PUNJAB MEDICAL TEACHING INSTITUTIONS (REFORMS) ACT 2020

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THE PUNJAB MEDICAL TEACHING INSTITUTIONS 
(REFORMS) ACT 2020 
(II of 2020) 
CONTENTS 
CHAPTER I 
PRELIMINARY 
 
1.  Short title, extent, application and commencement 
 
CHAPTER II 
DEFINITIONS 
 
2.  Definitions 
 
CHAPTER III 
MEDICAL TEACHING INSTITUTIONS 
 
3.  Medical Teaching Institutions 
 
4. Objectives of the Medical Teaching Institutions  
 
5. Provincial Policy Board 
 
6. Functions of Policy Board 
 
7. Board of Governors 
 
8. Appointment and removal of members of the Board 
 
9. Disqualification of members of the Board 
 
10. Conduct of business of the Board 
 
11. Functions and powers of the Board 
 
12. Search and Nomination Committee 
 
13. Medical Teaching Institutions  
 
14. Management Committee 
 
15. Dean 
 
16. Hospital Director 
 
17.  Functions of the Hospital Director 
 
 
 
18.  Medical Director 
 
19.  Functions of the Medical Director 
 
20. Nursing Director 
 
21. Finance Director 
 
22.  Services of the Medical Teaching Institution 
 
23.  Private practice 
 
24.  Retention of Fee 
 
25.  Duties of healthcare service providers 
 
26.  Fund 
 
27.  Budget, audit and accounts 
 
28.  Public servant 
 
29.  Removal of Difficulties 
 
30.  Power to make rules 
 
31.  Power to frame regulations 
 
32.  Overriding effect 
 
33. Repeal and saving 
 
 
 
 
TEXT 
1
THE PUNJAB MEDICAL TEACHING INSTITUTIONS (REFORMS) ACT 
2020 
 (II of 2020) 
    [19th March, 2020] 
An  
Act  
to improve medical education and enhance effectiveness, efficiency and 
responsiveness of healthcare services. 
It is necessary to improve medic al education and enhance effectiveness, efficiency 
and responsiveness of healthcare services in Medical Teaching Institutions, and to 
make provisions for the purposes ancillary thereto. 
Be it enacted by Provincial Assembly of the Punjab as follows: 
CHAPTER I 
PRELIMINARY 
1. Short title, extent, application and commencement .– (1) This Act may be 
cited as the Punjab Medical Teaching Institutions (Reforms) Act 2020. 
(2) It extends to whole of the Punjab. 
(3) It shall apply to such Medical Teaching Institutions as may be notified 
under the Act.  
 (4) It shall come into force at once. 
CHAPTER II 
DEFINITIONS 
2. Definitions.– In the Act: 
(a) “Act” means the Punjab Medical Teaching Institutions (Reforms) 
Act 2020; 
(b) "Basic Science Faculty" means a Medical Faculty not involved  i n 
patient care; 
(c) "Board" means the Board of Governors constituted under section 7 
of the Act; 
(d) “Chairperson” means the Chairperson of the Policy Board or the Board 
of Governors of a Medical Teaching Institution; 
(e) "Clinical Faculty" means a Medical Faculty inv olved in clinical care of 
patients, whether diagnostic or therapeutic; 
(f) "consultant" means and includes: 
                                                      
1This Act was passed by Provinc ial Assembly of the Punjab on 1 9 March 2020; assented to by the Governor of the Punjab on 
18 March 2020; and, was published in the Punjab Gazette (Extraordinary), dated: 19 March 2020, pp.3817-3828. 
 
 
(i) a person qualified to provide the highest level of medical and 
healthcare; and  
(ii) recruited or appointed as such;  
(g) "Dean" means the academic head of a Medical Teaching Institution; 
(h) “employee” means: 
(i) an employee of a Medical Teaching Institution appointed under 
the Act; or 
(ii) an existing employee of a Medical Teaching Institution, 
appointed before coming into force of the Act; or 
(iii) a civil servant who has opted to  become an employee of a 
Medical Teaching Institution under subsection (8) of s ection 22 
of the Act; or 
(iv) a civil servant who is  on deputation to a Medical Teaching 
Institution; 
(i) "Government" means Government of the Punjab;  
(j) "healthcare s ervices" means preventive, curative, promotive, 
rehabilitative health services and includes diagnostic, support 
services, laboratory, accident and emergency, pharmacy and 
paramedic support; 
(k) "Medical Faculty" means the Basic Science Faculty and Clinical 
Faculty and includes an Assistant Professor and above as well as 
Dean of a College, involved in teaching, training or patient care; 
(l) “Medical Teaching Institution” means a medical college, a dental 
college, or any other health related teaching institution and includes 
the affiliated teaching hospitals funded in majority by public funds 
and the majority operating expenses of which are funded by public 
funds, or which is directly under the control of the Government 
providing healthcare services, medical education  and training and 
medical research, as may be notified under section 3 of the Act; 
(m) "member" includes the Chairperson; 
(n)  “Policy Board” means the Provincial Policy Board established 
under section 5 of the Act;  
(o) "prescribed" means prescribed by the rules or t he regulations made 
or framed under the Act; 
(p) "regulations" means the regulations framed under the Act; 
(q) "rules" means the rules made under the Act; and 
(r) "Search and Nomination Committee" means the Search and 
Nomination Committee constituted under section 12 of the Act. 
CHAPTER III 
MEDICAL TEACHING INSTITUTIONS 
 
 
3. Medical Teaching Institutions .– (1) The Government may, from time to 
time, notify Medical Teaching Institutions in the official Gazette for the purposes of 
the Act. 
 (2) A Medical Teaching Institution shall be a body corporate having 
perpetual succession and a common seal with power to acquire, hold and dispose of 
movable and immovable property and may in its name sue and be sued: 
 Provided that a Medical Teaching Institution shall not dispose of an 
immovable property without permission of the Government. 
 (3)  Every Medical Teaching Institution shall consist of a college or a 
teaching institution and such number of hospitals as may be notified by the 
Government. 
4. Objectives of the Medical Teaching Inst itutions.– The objectives of the 
Medical Teaching Institutions shall be to: 
(a) undertake all functions required for providing health facilities to the 
people; 
(b) provide medical education, training and research;  
(c) provide health facilities and services to the people; and  
(d) perform such other ancillary functions as may be assigned by 
the Government. 
5. Provincial Policy Board .– (1) The Government shall, by notification in the 
official Gazette, establish a Policy Board to be known as Provincial Policy Board to 
oversee and supervise the functioning of the Medical Teaching Institutions.  
 (2)  The Policy Board shall consist of such number of members as the 
Government may determine but such members shall not be less than five and more 
than seven. 
 (3)  A member of the Policy Board shall not be a Government employee.  
(4)  The members of the Policy Board shall be appointed from a list of 
persons submitted by the Search and Nomination Committee.  
(5) No member of the Policy Board shall be a member of any Board 
concurrently.  
(6)  The members of the Policy Board shall hold office for a period of three 
years. 
(7)  The members of the Policy Board shall have such qualifications as 
may be prescribed. 
(8)  A member of the Policy Board shall be eligible for re -appointment for 
one more term. 
(9)  The Policy Board shall have a Chairperson who shall be elected in 
such manner as may be prescribed. 
 (10)  There shall be amongst the members of the Policy Board at least one 
retired professor of a medical institute. 
 
 
6. Functions of Policy Board.– (1) The Policy Board shall: 
(a) ensure that every Medical Teaching Institution complies with 
such minimum standards as are determined by the Government, 
the Punjab Healthcare Commission established under the 
Punjab Healthcare Commission Act, 2010 (Act XVI of 2010) or 
such other bodies as are authorized by law to issue the same or 
such higher standards as may be determined by the Policy 
Board; 
(b) ensure that every Medical Teaching Institution keeps and 
maintains medical records in an electronic form; 
(c) ensure that every Medical Teaching Institution keeps and 
maintains a list of inventories in an electronic form with a status 
update; 
(d) ensure the audit of medical and other records to determine the 
performance of the hospitals, its units or clinics and its 
personnel; 
(e) recommend to the Government, policies for the improvement of 
the Medical Teaching Institutions; 
(f) recommend to the Government, changes and modifications in 
minimum standards; 
(g) recommend model regulations and other policies and 
amendments therein to be framed by the Board of each Medical 
Teaching Institution; 
(h) plan and implement specialized central training programs as 
and when required for management and employees of all 
Medical Teaching Institutions;  
(i) ensure that minimum qualification standards established by the 
Pakistan Medical and Dental Council or other regulatory bodies 
are met to ensure merit based appointments, provided that the 
Board of any Medical Teaching Institution may enhance such 
minimum qualification of merit at their discretion; 
(j) provide guidance and advice on any matter referred by the 
Board of a Medical Teaching Institution or the Government; 
(k) review the annual reports of each Medical Teaching Institution 
and give recommendations thereon; and 
(l)  assist, aid or advise the Government on any matter relating to 
the health sector.   
(2) The Policy Board shall meet at least three times in a year, in addition to 
holding an annual meeting, which shall be attended by the members of the Boards of 
all Medical Teaching Institutions. 
(3) In order to carry out its functions under subsection (1), or in public 
interest, the Policy Board may: 
 
 
(a) call for record of any proceedings, any document or any person 
related to a Medical Teaching Institution for examination a nd 
inspection; 
(b) order an inquiry into any matter related to a Medical Teaching 
Institution to be conducted by any person; and 
(c) issue a direction to the Board, and the Board shall comply with 
such direction: 
Provided that in case of any difference of opinion between the Policy Board 
and the Board regarding a direction by the former, the matter shall be referred to the 
Government for decision which shall be final. 
7. Board of Governors .– (1) There shall be a Board of Governors for each 
Medical Teaching Institution. 
(2) The Board shall have overall superintendence and control over the 
functioning and administration of a Medical Teaching Institution. 
(3) The Board of each Medical Teaching Institution assisted by Secretary 
of the Board shall comprise such number of members as may be determined by the 
Government, but members of the Board shall not be less than five and more than 
seven.  
(4) No member of the Board shall be a Government servant. 
(5) A member shall, unless otherwise directed by the Chief Minister, hold 
office for a period of three years and shall be eligible for re-appointment. 
(6) A vacancy in the Board shall be filled within one month. 
(7) The Chairperson of the Board of a Medical Teaching Institution may, in 
case of exigency of service, appoint Deans, Medical Director, Hospital Director, 
Nursing Director or Finance Director on an officiating basis, and all such 
appointments shall be placed before the Board of Governors for approval within 
three months 
(8) The members of the Board shall be reputed members of society, and 
eminent technical and professional persons in their respective fields in the areas of 
law, finance, management, medical services, medical education and patient care. 
(9)  The Chairperson shall be elected by the members of the Board through 
voting from amongst themselves, and the Chairperson  shall preside over the Board 
meetings and 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. 
  (10)  If for any reason the Board becomes dysfunctional, the Government 
shall by notification constitute an administrative committee which shall perform the 
functions of the Board, and the Committee of Administration shall not act beyond a 
period of two months during which the Government shall reconstitute the Board or 
make the Board functional. 
 (11)  Where a Medical Teaching Institution being a constituent college is 
subject to an Act of a Medical University, the Vice Chancellor of that Medical 
University shall be an ex officio member of the Board.  
 
 
8. Appointment and removal of members of the Board.– (1) The members of 
the Board shall be appointed and notified by the Government on the 
recommendation of the Search and Nomination Committee constituted under section 
12 of the Act. 
 (2)  A member shall cease to hold office when a notification to that effect is 
issued by the Government. 
 (3)  The Government shall remove a member from the Board if he:  
(a) resigns;   
(b) fails to attend three consecutive meetings without sufficient 
cause;  
(c) becomes incapacitated; or 
(d) willfully contravenes the Act, the rules or the regulations. 
(4) Notwithstanding anything contained in the Act or any other law for the 
time being in force, the Chief Minister, may, on his own motion, or on 
recommendation of the Policy Board, dissolve the Board. 
9. Disqualification of members of the Board .– No person shall remain or be 
appointed as a member of the Board if he:  
(a) is of unsound mind;  
(b) has applied to be adjudicated as an insolvent and his  application is 
pending; 
(c) is an un-discharged insolvent ; 
(d) has been convicted by a Court of law for an offence involving moral 
turpitude; 
(e) has been debarred from holding any office under any  provisions of 
law; or  
(f) has a conflict of interest with such a position. 
10. Conduct of business of the Board .– (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, and in case of equality of v otes, the Chairperson of the Board shall 
have casting vote. 
 (2) No act or proceedings of the Board shall be invalid, merely on the 
ground of existence of any vacancy.  
 (3) The quorum shall be four members or two third of the total number of 
Board Members, whichever is less.  
 (4) The member count shall be determined by actual members being 
present and proxy vote shall not count. 
 (5) The Board may hold meetings as frequently as may be required; 
provided that the Board shall hold at least one meeting on 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 the Act and the rules made thereund er, the 
Board may constitute committees and sub committees to perform such functions as 
may be prescribed.  
  (8)  The remuneration for attending the Board meeting shall be such as 
may be prescribed by the rules.  
 (9)  The Secretary to the Board shall be an employee of the Board, who 
shall perform all secretarial and office functions of the Board at the direction of the 
Chairperson; and shall be responsible for recording minutes of the Board meetings, 
convening Board meetings, carrying out communication wi th all Board members, 
and all other functions as may be prescribed by the Board. 
11. 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 o f the Government policy are achieved, overseeing 
the effective management, and providing strategic  direction to the 
Medical Teaching Institution; 
(b) policy making of a Medical Teaching Institution and ensuring that the 
performance of a Medical Teaching I nstitution and its programmes are 
efficient and effective; 
(c) prescribing procedure for appointment, terms and conditions of service, 
disciplinary matters and other service matters for the employees of a 
Medical Teaching Institution; creation, re -designation or abolition of 
posts provided that the financial implications do not exceed the 
approved annual operating and development budget; 
(d) approval of vision and mission statement of a Medical Teaching 
Institution; 
(e) approval of annual business plan; 
(f) review and approval of major transactions, except that the sale of an 
asset of value in excess of rupees two million shall require prior 
approval of the Specialized Healthcare and Medical Education 
Department of the Government; 
(g) approval of new program s and services and monitor organizational 
performance; 
(h) approval of financial plans  and annual operating and development 
budget; 
(i) approval of bye -laws for medical staff and overseeing the process for 
appointment of members of the medical staff; 
(j) approval of programs and services to ensure that a Medical Teaching 
Institution fulfills legal, regulatory and accreditation requirements;  
 
 
(k) constitution of Finance Committee, and such other Committees or Sub-
Committees, as it may deem appropriate;  
(l) compliance with the policies and minimum standards made or set by 
the Government and the Board; 
(m) compliance with minimum standards set by the Punjab Health Care 
Commission or such bodies authorized by law to issue standards; 
(n) ensure the maintenance of all medical and other records in electronic 
form; and 
(o) ensure the maintenance of a list of inventories in an electronic form 
with a status update. 
  (2) Each Medical Teaching Institution shall be accountable to the 
Government for its performance and shall regularly provide performance based data 
at such intervals based on such performance monitoring format as may be set by the 
Government, for the Medical Teaching Institutions with attendant reward and 
disciplinary measures; 
  (3)  The Government shall  periodically evaluate the performance of the 
Medical Teaching Institutions against the set targets particularly related to efficiency,  
effectiveness and equity with attendant reward and disciplinary measures. 
  (4) The Board may delegate its powers for r ecruitment to various 
management levels within the Medical Teaching Institution. 
  (5) The Chairperson may make appointment of a Dean, Hospital Director, 
Medical Director, Nursing Director and Finance Director on officiating basis: 
  provided that all such appointments shall be for a period of three months: 
   provided further that the process of regular appointments shall be completed 
during the period of three months. 
  (6) The Board shall appoint the Dean, Hospital Directors, Medical 
Directors, Nursing D irectors and Finance Directors of the hospitals forming part of 
the Medical Teaching Institution. 
12. Search and Nomination Committee.– (1) The Chief Minister shall constitute 
and notify a Search and Nomination Committee for recommendations of persons 
from the private sector suitable to be appointed as members of the Board and 
members of the Policy Board, which  shall consist  of: 
(a) Minister for Health; Chairperson 
(b) Additional Chief Secretary Punjab; Vice Chairperson 
(c) Secretary to the Government, Sp ecialized Healthcare and 
Medical Education Department; member 
(d) Vice Chancellor of the concerned University; member 
(e) a philanthropist with substantial contribution to the public 
healthcare system to be nominated by Chief Minister; member 
(f) a retired senior person from medical profession to be nominated 
by Chief Minister; member 
 
 
(g) a representative of civil society to be nominated by the Chief 
Minister. member 
  (2) The Chairperson shall preside the meetings of the Committee and in 
his absence, the Vice Chairperson shall preside the meetings. 
  (3) A member from private sector shall, unless otherwise directed by the 
Chief Minister, 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 non -official member at any time 
after giving him an opportunity of being heard. 
13. Medical Teaching Institutions.– (1) Every Medical Teaching Institution shall 
be affiliated with a M edical University for purposes of syllabus, curriculum, training 
and examinations. 
 (2) A Medical Teaching Institution shall be headed by a Dean, and shall 
consist of Chairpersons and Medical Faculties of various departments of the Medical 
Teaching Institutions.  
 (3)  A Medical Teaching Institution shall have an Academic Council, 
headed by the Dean and consisting of such number of members as may be 
prescribed, to set principles and standards for teaching, research, training, student 
admissions, curriculum development and to ensure and inculcate the highest ethical 
standards: 
Provided that where a Medical Teaching Institution being a constituent college 
is subject to an Act of a Medical University, the Academic Council shall be headed 
by the Vice Chancellor of that Medical University.  
 (4) Where a Medical Teaching Institution is subject to an Act of a Medical 
University, the provisions of the Act shall be in addition to the provisions contained in 
the Act of that Medical University.  
14. Management Committee.– (1) For every Hospital forming part of a Medical 
Teaching Institution, there shall be a “Management Committee” headed by the Dean 
and consisting of the following: 
(a) Hospital Director; 
(b) Medical Director; 
(c) Nursing Director; 
(d) Finance Director; and 
(e) two persons nominated by the Board on the recommendation of 
the Dean.   
(2) The Management Committee shall: 
(i) subject to delegation of powers by the Board, appoint or 
terminate any employee of Medical Teaching Institution in 
accordance with the rules and regulations;  
(ii) review and recommend for approval to the Board, the annual 
operating and development budget for the Medical Teaching 
Institution, as may be prescribed by the regulations;  
 
 
(iii) coordinate efforts to ensure compliance of the rele vant 
Standards; 
(iv) submit a quarterly report on management, healthcare services 
and financial management on a prescribed format to the Board;  
(v) recommend to the Board any addition of a department, facility or 
post at the Medical  Teaching Institution; and  
(vi) perform all such functions as may be prescribed by the 
regulations. 
15. Dean.– (1) The Dean shall be appointed by the Board for a period of five 
years, and shall be eligible for re -appointment, on such terms and conditions and 
having such qualifications and experience as the Board may prescribe. 
 (2) The Dean shall be the Chief Executive Officer of the Medical Teaching 
Institution. 
 (3) The Dean shall act to ensure that the Medical Teaching Institution. 
(a) functions in accordance with the Act, t he rules and the 
regulations; 
(b) complies with minimum standards regarding provision of health 
services; 
(c)  maintains medical records of all patients; 
(d) maintains all other records; and 
(e) works in accordance with the policy directions of the Board. 
 (4) The Dean shall, on his appointment, simultaneously receive a faculty 
appointment at a level commensurate with his qualifications and the prescribed 
Institutional requirements for the faculty post: 
 provide that the term of office of a person as Dean s hall not have effect on his 
position in the relevant faculty. 
 (5) The chairpersons of various departments in the Medical Teaching 
Institutions shall be appointed by the Dean, from amongst the medical faculty on 
such terms and conditions and in such a mann er as may be prescribed and a 
chairperson may be removed by the Board on the recommendations of the Dean. 
 (6) The Dean may be removed from the office by the Board, before the 
expiration of the period of five years at any time on such grounds as may be 
prescribed including failure to achieve targets set by the Board. 
 (7) In the performance of his functions, the Dean shall be responsible to 
the Board and the chairpersons of the department shall be responsible to the Dean 
and the Academic Council. 
 (8) The B oard, in absence of Dean, shall appoint from amongst the 
chairpersons a Vice-Dean to perform the functions of the Dean. 
16. Hospital Director.– (1) The Board shall appoint a full time Hospital Director 
for every Hospital forming part of the Medical Teachin g Institution for a period of five 
years. 
 
 
 (2) The Hospital Director shall be eligible for re -appointment, on such 
terms and conditions as the Board may determine: 
 Provided that no member of the Board shall be appointed as Hospital Director. 
 (3) The Hosp ital Director shall possess 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 i n 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 p rovided in this sub­ section and 
shall have no right to do private practice. 
 (4) The Hospital Director may be removed from the office by the Board, 
before the expiration of the period of five years on such grounds as may be 
prescribed. 
 (5) In performance  of his functions, the Hospital Director shall be 
responsible to the Board. 
 (6) The Hospital Director shall not have any conflict of interest with his 
position as Hospital Director. 
17. Functions of the Hospital Director .– The Hospital Director shall be 
responsible for: 
(a) all non-clinical functions of the hospital; 
(b) preparation of the annual operating and development budget, and the 
business plan for presentation to the Management Committee and 
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) acting as the principal accounting officer responsible and accountable  
for maintaining financial discipline and transparency; 
(f) implementation and execution of Board and Management Committee 
policies and to achieve the targets set by the Board; and 
(g) ensuring compliance with minimum standards and maintenance of 
records 
18.  Medical Director.– (1) The Board shall appoint a full time Medical Director for 
every hospital forming part of the Medical Teaching Institution for a period of five 
years and shall be eligible for re -appointment, on such terms and conditions as the 
Board may determine: 
  Provided that no member of the Board shall be appointed as Medical Director. 
 
 
 (2)  The Medical Director shall, on his appointment, simultaneously receive 
a faculty appointment at a level commensurate with his qualifications and the 
prescribed institutional requirements for the faculty post: 
 Provide that the term of office of a person as Medical Director shall not have 
effect on his position in the relevant faculty. 
 (3) The Medical Director shall possess a recognized medical degree with 
management or administrative experience of working in management positions in an 
institution or organization as may be prescribed by the Board. 
(4) The Medical Director may be removed from the office by the Board, 
before the expiration of the period of five years , on such grounds as may be 
prescribed by the Board. 
 (5) All heads of the clinical department shall report to the Medical Director. 
 (6) In performance of his functions, the Medical Director shall be 
responsible to the Board 
(7) The Medical Director shall  not have any conflict of interest with his 
position as Medical Director. 
 
19.  Functions of the Medical Director .– The Medical Director shall be 
responsible for all clinical functions of the hospital, including: 
(a) ensuring clinical excellence in all functions of the hospital; 
(b) ensuring timely and appropriate management of patients; 
(c) ensuring the best services for all patients; 
(d) undertaking clinical governance for quality control; 
(e) assessing and auditing existing clinical programs and developi ng new 
clinical programs; 
(f) developing annual clinical budget; 
(g) medical equipment requests for presentation to the Hospital Director, 
the Management Committee and the Board; and 
(h) ensuring compliance with minimum standards pertaining to healthcare 
services and maintenance of medical records. 
20. Nursing Director.– (1) The Board shall appoint a full time, Nursing Director 
for every hospital forming part of the Medical Teaching Institutions for a period of five 
years, and shall be eligible for re -appointment,  on such terms  and  conditions as 
the Board may determine: 
 Provided that no Board member shall be appointed as Nursing Director. 
  (2) The Nursing Director shall possess such qualification and experience 
as may be prescribed by the Board 
  (3) The Nursing Director may be removed from the office by the Board 
before the expiration of the period of three years, on such grounds as may be 
prescribed by the Board. 
 
 
  (4) In performance of his functions, the Nursing Director shall be 
responsible to the Board.  
  (5) The Nursing Director shall not have any conflict of interest with his 
position. 
  (6) The Nursing Director shall be responsible for all nursing functions, 
including training of nurses, ensuring adequate nursing staff for all clinical 
requirements, 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. 
21. Finance Director.– (1)The Board shall appoint a Finance D irector for every 
hospital forming part of the Medical Teaching Institution, for a period of three years, 
in such manner as may be prescribed and shall be eligible for re-appointment. 
 (2) The Finance Director shall be an employee of a Medical Teaching 
Institution with such minimum qualification and perform such functions in relation to 
financial matters as may be prescribed. 
22.  Services of the Medical Teaching Institution .– (1) The Board may appoint 
such persons, experts or consultants in the  service of   the Medical Teaching 
Institution, as deemed necessary and on such terms and conditions as may be 
prescribed. 
 (2) Before the enactment of the Act, all administrative and teaching staff 
who are employees of a Medical Teaching Institutions regardless of st atus of terms 
and conditions of service shall be considered employees of the Medical Teaching 
Institution on such terms and conditions as may be prescribed by the Board: 
 Provided that such terms and conditions shall not be less favorable in 
financial terms than the terms and conditions admissible to them immediately before 
enactment of the Act. 
 (3) The civil servants serving in an existing Medical Teaching Institution, 
who opted for the employment of the Medical Teaching Institution, shall be subject to 
terms and conditions of employment as may be prescribed by the regulations 
including but not limited to their service structure, promotion and disciplinary matters 
and such employees shall be entitled to post -retirement benefits and emoluments as 
per existing laws and rules. 
 (4) A civil servant who does not opt for absorption in the Medical Teaching 
Institution, so notified, shall be dealt with in such a manner as provided in section 11-
A of the Punjab Civil Servants Act 1974 (VIII of 1974) for his future p osting, which 
includes deputation to the Medical Teaching Institution subject to a request by the 
Board: 
Provided that a civil servant working in a Medical Teaching Institution shall, at 
all times, be deemed to be on deputation all deductions made from the  pay of such 
civil servants shall be deposited by the borrowing authority: 
Provided further that the period of service of a civil servant working in a 
Medical Teaching Institution shall be counted towards his length of service. 
 
 
 (5) A civil servant at the request of the Board may be sent on deputation to 
the Medical Teaching Institution by the Government.  
 (6) For a civil servant on deputation to a Medical Teaching Institution, 
pension contribution shall be made by the Medical Teaching Institution. 
 (7)  The deputation of a civil servant in a Medical Teaching Institution may 
be terminated by the Board as per deputation policy of the Government and the 
rules. 
 (8) A civil servant who opts to join the employment of a Medical Teaching 
Institution, shall cease to be a civil servant from the date of his notification in the 
service of the Medical Teaching Institution and his seniority, pension and other 
employment affairs shall be determined in the manner, as may be prescribed. 
 (9) In addition to the Fund establi shed under section 26 of the Act, every 
Medical Teaching Institution shall establish from its own resources, a Fund for 
purposes of payment to its employees the contributory pension, benevolent fund, 
group insurance and general provident fund.  
 (10) If at any time, a Medical Teaching Institution reverts to the Government 
for its administration and management, the employees appointed under subsection 
(1) shall continue to serve the Medical Teaching Institutions, on the same terms and 
conditions as applicable to them immediately before such reversion. 
 (11) All employees of a Medical Teaching Institution, whether on deputation 
or appointed directly prior to enactment of the Act or pursuant to the Act, shall be at 
all times governed exclusively by the terms an d conditions of service, as may be 
prescribed. 
 (12) All employees of a Medical Teaching Institution, except the Dean, 
Hospital Director, Medical Director, Nursing Director and Finance Director, shall 
have the right to appeal to the Board, against any pena lty, censure or termination of 
their employment: 
 Provided that the Dean, Hospital Director, Medical Director, Nursing Director 
or Finance Director shall have the right to appeal against decision of the Board to the 
Provincial Review Board. 
 (13) The Provincial Review Board shall be notified by the Government for 
Medical Teaching Institutions and shall consist of such persons as may be 
prescribed by the rules. 
 (14) Any employee aggrieved by a decision of the Board shall have the right 
to appeal to the Provincial Review Board: 
Provided that a decision of termination by or upheld by the Board shall not be 
suspended pending decision of the appeal by the Provincial Review Board. 
 (15) On coming into force of the Act, all employment disputes as may be 
pending be fore any Court shall be transferred to the Provincial Review Board 
established by the Government under subsection (13) 
 (16) An appeal against a decision of the Provincial Review Board shall lie to 
the Supreme Court. 
 
 
 
23.  Private practice .– (1) After issu ance of a notification under section 3 all 
consultants working in a hospital forming part of a Medical Teaching Institution shall 
be given an option either to do their private practice within the hospital of the Medical 
Teaching Institution or to do their private practice outside the hospital of the Medical 
Teaching Institution, as the case may be, and the option shall be exercised within a 
period of sixty days after issuance of such notification: 
  Provided the Board may allow further time period for exerc ise of the option in 
such manner as may be prescribed by the rules. 
  (2) The employees who opt for private practice within the premises of the 
hospital 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) The option to do private practice shall be subject to a performance 
audit in such manner as may be prescribed by the rules, which shall also govern the 
ratio between private and public practice of an individual consultant. 
  (4) The employees who do not opt for private practice within the premises 
of the hospitals of the Medical Teaching Institution, shall not be entitled to any 
increase and adjustment, incentives, bonuses or other ancillary benefits  or 
administrative post, except as may be prescribed by the rules. 
  (5) In the performance of functions in the Hospital, a consultant shall be 
responsible to the Hospital Management, with respect to delivery of services. 
 (6) A Medical Teaching Institutio n 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.  
 (7) A Medical Teaching Institution shall remain open as long as necessary 
to provide services under the Act. 
 (8)  The individual consultant shall be held responsible for the most 
efficient use of the facilities and shall provide c ost and income projections for each 
new facility, equipment or service request with the support of Hospital Director and 
staff. 
  (9) Professional consultant’s fee for private practice shall not exceed the 
fees fixed by the Board. 
  (10) Private patient billing shall include 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 ho spital, and the 
professional fee component shall be returned to the consultant. 
  (11) No reduction of the professional component income to the consultant 
from the patient shall be permissible by the Medical Teaching Institution. 
  (12)  A percentage share  from the institutional charges shall be distributed 
between the employees of a Medical Teaching Institution, based on the performance 
and productivity, according to a format to be prescribed by the regulations. 
 
 
24.   Retention of Fee .– (1) Notwithstanding anything contained in any law or the 
rules, a Medical Teaching Institution shall retain receipts  from various fees levied by 
the  Government or the Board to meet its recurring and development expenditure. 
  (2) The amount realized from receipts of a Medi cal Teaching Institution 
shall not be deducted from the annual grant of the Medical Teaching Institution 
provided by the Government and such amount realized from receipts shall be utilized 
as may be specified by the Board. 
25.  Duties of healthcare service  providers.– Every healthcare service provider 
in a Medical Teaching Institution shall: 
(a) comply with the minimum standards; 
(b) maintain medical records and other records in the prescribed manner; 
and 
(c) provide the same level of care to private and non-private patients. 
26.  Fund.– (1) There shall be a Fund to be known by the name of each Medical 
Teaching Institution and shall vest in the Medical Teaching Institution concerned. 
  (2) The Fund established under section 14 of the Punjab Medical and 
Health Institutions Act, 2003 (IX of 2003), shall be deemed to have been established 
under the Act. 
  (3) The Fund shall consist of: 
(a) grants from the Government as a single line budget; 
(b) receipts and user charges as specified by the Board in 
consultation with the Gov ernment from time to time in such 
manner as may be prescribed; 
(c) voluntary contributions or donations; and 
(d) grants from other sources. 
  (4) The Fund shall be kept in such custody and shall be utilized and 
regulated in such manner as may be prescribed  by the regulations after approval 
from the Government. 
  (5) The Fund account shall be maintained at such Bank or Treasury as 
may be prescribed by regulations after approval from Government 
  (6) The Board may, in so far as its money is not required for i mmediate 
expenses, invest the surplus money in such manner as may be prescribed. 
  (7) The Board shall not invest any money from the Fund in listed securities 
or any derivatives thereof, whether listed or not. 
27.  Budget, audit and accounts .– (1) The oper ating and development budget  
of a Medical Teaching Institution shall be approved by the Board and its accounts 
shall be maintained and audited in such manner as may be prescribed by the 
regulations. 
 (2) The Chief Minister may order to carry out special a udit other than 
routine audit through third party as and when deemed necessary. 
 
 
 (3) The accounts of a Medical Teaching Institution shall be audited by the 
Auditor-General of Pakistan. 
28.  Public servant.– All employees of the Medical Teaching Institution s shall be 
deemed to be public servants within the meaning of section 21 of the Pakistan Penal 
Code, 1860 (XLV of 1860). 
29. Removal of Difficulties .– (1) Notwithstanding anything contained in the 
provisions of the Act, the Government may take such measures as deemed fit for the 
purpose of removing difficulties and ensuring effective and efficient healthcare 
management. 
  (2)  The Government may vest powers and functions in the Chairperson of 
the Board under the rules, which are not inconsistent with the Act. 
30. Power to make rules .– The Government may, by notification in the official 
Gazette, make rules for giving effect to the provisions of the Act. 
31. Power to frame regulations .– (1) The Board may frame regulations not 
inconsistent with the provision of  the Act, applicable standards and the rules for 
carrying out the purposes of the Act. 
  (2) The power to frame regulations conferred by this section shall be 
subject to the condition of previous publication and, before framing the regulations, 
the draft thereof shall be published, in the official Gazette, and 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. 
32.  Overriding effect .– Unless oth erwise provided by the Act and subject to 
subsection (4) of section 13, the provisions of the Act shall have an overriding effect 
and the provisions of any such law to the extent of inconsistency with the Act shall 
cease to have effect. 
33. Repeal and saving.– (1)The Punjab Medical Teaching Institutions (Reforms) 
Ordinance 2019 (XII of 2019) is hereby repealed. 
 (2)  Where applicable, a reference to the Act shall be deemed a reference 
to the Punjab Medical Teaching Institutions (Reforms) Ordinance 2019 (XII of 2019). 
 (3)  Notwithstanding the repeal of the Punjab Medical Teaching Institutions 
(Reforms) Ordinance 2019  (XII of 2019), all actions taken under the repealed 
Ordinance shall be deemed to have been taken under the Act.