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March 4, 2002
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Monday
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Zilhaj 19, 1422
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Doctors and the ban
MoU on gas pipeline
QAU under deficit
Doctors and the ban
THE new — but controversial — health policy introduced in Punjab and the NWFP by the provincial governments has led to a standoff between the government and the medical profession. The contentious issue at the moment is the ban that has been imposed on private practice by senior doctors in government hospitals. The PMA has termed the ban detrimental to the health sector. But a section of opinion, which is strongly critical of the negligence shown by some consultants in public sector hospitals, has welcomed the move. The situation points to the decay in the health sector, and it is evident that the ban on private practice will not improve matters. The resistance from the doctors, a majority of whom have adopted the line of non-cooperation, will deepen the crisis.
The underlying rationale of this move is not clear. It cannot be denied that a number of cases have been reported where doctors have neglected their work in a government hospital to pay more attention to their private patients from whom they generate lucrative earnings. But simply asking them not to see patients privately will not improve the working of the hospitals. Given the measly pay scales of government doctors, economic compulsions make private practice inevitably attractive to them, specially when the marketplace has come to dominate society. The private hospitals and some autonomous institutions in the public sector, which disallow private practice, compensate their consultants with handsome salaries. The government, thus, will not be able to retain the services of its clinicians if it cannot pay them well and restrains them from their lucrative practice.
If the underlying idea of the newly introduced “institution-based private practice” is to generate revenues for the exchequer, the scheme is not worth the alienation it is causing. Under this plan the clinicians will be required to give 40 per cent of their fee (fixed at Rs200 per patient) to the hospital and five per cent as income tax to the government. This fee structure will at best fetch a modest sum for the government and will not work without the cooperation of the doctors. The institution-based private practice may ultimately offer no better services than the hospital does, albeit at a higher fee.
It would be more advisable for the two to rethink this measure which has already been rejected by Sindh. Having said this, we must also stress the need for the government to take a hard look at the health sector and consider reforms in the public health delivery system. Ther