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| June 1, 2005 | Wednesday | Rabi-us-Sani 23, 1426 |
SBP governor says health delivery system elitist
ISLAMABAD, May 31: State Bank of Pakistan (SBP) Governor Dr Ishrat Hussain on Monday called for addressing the root causes of the failure of health services delivery to the poor rather than increasing spending on the health sector. Speaking at the launch of Mahbubul Haq Human Development Centre’s “Human Development in South Asia 2004 — The Health Challenge”, he termed the country’s health delivery system elitist, where rationing of access to service was done according to the status of the patient. The system favours the elite over the poor, who are in more need of help, he added.
He wondered why the country failed to progress on the social indicators despite unanimity among all political forces and other stakeholders on the issue. Look at the manifestoes of all political parties and you would see that there is almost a consensus on the issue of human development, he said.
The SBP governor urged the elected representatives to act as watchdogs for health care centres in their constituencies by monitoring their performance and ensuring delivery of services to the poor rather than remaining more interested in the postings and transfers of doctors.
This would improve the standing and image of the elected representatives among their electorates, he observed.
Criticizing the management of social services, Dr Hussain said inexperienced and unqualified persons were aspiring for administrative functions simply because of perks and privileges. Things, he said, could improve by having specialist administrators in such institutions. There is no point in having a top class surgeon or a physician run a hospital; its not their job; “we need to have specialists for administrative cadres,” Dr Hussain said.
He said there was no sense in the grassroot health institutions being run by the local governments, while the transfers and postings were done by the provincial governments. Another problem with the health sector was bundling of functions — planning, execution, implementation and regulation at all tiers. This, he said, was impairing the capacity of the government agencies and the situations demanded immediate rectification. He called for independent regulatory mechanisms, saying regulation of private medical education was begging government’s attention.
Calling for a clear delineation of responsibility and accountability of results, the governor said the structural ambiguity concerning responsibility in different tiers coupled with overlapping of roles had created confusion and resulted in wastage of resources.
Earlier, Adviser to the Prime Minister on Finance and Economics Dr Salman Shah said the challenge before the government was sustaining the growth rate that it had achieved. “If we are able to sustain this for a decade or so, we would then be able to create a dent in the poverty.”
He said one of the critical dimensions in the government’s strategy was the human element and major investment in the education and health sectors was being planned. The government, Dr Shah said, aimed at raising the spending on social sector to 6-7 per cent of the GDP.
Besides, he said, Khushal Pakistan Fund had been established with primary focus on human development. This fund, he maintained, would help the government deal with the health and education sectors in a more comprehensive way.
Sharing the findings of the report, Mahbubul Haq Human Development Centre President Khadija Haq said Pakistan’s public health expenditure was not only lower than that of other developing countries, but had also not experienced any visible improvements in the last three decades.
The report comes up with four broad findings: the economic growth in the region has not translated into better health for majority of population; whatever improvement in health has happened, it has not reduced the existing inequity based on gender, class and location; efficiency and accountability have been missing from health delivery system provided by both the public and private sectors and that the health sector reforms have not worked.
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