KARACHI: Donors have no role in health units they revive
By Nizamuddin Siddiqui
KARACHI, March 31: A philanthropist and his team were allowed some say in the operations of a unit in a government hospital, which they helped revive through millions of rupees in donations, only after considerable pressure from various quarters.
A well-placed source told Dawn on Monday that even though the philanthropist in question had been assured a role in the operations of the once sick unit, which was inaugurated by a VVIP late last year, a memorandum of understanding dealing with the operations of the unit was initialled after a lot of reluctance on the part of government officials.
The source said the donors had to approach several influential people and inform them of the health department’s attitude towards the issue. The philanthropists got some say after these influential people exerted pressure on the department.
In recent days Dawn has come across several people who have donated generously to the public hospitals but who are not being allowed much say in the day-to-day operations of the units they helped revive. This shows that all’s not well vis-a-vis the government’s much-publicized Public Private Partnership (PPP) programme.
A source disclosed that no blueprint existed for the would-be saviours of the sick units under the PPP. No set of common guidelines had been formulated yet that could be followed by all the donors and philanthropists. Each venture thus was a journey into the unknown for the philanthropists.
This is despite the fact that the PPP initiative is the baby of federal government and President Musharraf, in his speeches, has termed it an important element in his policies.
In the prevailing circumstances, then, it is really surprising for some people that so many PPP initiatives have actually taken off the ground and several sick units revived. What surprises them is that so many people are donating large amounts despite lack of standard and uniform policy regulations.
A senior official, who talked to Dawn on condition of anonymity, opined that some philanthropists belonging to the business community didn’t see donations as pure social work.
“They view them as social work-cum-investment. They realize full well that, if handled properly, the PPP projects can be quite rewarding in terms of goodwill generated. This often becomes an incentive for them.”
The official added that not all donors thought this way. “There are a number of genuine people too. But the genuine people actually demand anonymity whenever they donate some amount.”
This official said the businessmen who sought publicity for their initiatives didn’t mind too much if the units revived through their funds again fell into the doldrums. “This is so because their prime aim is not to provide service to the people for which continuation of satisfactory performance of the unit was essential
“Their main aim is to hog the limelight. They couldn’t care less if, after this objective is achieved, the unit concerned falls upon bad times.”
A businessman who is instrumental in reviving at least two sick units didn’t agree with this contention. He said there was no need to doubt the intentions of all donors.
“Some people make out philanthropy to be one big profitable exercise. If this is true, why don’t all the businessmen become donors and philanthropists?”
A government official said it was imperative that standard guidelines for the PPP initiatives be formulated as soon as possible. “First of all the government should formulate a set of common guidelines — a blueprint if you like — which should regulate the steps taken under each PPP project.”
But if the government didn’t formulate a set of guidelines, the organizations interested in attracting donations should do so, he said.
“This they should do in the interest of transparency and fairplay. So, every medical superintendent, every director should make it a point that common guidelines are drafted which are followed under each PPP initiative.”
He was of the view that the guidelines should govern not only the “funding phase” of the project but also the “operation phase”. “That is to say, the blueprint should include not only the principles governing cash flows but also the ones dealing with issues in management of the revived units.
“This section of the blueprint, in other words, should mention clearly how much say will the donors have in the operations of the resuscitated units.”
The official said every donor should know beforehand if he would have any say in the operations of the once sick units. He was of the view that the donors should enjoy considerable say in the units after the funding phase is completed satisfactorily.
Two donors who were instrumental in reviving a couple of sick units in the Civil Hospital Karachi said every philanthropist should be allowed “due” role in the operations of the project.
“First, there should be impartial people inside the system to protect the interest of the masses. Secondly, I don’t think the government officials are sincere enough to ensure that the revived units are run properly once they are removed from the limelight after ribbons are cut and speeches are made.”
When asked to comment over the issue, a senior official of the Pakistan Medical Association raised a very interesting point. He said the people who wanted to work for the welfare of the masses didn’t care if there were proper guidelines or not.
“Look, the government doesn’t give us enough money. So there’s no choice for the hospitals but to look up to philanthropists for assistance. And we need money urgently because the sooner we get down to the job at hand the better.”
He said the philanthropists and doctors who either wanted to revive sick units or build new ones didn’t really care if proper guidelines were in place or not. “Guidelines or no guidelines, these people want to press forward and get down to business.
“They don’t want to waste months upon months waiting for rules and regulations that will only serve to dampen the spirits of all and sundry.”
A government official warned that if proper guidelines were not formulated anytime soon, the units which had been revived recently under the PPP programme might soon fall upon bad times.
“Interference from government officials will ensure this. Systems are not run by funds but by people. Without proper blueprints, people cannot perform optimally.”
