis and restore its regulatory credibility.
The absence of IHRA’s CEO at a crucial committee meeting, specifically convened to assess the regulator’s performance, drew immediate criticism from lawmakers. Instead, the authority was represented by the Director General, referred to in session as “Dr. Sahab,” Head of Communications Mr. Mubashir, and another official identified as “Maroof Sahab.”
Central to the discussion were critical issues regarding IHRA’s governance structure. Lawmakers expressed grave concern over the composition of IHRA’s board, alleging significant conflicts of interest as several members reportedly own or manage private healthcare facilities—the entities the authority is meant to oversee. Committee Convener Dr. Amjad Ali Khan questioned the legitimacy of policy decisions under these circumstances, noting, “A person with a conflict of interest can’t vote, so how can they write policy?” He further accused board members of exploiting their positions by granting lifetime registrations to their hospitals while delaying routine registration requests from others.
In response to these allegations, the committee resolved to formally recommend immediate replacement of all board members found to have vested interests. Furthermore, the Ministry of National Health Services has been asked to urgently implement these recommendations to restore confidence in the oversight process. Lawmakers stressed that no credible regulatory oversight is possible when the regulator is compromised by those it is tasked to regulate.
IHRA’s inability to perform its core functions effectively since the passage of the IHRA Act in 2018 was another focal point of criticism. Despite regulations being finalized in 2022, critical regulatory committees—including Licensing, Inspection, Price Determination, and Registration—remain either non-functional or unable to fulfill their responsibilities. Alarmingly, not a single private hospital in Islamabad currently holds a final operating license; hospitals continue to operate provisionally due to IHRA’s failure to finalize essential licensing documents.
This regulatory paralysis was particularly criticized in relation to the widely reported death of a 13-year-old patient at Maroof Hospital. Although medical records revealed a potentially preventable cause and allegations of refused treatment surfaced, IHRA’s representative dismissed the case as “time-barred.” Rejecting this reasoning outright, lawmakers accused the authority of hiding behind procedural excuses, and subsequently ordered a re-investigation into the matter.
The inspection process itself was deemed insufficient by committee members. Highlighting an inspection carried out at Shifa International Hospital as an example, lawmakers criticized IHRA’s selective auditing approach, noting inspections targeted only limited departments—such as blood banks and radiology—while neglecting wider oversight of clinical and financial management. The committee reminded the authority of its clear legal mandate, under the IHRA Act, to conduct comprehensive hospital inspections, including financial audits.
In addition to regulatory and inspection lapses, lawmakers raised concerns over the wide variance and inflated charges for basic medical tests. They sharply criticized IHRA for failing to operationalize the critical Price Determination Committee, urging that such a mechanism is essential to introduce transparency and uniform pricing in healthcare services. Consequently, the committee instructed IHRA to fully activate and empower its Price Determination Committee within one month to oversee and standardize medical charges.
Interestingly, hospitals themselves encouraged IHRA to adopt a more assertive approach towards regulation. Representatives from private healthcare providers requested that the authority tackle the pervasive issue of quackery and the existence of numerous unlicensed facilities, noting their detrimental impact on public trust and patient safety.
To address the range of identified shortcomings, the parliamentary panel issued binding orders and gave IHRA strict deadlines. Within a one-month period, the authority must fully operationalize the Price Determination Committee, initiate clinical and financial audits at private hospitals, finalize and distribute licensing paperwork, and transition hospitals from provisional to permanent licensing status. Additionally, IHRA must urgently prepare an action plan, in coordination with the Ministry of National Health Services, to revive Islamabad’s 16 Basic Health Units (BHUs), most of which currently remain non-functional.
Lawmakers cited legal provisions within the IHRA Act of 2018, particularly Regulation No. 13, which prohibits board members from participating in decisions involving their direct or indirect interests. Reinforcing IHRA’s statutory capabilities, Law Ministry representatives confirmed that the regulator legally possesses broad authority to create specialized committees and engage external experts or auditors—powers that remain underutilized.
Concluding the meeting, committee members issued a warning: IHRA must no longer operate as an institution captured by vested interests. Instead, it must rapidly transform itself into a truly independent and effective healthcare regulator, capable of protecting public interests. Failure to comply with the committee’s directives, lawmakers warned, would trigger more comprehensive institutional reforms with or without the cooperation of IHRA’s current leadership.
