PUNJAB PRIMARY AND SECONDARY HEALTHCARE SERVICES ACT 2025

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PUNJAB PRIMARY AND SECONDARY HEALTHCARE 
SERVICES ACT 2025  
(LX of 2025) 
CONTENTS 
1. Short title, extent and commencement. 
2. Definitions. 
3. Healthcare Facilities. 
4. Maryam Nawaz Community Health Services. 
5. Maryam Nawaz Health Clinics. 
6. Outreach Mobile Healthcare Units. 
7. Maryam Nawaz Hospitals. 
8. Tehsil Headquarter Hospitals. 
9. District Headquarter Hospitals. 
10. Monitoring, Reporting & Evaluation. 
11. Health Data Protection and Confidentiality. 
12. Digital Referral System. 
13. Responsibilities of the Department. 
14. Director General, officers, etc. 
15. Recruitment of Human Resource. 
16. Liaison with other departments, etc. 
17. Public Servants. 
18. Indemnity. 
19. Delegation of Powers. 
20. Power to make rules. 
21. Act to override. 
22. Removal of difficulties. 
23. Saving.
TEXT 
1
PUNJAB PRIMARY AND SECONDARY HEALTHCARE SERVICES 
ACT 2025  
(LX of 2025) 
           [01 July 2025] 
An 
Act 
to provide the mechanism for provision of healthcare services, as well as operation 
and management of primary and secondary healthcare facilities 
It is necessary and expedient to provide for a framework for provision of primary and 
secondary healthcare services through a complete structure of outreach community 
services, primary essential package of healthcare services and hospital based 
secondary healthcare to ensure universal access to quality healthcare, digitization of 
public healthcare records and building a digital referral mechanism within the 
province of Punjab.  
It is hereby enacted by Provincial Assembly of the Punjab as follows: 
1. Short title, extent and commencement . – (1) This Act may be c ited as the 
Punjab Primary and Secondary Healthcare Services Act 2025. 
(2) It extends to the whole of Punjab. 
(3) It shall come into force at once. 
2. Definitions.– In the Act: 
(a) “Act” means the Primary and Secondary Healthcare Services Act, 
2025; 
(b) “agreement” means a written contract stipulating terms and conditions 
between service provider and the Department for provision of 
Community Health Inspectors or management of health facilities 
between the health manager and the Department; 
(c) “Community Health Inspector” means an accredited healthcare 
professional designated under this Act; 
(d) “Department” means the Health and Population Department, 
Government of the Punjab; 
(e) “Director General” means the Direct or General Health Services, 
Punjab; 
(f) “Directorate” means the Directorate of Monitoring and Evaluation as 
established under section 10 of the Act; 
(g) “electronic medical records” means digital records of a person’s 
medical history, diagnostics, clinical assessm ents and healthcare 
                                                 
1
This Act was passed by Provincial Assembly of the Punjab on 26 June 2025; and was assented to by Governor of the Punjab 
on 01 July 2025; and was published in the Punjab Gazette (Extraordinary), dated: 01 July 2025, pp. 05-10. 
 
 
services received through Community Health Inspector, outreach 
mobile healthcare units or at any primary or secondary healthcare 
facility; 
(h) “Government” means the Government of the Punjab; 
(i) “healthcare facility”  means premises provided un der section 3 of the 
Act; 
(j) “health manager”  means medical practitioner for outsourced service 
delivery or specialist consultants  provided under section s 5 and 7 of 
the Act; 
(k) “healthcare services” means and includes all services relating to 
primary and second ary healthcare as notified by the Department from 
time to time for improving quality of healthcare service delivery; 
(l) “health data” means the data described in section 11 of the Act;  
(m) “medical practitioner” means an MBBS doctor regist ered with the 
Pakistan Medical and  Dental Council and has a valid registration 
throughout his engagement as service provider; 
(n) “patient” means any individual who visits a healthcare facility and 
receives a healthcare service; 
(o) “prescribed” means as prescribed by the rules framed under the Act;  
(p) “service provider” means medical practitioner, specialist consultants, 
health manager, outsourced agency providing Community Health 
Inspectors, or any person who has been hired for any purpose under 
the Act; 
(q) “specialized hospital” means a hospital which is directly under the 
control of the Specialized Healthcare and  Medical Education 
Department, Government of the Punjab; and 
(r) “Union Council” shall have the same meaning as provided in the 
Punjab Local Government Act, 2022 (Act XXXIII of 2022). 
3. Healthcare Facilities.– Following premises shall serve as healthcare facilities 
under the provisions of the Act: 
(a) Maryam Nawaz Health Clinics; 
(b) Maryam Nawaz Hospitals; 
(c) Tehsil Headquarter Hospitals; and 
(d) District Headquarter Hospitals. 
4. Maryam N awaz Com munity Health Services .– (1) Maryam Nawaz 
Community Health Services Programme shall provide basic healthcare to people 
from birth to end of life at home and in communities thro ugh Community Health 
Inspectors. 
(2) The Government shall determine terms and co nditions, fee for services 
and responsibilities of the Community Health Inspectors. 
 
 
(3) In addition to the general responsibilities, the Department may from 
time to time notify designated area, description of services and additional tasks, 
related and ancillary to healthcare services, for Community Health Inspectors. 
(4) The Department shall hire Community Health Inspectors either directly 
or through third party service providers. 
Provided that in case Community Health Inspectors are hired through a third-
party service provider, all modalities shall be finalized through a written Agreement. 
5. Maryam Nawaz Health Clinics .– (1) The Department shall make 
arrangements for provision of essential package of healthcare services through 
establishing one or more fully equipped Maryam Nawaz Health Clinics in each Union 
Council depending on population of the Union Council by either upgrading the 
existing healthcare facilities or by constructing new healthcare facilities wherever 
required, to be determined by the Government. 
(2) Maryam Nawaz Health Clinic shall be made operational on 
performance-based financing, through complete outsourcing to a medical practitioner 
as a health manager, for operational management, including clinical services, 
provision of allied health professionals and free medicines to patients. 
(3) The Government shall determine eligibility criteria and devise a 
mechanism for hiring of health manager through an open competitive process for the 
purpose. 
(4) Terms and conditions of Agreement of outsourcing shall be determined 
by the Government containing, inter alia, the following: 
(a) Scope of services; 
(b) Responsibilities of parties; 
(c) Financial terms; 
(d) Duration of contract; 
(e) Monitoring and evaluation mechanisms; 
(f) Termination and dispute resolution clauses; and 
(g) Any other special policy instructions issued by the Department 
from time to time. 
(5) Subsequent to digitization of health data of catchment population for 
each health clinic; the Government may decide to make the said clinic operational 
through outsourcing of services to a health manager on capitation payment basis. 
(6) The Government shall determine the designated catchment area of 
health clinic, the rate of capitation payment per person and the duration of 
Agreement for the purpose. 
6. Outreach Mobile Healthcare Units .– The Department shall make 
arrangements for provision of healthcare services in uncovered urban areas or hard 
to reach areas through mobile healthcare service units. 
7. Maryam Nawaz Hospitals .– (1) The Department shall make arrangements 
for provision of healthcare services including  but not limited to pediatrics, dental, 
 
 
gynecological and surgical procedures, and related diagnostic services across the 
province either through establishment of at least one fully equipped  Maryam Nawaz 
Hospital to address the needs of population constituting catchment area of maximum 
five Maryam Nawaz Health Clinics by upgrading the existing facilities or constructing 
such new hospitals wherever required, to be determined by the Government. 
(2) Maryam Nawaz Hospitals shall be made operational through complete 
outsourcing on performance -based financing to  health manager, comprising the 
prescribed specialist consultants, for operational management, including clinical 
services, provision of allied health professionals and free medicines to patients. 
(3) The Government shall determine eligibility criteria, qualification and the 
mechanism for hiring specialist consultants through an open competitive process for 
outsourcing purpose.  
(4) Terms and conditions of Agreement for outsourcing are to be 
determined by the Government containing, inter alia, the following: 
(a) Scope of services; 
(b) Responsibilities of parties; 
(c) Financial terms; 
(d) Duration of contract; 
(e) Monitoring and evaluation mechanisms; 
(f) Termination and dispute resolution clauses; and 
(g) Any other special policy instructions issued by the Department 
from time to time. 
8. Tehsil Headquarter Hospitals .– (1) The Department shall make 
arrangements for provision of wide range of secondary level specialist healthcare 
services and related diagnostic services at tehsil level, except district headquarters, 
across the province by establishing at least one fully equipped Tehsil Headquarter 
Hospital, to be determined by the Government. 
(2) The Departmen t shall determine and notify the range of specialist 
services, outpatient, inpatient and emergency services to be provided by Tehsil 
Headquarter Hospitals. 
(3) The Government may determine operational mechanism for  Tehsil 
Headquarter Hospitals through admi nistration by the Department or complete 
outsourcing to eligible  persons for management, provision of administrative and 
clinical services, provision of allied health professionals, support staff and free 
medicines to patients through open competitive proc ess on performance -based 
financing. 
9. District Headquarter Hospitals .– (1) The Department shall make 
arrangements for provision of complete package of secondary level specialist 
healthcare services and related diagnostic services at district headquarters ac ross 
the province, except where specialized hospitals are set up, by establishing at least 
one fully equipped District Headquarter Hospital, to be determined by the 
Government. 
 
 
(2) The Department shall determine and notify complete range of services 
relating to each specialty, outpatient, inpatient and emergency services to be 
provided by District Headquarter Hospitals. 
(3) The Government may determine operational mechanism for District 
Headquarter Hospitals through administration by the Department or compl ete 
outsourcing of management, provision of administrative and clinical services, 
provision of allied health professionals, support staff and free medicines to eligible 
persons through open competitive process on performance-based financing. 
10. Monitoring, Reporting & Evaluation.– (1) The Department shall establish a 
Directorate comprising of a Command & Control Center for monitoring, reporting, 
evaluating and regulating service delivery at all primary and secondary levels. 
(2) The directorate may employ an i ntegrated approach of collection, 
verification and analysis of real-time health data from the healthcare facilities through 
electronic medical records, including, inter alia,  provision of community services, 
preventive services, patient visits,  general ph ysician and specialist medical 
practitioner consultations, diagnostic services, surgical and other curative 
procedures, emergency care, maternal and child healthcare services, immunizations, 
family planning, closed circuit television footage, routine and s urprise field visits 
through designated monitoring assistants. 
(3) The Department may appoint and post such number of officers for this 
directorate as deemed necessary keeping in view its requirements. 
(4) The Department, for the purpose of defining the ma ndate of this 
directorate, shall notify specific responsibilities from time to time. 
11. Health Data Protection and Confidentiality.– (1) Subject to the provisions of 
this Act, all data  or information acquired or collected by the Department, either 
through physical or electronic methods shall make part of the “health data”, which 
shall include: 
(a) person’s demographic and medical information and any other 
ancillary data acquired during the course of service delivery; 
(b) any information acquired through electronic medical records; 
(c) data regarding stock details of bio -medical or other equipment, 
machinery, medicines, consumables, vaccines and any other 
moveable or immovable assets pertaining to the Community 
Health Inspector or healthcare facilities; 
(d) Any data or infor mation to determine service delivery 
performance of Community Health Inspectors, Health Managers, 
Healthcare Facilities or any service provider; 
(e) Any data relating to key performance indicators; 
(f) Any data relating to communicable and non -communicable 
diseases; 
(g) Any data acquired in the course of performance of contractual 
obligations under the Agreement;  
 
 
(h) Any data which is acquired directly or indirectly under the 
provisions of the Act, rules framed h ereunder and the 
Agreement; and 
(i) Any other form of data as ma y be prescribed in the rules or as 
the Department may notify from time to time. 
Provided that all the rights relating to the Health Data are reserved by the 
Department, and the same may be used and shared for analysis to improve the 
quality of health service delivery by the Department. 
Provided further that the Health Data may be provided upon the directions of 
a Court or a forum strictly in accordance with the prevalent law.   
(2) The protection and confidentiality of the Health Data shall be ensured. 
Any person who has acquired access to the Health Data, voluntarily or involuntarily, 
shall keep the same confidential and may not use or disseminate it without the 
specific approval of the Department. 
12. Digital Referral System .– (1) The Department shall make te chnical 
arrangements and capacity building support for establishing Digital Referral System 
with two -way referral from primary level facilities to secondary level facilities or 
specialized hospitals and vice versa with the aim to optimize patient satisfact ion and 
utilization of time, human and financial resources. 
 (2) The Department shall determine and notify standard operating 
procedures for implementation of digital referral system at all healthcare facilities and 
outreach mobile healthcare units. 
13. Responsibilities of the Department .– The Department shall be responsible 
for: 
(a) allocation and provision of necessary development or non-development 
resources and support from local or international agencies for provision 
of healthcare services at all levels; 
(b) ensuring provision of necessary infrastructure, equipment, machinery, 
vaccines, medicines and any other ancillary items as may be required; 
(c) monitoring provision of healthcare service delivery in community and at 
Health Facilities and take necessary correct ive measures, wherever 
required; 
(d) carrying out routine third -party evaluations to analyze service delivery 
performance in community and at Healthcare Facilities; 
(e) provision of platforms for necessary capacity building trainings and 
workshops for healthcare service providers from time to time on its own 
or through third parties, non -government organizations and other 
entities for improving the standard of services; 
(f) making arrangement for dissemination of information through print and 
social media regarding healthcare services when necessary; and  
(g) safeguarding the implementation of the provisions of this Act, rules 
framed hereunder, and the terms of the Agreement. 
 
 
14. Director General, officers, etc .– (1) The Director General, on behalf of the 
Department and subject to such terms and conditions as may be determined by the 
Department, shall be the designated authority to ensure functioning and 
implementation of the provisions of this Act. 
 (2) The Department may appoint such number of officers, advisors, 
experts, cons ultants or other employees as per its requirements for smooth 
implementation of the Act. 
15. Recruitment of Human Resource .– (1) All recruitment of clinical or non -
clinical staff including inter alia  administrative staff, specialist consultants, medical 
practitioners, pharmacists, allied health professionals and support staff shall be on 
special pay packages for a fixed term. 
(2) The Government shall determine terms and conditions, special pay 
packages and job description of all positions mentioned in sub-section (1). 
(3) The Government shall constitute Special Selection Committees for all 
recruitment mentioned in sub-section (1). 
(4) Human resource hired under this Act through any mode shall n either 
be entitled to regularization of services regardless of the duration of their work 
performed for the purposes of this Act  nor shall claim status of Civil Servant under 
the Punjab Civil Servants Act 1974.  
16. Liaison with other departments, etc.– (1) For the purposes of uninterrupted 
healthcare service delivery under the provisions of the Act, the Department may 
establish liaison with any other department, authority or body of the Government or 
any third party. 
 (2) In that eventuality, such department, autho rity or body of the 
Government, third party, non -government organization or a foreign agency shall be 
bound to provide assistance to the best of its capacity for furthering the purpose of 
the Act and the rules framed hereunder. 
17. Public Servants .– The Direc tor General, an officer, expert, advisor, 
consultant, clinical or non-clinical staff member, health manager or community health 
inspector working directly under the Act, shall be deemed to be a public servant in 
terms of Section 21 of the Pakistan Penal Code, 1860 (XLV of 1860). 
18. Indemnity.– No suit, prosecution or other legal proceedings shall lie, against 
the Government, Department, Director General or any other person providing 
healthcare service, for anything which is, in good faith, done or intended to  be done 
under the Act or the rules. 
19. Delegation of Powers .– (1) The Government or the Department may, by 
notification, delegate any of the powers under this Act to an officer subordinate or 
any other local authority or entity in such circumstances and on such conditions as it 
may determine. 
 (2) The Department may constitute committees for the purpose of 
completing the assignments and regulating the affairs under the provisions of the 
Act, and the rules framed hereunder.  
 
 
20. Power to make rules .– (1) Government may, by notification in the official 
Gazette, make rules to carry out the purposes of the Act. 
 (2) Without prejudice to the generality of provisions of sub -section (1), the 
rules may provide for, inter alia, any of the following: 
(a) Functioning, maintenance, and performance of healthcare 
facilities; 
(b) collection, monitoring, reporting, evaluation, analysis and 
protection of data; 
(c) provision of designated health services at the healthcare 
facilities; 
(d) any other matter in furtherance of the provision of the Act. 
21. Act to override.– Notwithstanding anything contained in any other law for the 
time being, the provisions of this Act shall have an overriding effect. 
22. Removal of difficulties .– If any difficulty arises in giving effect to the 
provisions of the Act , the Government may, by an order, not inconsistent with the 
provisions of the Act, remove the difficulty. 
23. Saving.– (1) All actions already taken by the Department to  the extent that 
they are not inconsistent with the objectives and provisions of the Act,  shall be 
deemed to have been validly done. 
 (2) The Department may, to the extent of any inconsistency, make 
requisite changes for bringing the existing framework in consonance with the 
provisions of the Act.