After section 7 of the original Act, the following section 7A. Added:-“7a. Creation of posts: (1) Posts in the health service will be created as prescribed. When reviewing or modifying the structure and staffing, the ministry shall conduct an organization and management survey based on the reasons for adding the program, workload, nature of work and staffing and the justification and available human resources, and send it to the Ministry of General Administration with the consent of the Ministry of Finance. In the case of changes in the organization structure and positions without creating a vacancy, only the organization and management survey of the changed organization structure and positions can be submitted. shall be evaluated and submitted to the Government of Nepal, Council of Ministers for approval within thirty days.

(4) Vacancies created and filled in contravention of this clause shall be automatically cancelled.”