January 14, 2006	Saturday	Zilhaj 13, 1426

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ISLAMABAD, Jan 13: Private hospitals and nursing homes, which have mushroomed in every nook and corner of the country, are functioning without proper accreditation or any government’s quality maintenance mechanism to check delivery of quality health care to patients.

“With notable exceptions, private hospitals, nursing homes and clinics in Pakistan do not follow facility design standards, while the high cost involved in building a hospital always leads to a tradeoff between quality and costs,” says a Gateway Paper on Health Systems in Pakistan-a Way Forward, available with Dawn. The publication has been issued by the recently-launched Pakistan’s Health Policy Forum.

The report has stressed the need for establishing mechanisms by the government to ensure optimal quality for different tiers of health care providers across the country. Such measures should also include establishment of an institutional mechanism like the national council for health care quality, mandated to formulate minimum quality standards for the establishment of hospitals, nursing homes and clinics. The same council should also provide specific criteria for yearly or biennial inspection of health facilities and undertake inspections to ensure compliance with these standards.

In the absence of such measures, there seems to be no check on private establishments to ensure optimal quality of services, particularly when such facilities are making high return on their investments, the report said.

Pakistan is a large market for private health care delivery where the private sector has developed considerably by capitalizing on demand despite lack of any conscious effort by the government to promote private sector, it said.

However, despite its mammoth size, the sector is still poorly regulated, as a result of which most facilities it offers provide a living or profits to owners but do not offer universal financing concessions to poor patients.

Currently, private clinics are more than often set up in unhygienic environments and employ rudimentary medical technology. Moreover, top managements of such setups do not have enough leverage to establish multidisciplinary facilities with optimal technological backup.

Once such facilities have been established, no formal system exists to ensure quality care through yearly or biennial inspections by local health authorities, the report said.

On the other hand, the Pakistan Medical and Dental Council (PMDC) only licenses doctors to practise medicine, but does not provide minimum standards for the establishment of health care facilities, it deplored.

However, two reputable private hospitals, one in Karachi and the other in Lahore, are in the process of getting accredited from the Joint Commission of Accreditation of Hospital Organizations USA, which certifies facilities worldwide on specific performance criteria.

There is a great need for a local accreditation council for defining and maintaining optimal standards of management, quality and services provided in private facilities, while potential within PMDC to play a role in this connection needs to be explored, the report suggested.