November 27, 2001	Tuesday	Ramazan 11, 1422

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MULTAN, Nov 26: Eighty per cent patients prefer private sector health facilities in the Punjab, say survey reports of the health department’s special projects wing.

Hakeems, quacks and traditional healers also included in the private sector health coverage.

The public sector provides only 20 per cent coverage in health sector through its 2,460 basic health units, 287 rural health centres, 58 tehsil headquarters hospitals and 26 district headquarters hospitals.

As many as 150,000 doctors, paramedical staff and other officials are deputed at 5,000 health facilities in the province. On the average, five patients visit a BHU, 20 RHC and about 40 THQ hospital daily. The average manpower deputed at a BHU is 10, at RHC 30 and at THQ hospital 70 to 90.

Around 70 per cent of the health department’s budgetary allocations are spent on the establishment expanses. A sum of Rs8.5 billion has been earmarked for the health sector in the Punjab during the ongoing fiscal.

The reports reveal that 50 per cent of the staff usually remains absent from the place of their posting “owing to their ‘over indulgence’ in private practice”.

Only 30 per cent of the health sector budget is supposed to be utilized on services, including medicines and consumables. Ironically, 50 per cent of the allocations lapse every year owing to non-utilization of the funds. Most of the remaining 50 per cent funds have to be utilized to pay utility bills, POL expenditures, stationery, TA and DA.

The reports pointed out that in some areas specialist doctors posted at DHQs and THQs have not been transferred for the last 20 years. They have established their private hospitals or clinics in the vicinity of the state-run hospitals. Consequently, the public sector health facilities have become mere referral places to their private hospitals.

In some cases, the specialists have either taken away equipment of the state-run hospitals to their clinics and hospitals or it is deliberately kept inoperative. This also forces patients to go to the private health facilities.

Negligence on the part of health authorities has turned buildings of several state-run health facilities, especially in rural areas, into ruins. A survey report says about 60 per cent of the buildings have not been repaired for the last 10 to 15 years.

According to the reports, other causes for the failure of state-operated health facilities are shortage of medicines, poor system of supervision and evaluation of the staff performance, inadequate delegation of powers to the administrators concerned and cross under-utilization of primary health care facilities.

The reports suggest measures to restore people’s confidence in state-run health facilities like transfer of the staff after every three years, streamlining the availability of medicines along with a vigil on their pilferage, recovery and repair of the hospital equipment, regular supervision, training of the staff to improve their professional skills and attitude, proper delegation of financial powers to the administrators and incentives to the hard-working officials.

It is also suggested that some of the state-run health facilities should be handed over to NGOs or the private sector under certain conditions through the recently-formed local governments.

According to a senior health official, the handing over of state health facilities to NGOs yielded positive results in the past. At some places, medical officers had arranged medicines and equipment at their own and charged a nominal fee from the patients against these services.

“These unofficial arrangements also produced good results,” the official said, and added “the number of patients increased manifold at such health facilities”.

He said the health services sector had to be revamped with jointly by public and private sectors, especially in rural areas of the province where major chunk of the population resides.