Federal Medical Teaching Institutes Act, 2021 (Repealed by Act No.I of 2023)

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THE FEDERAL MEDICAL TEACHING INSTITUTES ACT, 2021 
 
 
  
CONTENTS 
_____________ 
 
CHAPTER I 
PRELIMINARY 
1. Short title, extent, application and commencement. 
CHAPTER II 
DEFINITIONS 
2. Definitions. 
CHAPTER III 
MEDICAL TEACHING INSTITUTE 
3. The medical teaching institution 
4. Board of Governors 
5. Conduct of business. 
6. Functions and powers of the Board 
7. Search and nomination council 
8. Governance 
9. Management committee 
10. Dean 
11. Hospital Director 
12. Functions of the Hospital Director 
 
Updated till 11.04.2023
 
13. Medical Director 
14. Functions of the Medical Director 
15. Nursing Director 
16. Finance Director 
17. Service of medical teaching institution 
18. Tribunal 
19. Private practice 
20. Retention of fee. 
21. Fund. 
22. Budget, audit and accounts 
23. Employees to be public servant 
24. Removal of difficulties 
25. Power to make rules 
26. Power to make regulations 
27. Overriding effect 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
THE FEDERAL MEDICAL TEACHING INSTITUTES ACT, 2021 
ACT NO. XII OF 2021 
 
[10th August, 2021] 
Act 
 to re-organize the Federal medical teaching institute and teaching hospitals thereof 
WHEREAS it is expedient to re-organize and provide autonomy to the  Federal medical teaching 
institutes and their affiliated teaching hospitals to enhance the services being rendered by the institutions 
to improve performance, enhance effectiveness, efficiency and responsiveness for the provision of quality 
healthcare services and education and to make them into state of the art model institution of Pakistan; 
It is hereby enacted as follows:— 
CHAPTER I 
PRELIMINARY 
 
1. Short title, application and commencement.—(1) This Act shall be called the Federal  
Medical Teaching Institutes Act, 2021. 
 
(2) It shall apply to all Federally owned or operated medical teaching institutes, its affiliates and 
subsidiaries thereof in Pakistan, 
 
(3) It shall come into force at once. 
 
   CHAPTER II 
DEFINITIONS 
 
2. Definitions.—In this Act, unless the context otherwise requires,— 
 
(a) “basic science faculty” means a medical faculty not involved in patient care; 
 
(b) “Board” means the Board of Governors constituted under section 4; 
 
(c) “Chairperson” means the Chairperson of the Board; 
 
(d) “clinical faculty” means a medical faculty involved in any manner with a clinical 
care of patients, whether diagnostic or therapeutic; 
 
(e) “college” means a medical college, dental or a nursing college in the public sector; 
 
(f) “consultant” means and includes— 
 
(i) those medical faculties involved in patient care; or 
 
 
(ii) those staff who act as service provider to the patients in the hospital; 
 
(g) “dean” means the academic head of the medical teaching institution; 
 
(h) “employee” means a person who is— 
 
(i) an employee appointed by the Board of the medical teaching  institution under 
this Act or rules and regulations made there- under; or 
 
(ii) a civil servant who has opted to become an employee of the medical teaching 
institution under section 17. 
 
(i) “medical faculty” means and includes the basic science faculty and  clinical faculty 
which includes senior registrar and above as well as  dean of the medical teaching 
institute, involved in teaching, training or patient care; 
 
(j) “Government” means the Federal Government; 
 
(k) “healthcare services” means preventive, curative, promotive, rehabilitative health 
services and include diagnostic, support services, laboratory, accident and 
emergency, pharmacy and paramedic support; 
 
(l) “member” means a member of the Board and includes Chairperson; 
 
(m) “medical teaching institution” means a public sector medical, dental or nursing 
college or any other medical teaching institution  and their affiliated teaching 
hospitals lo cated anywhere in Pakistan  owned and controlled by the Federal 
Government and included or  notified by the Federal Government in Schedule-I to 
this Act; 
 
(n) “prescribed” means prescribed by rules or regulations made under this Act; 
(o) “regulations” means regulations made under this Act; 
 
(p) “rules” means rules made under this Act; 
 
(q) “search and nomination council” means search and nomination council notified by  
the Government under section 7, and 
 
(r) “Tribunal” means the Federal Medical Teaching Institutions Tribunal established 
under this Act 
 
CHAPTER III 
MEDICAL TEACHING INSTITUTE 
3. The medical teaching institution .—(1) The institutions included  in Schedule -I shall be 
 
medical teaching institutions established under this Act as  an autonomous body having perpetual 
succession and a common seal with power to acquire, hold and dispose off movable property and may 
in its name sue and be sued. 
 
(2) The objective of the medical teaching institution shall be to undertake all functions required 
for providing health facilities and healthcare services to the people and to provide medical education and 
training and research and to perform such other functions as are assigned to it by the Government from 
time to time. 
 
4. Board of Governors .—(1) There shall be a Board of Governors of  the medical teaching 
institution to administer and manage its affairs and shall  have overall superintendence and control over 
the functions and all their related matters. 
 
(2) The Board of Governors shall comprise such number of members  as may be determined by 
the Government but shall neither be, less than three  members and nor exceed seven members and all of 
whom shall be from the private sector. 
 
(3) The members shall be appointed by the Government on the recommendation of the search and 
nomination council constituted under section 7: 
 
Provided that the members shall, unless otherwise directed by the Government, hold office for a 
period of three years and be eligible for re- appointment. 
 
(4) The members may include eminent technical and professional persons in their respective 
fields having significant aptitude and time available  for improving the hospital services, such as legal, 
finance, economics, management, medical profession, retired civil servants, educationists, social workers, 
representatives of civil society, businessmen and renowned philanthropists. 
 
(5) The Chairperson shall be elected by the members through voting  from amongst the mselves 
and he shall preside over the Board meetings. In case  of his absence, the Chairperson may nominate a 
Board member as acting Chairperson or if he has not done so, the members present shall elect an acting  
Chairperson for that meeting. 
 
(6) The membership of a member shall cease and fall vacant if the  member resigns, or fails to 
attend three consecutive meetings of the Board without sufficient cause or for any other reasons which 
incapacitate the member to remain as member. Any such vacancy shall be filled within one month. 
 
(7) The membership of a member may be terminated by notification in  the official Gaz ette on 
grounds of incompetence or for reasons noted in sub - section (8) or in view of actions of such member 
which bring the medical teaching institution or the Board into disrepute. 
 
(8) No person shall be appointed or remain as a member of the Board, if such person— 
 
(a) is by a competent court of law declared as of un-sound mind; 
 
 
(b) has before a court of law applied to be adjudicated as an insolvent and his 
application is pending; 
 
(c) is by a competent court of law declared an un-discharged insolvent; 
 
(d) has been by a court of law convicted for an offence involving moral turpitude; 
 
(e) has been debarred from holding any office under any law; or 
 
(f) has a conflict of interest with such a position. 
 
5. Conduct of business.—(1) All decisions of the Board shall be taken by consensus and in case 
of division of opinion, the decision shall be taken by majority of votes: 
 
Provided that in case of equality of votes, the Chairperson of the Board shall have a second casting 
vote. 
 
(2) No act or proceedings of the Board shall be invalid, merely on the ground of existence of any 
vacancy in or defect in constitution of the Board, subject to the condition that any act or proceeding of the 
Board taken by less than three members on account of vacancies shall be ratified immediately by the 
Board upon the minimum membership of the Board prescribed under sub-section (2) of section 4. 
 
(3)  The quorum for meeting of the Board shall be four members or two- thirds of the total number 
of Board Members, whichever is less. 
 
(4) The member count shal l be determined by actual members present  and proxy votes shall not 
count. 
 
(5) The Board may hold meetings as frequently as required, but shall hold at least one meeting on 
a quarterly basis. 
(6) Special meetings of the Board shall be convened on the special request of at least one third of 
the Board members for consideration of any important or urgent matter. 
 
(7) Subject to the provisions of this Act and the rules and regulations made there-under, the Board 
may appoint sub-committees of the Board, provided that a sub-committee shall be at all times headed by 
a member of the  Board who is also a member of such committee and such sub-committees constituted 
shall perform such functions as may be prescribed by the Board or the rules or regulations made pursuant 
to this Act. 
 
(8) The remuneration for attending the Board meeting shall be such as may be prescribed. 
 
(9) The Secretary to the Board when appointed shall  be an employee  of the Board, who shall 
perform all secretarial and office functions of the Board  at the direction of the Chairman and shall be 
responsible for recording minutes of the Board meetings, convening Board meetings, carrying out 
 
communication with all Board members and all other functions as may be prescribed. 
 
 
6. Functions and powers of the Board.—(1) The Board shall be responsible for.— 
 
(a) ensuring that the objectives of the medical teaching institution within the overall 
ambit of Government policy are achieved, overseeing effective management and 
providing strategic direction to the medical teaching institution; 
 
(b) policy making of the medical teaching institution and ensuring that  its performance 
and its programmes are efficient and effective; 
 
(c) prescribe procedures for appointment, terms and conditions of service, disciplinary 
matters and other service matters for the employees; 
 
(d) creation, re-designation, up-gradation, down-gradation or abolition of posts pursuant 
to prior consultation with the Establishment Division where such posts may be 
occupied by persons in government service and provided that while creating posts 
having the financial implications in excess of the approved annual budget  that shall 
require prior consultation with the Finance Division; 
 
(e) approval of vision and mission statement; 
 
(f) approval of annual business plan; 
 
(g) review and approval of major transactions; 
(h) approval of new programs and services and monitor organizational performance; 
(i) approval of financial plans and annual budget; 
(j) approval of regulations for medical staff and overseeing the process for appointment 
of members of the medical staff; 
(k) approval of programs and services to ensure that all legal, regulatory and 
accreditation requirements are met; 
(l) constitution of a finance committee and such other committees or sub-committees, 
as it may deem appropriate; and 
 
(2) Medical teaching institution shall be accountable to Ministry of  National Health Services, 
Regulations and Coordination for its performance and  shall regularly provide performance based data at 
set intervals based on Ministry of National Health Services, Regulations and Coordination set performance 
monitoring format, with attendant reward and discipline measures and the Ministry of National Health 
Services, Regulations and Coordination shall also  periodically evaluate the performance of the medical 
 
teaching institution against the set targets particularly related to efficiency, effectiveness and equity with  
attendant reward and discipline measures. 
(3) The Board shall in prescribed manner appoint the dean, hospital  director, medical director, 
nursing director and finance director of the medical teaching institution. 
(4) The Chairperson, of the Board may, in case of exigency of service,  appoint the dean, medical 
director, hospital director, nursing director and finance director on officiating basis. All such appointments 
shall be placed before the Board for approval within three months. 
7. Search and nomination council.—(1) The Government shall constitute and notify a search 
and nomination council, to recommend persons from private sector suitable to be appointed  as members 
of the Board and which shall consist of— 
(a) Minister Concerned or his representative or Federal 
       Minister nominated Chairman by the Prime Minister; Chairman 
 
(b) Secretary of the Division concerned;        Vice Chairman 
 
(c) Secretary Planning Division;            Member 
 
(d) Vice Chancellor of the Quaid e Azam University;  Member 
 
(e) a philanthropist with substantial contribution to 
       public healthcare to be nominated by Government;  Member 
  
(f) a retired senior person from medical profession to 
       be nominated by Government;             Member 
 
(g) a representative of civil society to be nominated 
       by Government.            Membe 
 
 
(2) The Chairman shall chair the meeting of the council search and  nomination and in his  
absence, the Vice-Chairman shall chair the meeting. 
 
(3) A member from the private sector shall, unless otherwise directed by Government, hold office 
for a period of three years and shall be eligible for another term of three years or part thereof as the 
Government may deem appropriate: 
 
Provided that the Government may remove a member appointed pursuant to clauses (e), (f) and 
(g) of sub-section (1) at any time after giving him an opportunity of being heard. 
 
8. Governance.—(1) Each college under the medical teaching institution shall be headed by a 
dean and the dean of the medical college shall act as the chief executive officer of the medical teaching 
institution and shall further consist of chairpersons and medical faculties of various departments of  the 
 
college as may be prescribed. 
 
(2) In each college, there shall be an academic council headed by the  dean of the college and 
consisting of members as prescribed entrusted with the  function to prescribe and set principles and 
standards for teaching, research, training, student admissions, and curriculum development, to ensure and 
inculcate the highest ethical standards. 
 
(3) Administrative control of a college which is also a constituent college of a university shall 
vest in the medical teaching institution except the conduct of examinations which shall be determined by 
the university. 
 
9. Management committee .—(1) For a medical teaching institution  there shall be a 
management committee consisting of— 
 
(a) dean of the medical teaching institution; Chairman 
 
(b) hospital director; Member 
 
(c) medical director; Member 
 
(d) nursing director; Member 
 
(e) finance director; Member 
 
(f) any other two persons appointed by the Board 
on the recommendation of the dean of the medical 
teaching institution. Member 
 
 
 
(2) The management committee shall recommend to the Board any  addition of a department, 
facility or post at the medical teaching institution. 
 
(3) The management committee shall perform all such other functions as may be prescribed. 
 
10. Dean.—(1) The dean of the colleges shall be appointed by the Board for a period of five years 
and shall be eligible for re -appointment, through merit-based process on such terms and conditions and 
having such qualifications  and experience as may be prescribed. The dean  shall further act as per the  
directions of the Board in prescribed manner. 
 
(2) The dean, on appointment, shall simultaneously receive a faculty  appointment at a level 
commensurate with his qualifications and the prescribed  institutional requirements for the faculty post, 
which appointment shall not be limited to the term applicable to the office of the dean. 
 
(3) The chairperson of various departments shall be appointed by the  dean through merit-based 
 
process, on such terms and conditions and in such a manner as may be prescribed. A chairperson may 
be removed by the Board on the recommendation of the dean, after giving him the opportunity of being 
heard. 
 
(2) The dean may in the prescribed manner be removed from the office  by the Board through a 
process at any time on the grounds including failure to achieve targets set by the Board. 
 
(3) in the performance of his functions, the dean shall be responsible to  the Board and the 
chairpersons of the departments shall be responsible to the dean and academic council. 
 
(4) The Board from amongst the chairpersons of the departments shall  appoint a vice -dean to 
perform the functions of the dean in the absence of the dean. 
 
 
11. Hospital Director.—(1) The Board shall appoint a full time hospital director for a period of 
five years and shall be eligible for re-appointment, on such terms and conditions as may be prescribed 
and no Board member shall be appointed as hospital director. 
 
(2) No person shall be appointed as the hospital director unless he  possesses a recognized 
master’s degree in hospital management or health services management or business management or 
public health or public administration or any other relevant management qualifications having 
experience of management in an organization or institution as may be prescribed: 
 
Provided that a person, who possesses a recognized medical degree may also apply for the post 
of hospital director with the condition that he shall have an additional management degree and 
experience provided in this sub-section and shall have no right to do private practice. 
 
(3) The hospital director may, after giving him an opportunity of being  heard, be removed from 
the office by the Board, before the expiration of the period of five years, on such grounds and through a 
process as may be prescribed. 
 
(4) In performance of his functions, the hospital director shall be responsible to the Board. 
 
(5) The hospital director shall not have any conflict of interest with such a position. 
 
12.  Functions of the Hospital Director.—The hospital director shall be responsible— 
 
(a) for all non-clinical functions of the hospital; 
 
(b) Preparation of the annual budget and business plan for presentation  to the 
management committee and the board; 
 
(c) maintenance of building and engineering services; 
 
(d) maintenance and development of all ancillary services, including but not limited 
 
to pharmacy, nursing, materials management, human resources, clerical, 
communications and security services; 
 
(e) to act as the principal accounting officer responsible and accountable for 
maintaining financial discipline and transparency; and 
 
(f) for implementation and execution of Board and management committee policies 
and to achieve the targets set by the Board. 
 
 
13. Medical Director.—(1) The Board shall appoint a full time, medical director for the 
hospital for a period of five years and shall be eligible for re-appointment, on such terms and conditions 
as may be prescribed and no Board member shall be appointed as medical director. 
 
(2) The medical director, on appointment, shall simultaneously receive a faculty appointment at 
a level commensurate with his qualifications and the prescribed institutional requirements for the faculty 
post, which appointment shall not be limited to the term applicable to the office of the medical director. 
 
(3) No person shall be appointed as the medical director unless he possess a recognized medical 
degree with management or administrative experience of working in management positions in an 
institution or organization as may be prescribed. 
 
(4) The medical director may, after giving him an opportunity of being heard, be removed from 
the office by the Board, before the expiration of the  period of five years, on such grounds and through 
a process as may be prescribed. 
 
(5) All clinical department heads will report to the medical director. 
 
(6) In respect of performance and functions, the medical director shall  be responsible to the 
Board. 
 
(7) The medical director shall not have any conflict of interest with such a position. 
 
14.  Functions of the Medical Director .—The medical director shall  be responsible for all 
clinical functions of the hospital, including but not limited to— 
 
(a) ensuring clinical excellence in all aspects of hospital functions; 
 
(b) ensuring timely, appropriate management of patients; 
 
(c) ensuring the best outcomes for all patients; 
 
(d) undertaking clinical governance for quality control; 
 
(e) assessing and auditing existing clinical programs and developing  new clinical 
programs; and 
 
(f)    developing an annual clinical budget, including capital medical equipment 
requests for presentation to the hospital director, the management committee and 
the Board. 
 
 
15. Nursing Director.—(1) The Board shall appoint a full time, non - practicing nursing director 
for the hospital for a period of five years and shall be  eligible for re -appointment, on such terms and 
conditions as may be prescribed and determine; provided no Board member shall be appointed as such. 
 
(2) No person shall be appointed the nursing director unless he possesses such qualification and 
experience as may be prescribed. 
 
(3) The nursing director may, after giving him an opportunity of being heard, be removed from the 
office by the Board, before the expiration of the  period of five years, on such grounds and through a 
process as may be prescribed. 
 
(4) In respect of performance and functions, the nursing director shall be responsible to the Board. 
 
(5) The nursing director shall not have any conflict of interest with such a position. 
 
(6) The nursing director shall be responsible for all nursing functions, including training of nurses, 
ensuring adequate nursing staffing for all clinical needs, maintaining the highest nursing standards and 
performing regular audits of nursing functions. 
 
(7) The nursing director shall perform such other functions as may be prescribed by the Board. 
 
16. Finance Director .—The finance director shall be appointed by the  Board in the prescribed 
manner, for a period of three years and shall be eligible for re-appointment, with minimum qualifications 
and to perform such functions in relation to financial matters as may be prescribed. 
 
 
17. Service of medical teaching institution.—(1) The Board may appoint such persons, experts or 
consultants, as deemed necessary and on such terms and conditions as may be prescribed. 
 
(2) All existing administrative and teaching staff recruited in the manner prescribed under the 
recruitment rules as applicable before commencement of this Act, subject to sub -section (3), shall be 
deemed to be  employees of the medical teaching institution on such terms and conditions as  may be 
prescribed: 
 
Provided that such terms and conditions shall not be less favorable in financial terms than the terms 
and conditions admissible to them immediately before the commencement of this Act. 
 
(3) On commencement of this Act, all the civil servants serving in the medical teaching institution, 
within a period to be notified by the Government,  may exercise a one time irrevocable option to become 
employees of the medical teaching institution. The civil servants who opt for such employment, shall be  
subject to terms and conditions of employment as ma y be prescribed including  but not limited to their 
service structure, promotion and disciplinary matters.  Such opting employees shall be entitled to post-
retirement benefits and emoluments as per existing government laws and rules. The medical teaching  
institution shall deposit pension contribution on their behalf. 
 
(4) A civil servant who does not exercise the option pursuant to sub- section (3) of section 17 shall 
remain a civil servant and shall be deemed an  employee of an attached department in terms of schedule 
III of Rules of Business, 1973 as amended from time to time and entitled to all the perks, pension, gratuity, 
housing (within the medical teaching institute if available and  Ministry of Housing and Works), 
monetization, health facilities and other privileges declared by the Federal Government from time to time 
 
 
(5) The civil servants under sub -section (4) shall be entitled to be posted to any MTI post for 
which they are eligible under MTI rules and regulations and such eligibility will continue for a period 
of 10 years. They will  remain eligible to hold the positions of chairman/  head of department in line 
with criteria for these positions in the MTI regulations. 
 
(6) The options under sub-section (3) once exercised shall be final. A civil servant, who opts to 
serve the medical teaching institution, shall cease to be a civil servant from the date of his absorption in 
the service of the medical  teaching institution and his seniority, pension and other matters vis-a-vis 
employment with the medical teaching in stitution, shall be determined in the  manner, as may  be 
prescribed. 
 
(7) If at any time, the management of the medical teaching institution reverts to the Government 
for any reason, the employees appointed under sub-section (1) shall continue to serve the medical 
teaching institution, on the  same terms and conditions as applicable to them immediately before such 
reversion. 
 
(8) Subject to the other provisions of this section, all employees, whether having opted or 
directly appointed prior to commencement of this Act or pursuant to this Act shall be at all times be 
 
governed exclusively by the terms and conditions of service as may be prescribed. 
 
(9) All employees, except the dean, hospital director, medical director,  nursing director and 
finance director, shall have the right to appeal against any  penalty to the Board unless such penalty is 
imposed by an order of the Board itself. 
 
(10) Any employee aggrieved by a decision of the Board including the  dean, hospital 
director, medical director, nursing director and finan ce director, may seek resolution of the grievance 
by referral of the grievance or dispute to the Tribunal. 
(11) Any and all employment disputes as may be pending before the courts of law shall 
be deemed transferred with immediate effect for adjudication to the Tribunal established under this Act. 
18. Tribunal.—(1) The Government shall establish by notification in  the official Gazette a 
Tribunal which shall perform its functions in the prescribed manner for the purpose of sub-sections (10) 
and (11) of section 17. 
The Tribunal shall consist of a minimum of six members appointed  for a term of five years by 
the Government in the prescribed manner and no  person shall be appointed as member of the Tribunal 
unless he has been a Judge of the Supreme Court or a High Court or an advocate of the Supreme Court 
of Pakistan having at least twenty-five years experience of active practice as an advocate 
 
(2) The Government shall in the prescribed manner appoint a Secretary of the Tribunal who shall 
be responsible for managing the affairs of the Tribunal and its operations. 
 
(3) The members of the Tribunal shall receive such remuneration as may be prescribed by rules. 
 
(4) Each dispute referred to the Tribunal shall be decided within a maximum period of ninety days 
from being filed. 
 
(5) The parties m ay be required to pay an institution and other fees as  may be prescribed. Any 
shortfall in the cost of operation of the Tribunal shall be funded by the Government. 
 
(6) Any party may within thirty days file an appeal against a decision  of the Tribunal before the 
High Court of the competent jurisdiction and which shall be heard by a Division Bench of the High Court 
and decided within six months of being instituted. 
 
19. Private practice .—(1) After the commencement of this Act, all  consultants working in 
government hospitals, clinics, imaging facilities and laboratories belonging to the medical teaching 
institution shall be given an option either to do their private practice within the hospitals, clinics, imaging 
facilities and laboratories of the medical teaching institution or to do their private practice outside the 
hospitals, clinics, imaging facilities and laboratories of the Medical Teaching  Institution, as the case may 
be. The option shall in the prescribed manner be exercised within a period of sixty days as prescribed under 
regulations. 
 
(2) Employees who opt for private practice within the premises of the  hospital, clinics, imaging 
 
facilities and laboratories of the medical teaching institution, may be entitled to such increase in salary, 
adjustment, bonuses or other ancillary benefits, as the Board may approve. 
 
(3) Employees who do not opt for private practice within the premises  of hospitals, clinics, 
imaging facilities and laboratories of the medical teaching institution, shall he allowed to do their private 
practice outside the premises of  the hospitals, clinics, imaging facilities and laboratories of the medical 
teaching institution and shall not be entitled to any increase in adjustment, incentives  bonuses or other 
ancillary benefits, or to hold management or lead positions,  except in case of  extreme exigency as 
determined by the Board. 
 
(4) Ali employees hired after the commencement of this Act shall be  expected to perform their 
private practice within the medical teaching institutions hospital, clinics, imaging facilities and 
laboratories and shall not be permitted private practice outside these facilities. 
 
(5) In the performance of functions in the hospital, the consultant shall be responsible to the hospital 
management, with respect to service provided to the patients in the hospital and shall follow all the rules 
and regulations relating to hospital management. 
 
(6) The medical teaching institution shall provide facilities for the most efficient services to allow 
the consultants to perform their services at the  highest level of excellence, including space, equipment, 
nursing, ancillary or clerical staff, laboratory, imaging and inpatient and surgical services as needed. Such 
facilities shall remain open as long as necessary to provide these services. The individual consultant shall 
be held responsible for the most efficient use of  the facilities and shall be expected to provide cost and 
income projections for each new facility, equipment or service request with the support of hospital director 
and staff. 
(7) Consultants professional fee shall not exceed the usual and customary fees charged for the same 
services in the community, assuring efficiency and value for money to the clients. 
(8) Private patient billing shall consist of the professional fee component and the institutional 
charges representing the charges of the clinic,  imaging facility, laboratory services or other institutional 
charges: 
 
Provided that all patient billing shall be done only by the hospital, clinic,  imaging facility or 
laboratory, and the professional fee component shall be returned to the consultant. 
(9) No reduction of the professional component income to the Consultant from the patient shall be 
permissible by the medical teaching institution. 
(10) A percentage share from the institutional charges shall be distributed between the employees, 
based on performance and productivity, according to a format to be prescribed by regulations. 
20. Retention of fee.—(1) Notwithstanding anything contained in any  law or rules, the medical 
teaching institution shall r etain receipts from various  fees levied by Government or the Board to meet 
recurring and development expenditure of the medical teaching institution. 
 
(2) The amount realized from such receipts shall not be deducted from  the annual grant provided 
by Government and such amount realized from the  receipts shall be utilized as per specification by the 
Board. 
 
21. Fund.—(1) There shall be a Fund in the name of the Medical  Teaching Institution Fund and 
the management thereof shall vest in the Board. 
 
(2) The Fund shall consist of— 
(a) grants from the Government as a single line budget; 
(b) receipts and user charges as specified by Board in consultation with Ministry of National 
Health  S Services, Regulations and Coordination from time to time in such manner as may 
be prescribed; 
 
(c) voluntary contributions or donations; and 
(d) grants from other sources. 
(3) The Fund shall be kept in such custody and shall be utilized and regulated in such manner as 
may be prescribed by regulations after consultation  with the Ministry of National Health Services, 
Regulations and Coordination. 
(4) The Fund account shall be maintained at such bank or treasury as  may be prescribed by 
regulations after consultation with the Ministry of National  Health Services, Regulations and  
Coordination. 
(5) Subject to any other law for the time being in force in this behalf, the Board may, in so far as 
its money is not required for immediate expenses,  invest the surplus money in such manner as may be 
prescribed. 
(6) The Board may invest surplus money as prescribed under the regulations. 
22. Budget, audit and accounts .—(1) The budget shall be approved  by the Board and its 
accounts shall be maintained and audited in such manner as may be prescribed on the advice of the Auditor 
General of Pakistan. 
(2) Government shall carry out annual audit of the Board through a third party. 
(3) The medical teaching institutions accounts shall be audited by the  Auditor General of 
Pakistan. 
23. Employees to be public servant .—The employees of the medical  teaching institution shall 
be deemed to he public servants within the meaning of section 21 of the Pakistan Panel Code, 1860 (Act 
XLV of 1860) provided it shall  not ascribe to them any rights of employment or benefits as may be 
otherwise applicable to public servants. 
 
 
24. Removal of difficulties.—if a difficulty arises in giving effect to any of the provisions of this 
Act, the Government may, by notification in the official Gazette, make such order as it deems necessary for 
removal of the difficulty: 
Provided that this power shall not be exercised after two years of the commencement of this 
Act. 
25. Power to make rules .—(1) The Government may, by notification  in the official Gazette, 
make rules for giving effect to the provisions of this Act. 
(2)    The power to make rules conferred by this section shall be subject to the condition of previous 
publication and, before making any rules, the draft thereof shall be published on the website of the medical 
teaching institution and the Division concerned for eliciting public opinion thereon within a period of not 
less than fifteen days from the date of publication. 
26. Power to make regulations.—(1) The Board may make regulations, not inconsistent with 
the provisions of this Act and the rules, for  carrying out the purposes of this Act subject to the financial 
regulations not being contrary to any general directions of the Finance Division pertaining to  utilization 
of public funds. 
(2) The power to make regulations conferred by this section shall be  subject to the condition of 
previous publication and, before making any regulations, the draft thereof shall be published on the 
website of the medical teaching institution, for eliciting public opinion thereon within a period of not less 
than fifteen days from the date of publication. 
27. Overriding effect.—(1) Notwithstanding anything to the contrary contained in any other law 
for the time being in force, the provisions of this Act  shall have an overriding effect and the provisions 
of any such law to the extent of such inconsistency to this Act shall cease to have effect. 
(2)   In the event of a conflict between this Act and a statute constituting a university, the provisions 
of this Act shall prevail. 
 
 
 
 
 
 
 
 
 
 
 
SCHEDULE-I 
(see sections 3) 
List of institutions (colleges and hospitals) declared as medical teaching institution 
 
1. Pakistan Institute of Medical Sciences, Islamabad along with the  Federal Medical and Dental 
College, Islamabad being a teaching hospital and constituent college respectively of the Shaheed Zulfigar 
Ali Bhutto Medical University, Islamabad. 
2. School of Dentis try, Islamabad and its Dental Hospital being a  constituent college of the 
Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad.