The Islamabad Healthcare Regulatory Authority (IHRA) did not inspect the Pakistan Institute of Medical Sciences (PIMS) for compliance with minimum safety and quality-of-care standards, saying the IHRA Act places responsibility for certifying public-sector hospitals' compliance with its standards on the federal government. IHRA officials said the Islamabad Healthcare Regulation Act, 2018, treats public-sector health facilities differently from private hospitals. Public hospitals are deemed registered, while the federal government is responsible for certifying that they meet the minimum safety standards prescribed by the Authority.

Officials said public hospitals are required to apply to IHRA for licences for the health services they provide. However, PIMS has not applied for a licence despite the authority having been operational for several years. "We set the minimum safety standards through our Minimum Service Delivery Standards, but, in the case of public-sector hospitals, the federal government is responsible for certifying whether its hospitals comply with those standards," an IHRA official told Probes Pakistan.

Section 28 of the Islamabad Healthcare Regulation Act, 2018, states that public-sector healthcare establishments shall be deemed registered under the law. It requires the federal government to provide IHRA with a list of its healthcare establishments and details of the services they provide. Section 28(3) states that the federal government shall be responsible for certifying that its healthcare establishments comply with the minimum safety standards set by IHRA.

Federal Health Minister Syed Mustafa Kamal also acknowledged the issue, stating that Prime Minister Shehbaz Sharif had directed him to meet the federal law minister to address concerns relating to IHRA, adding that the matter would be resolved within 7 days. It remains unclear whether IHRA had formally directed PIMS and other federal hospitals to apply for licences, and what action, if any, was taken after they did not do so.