ISLAMABAD, Dec 24: All public and private sector hospitals would be brought under a strict watch through an ambitious regulatory framework being developed by the government to ensure desired standards at health facilities in the country.

An official source told Dawn that the new law being framed would require establishment of a regulatory body, which would ensure that all hospitals in the public as well as the private sectors conformed to certain guidelines.

In the public sector, there are approximately 1,022 hospitals in the country, of which 56 are tertiary level, 116 district level facilities, whereas 850 are small and medium size hospitals.

Perhaps the biggest challenge being faced by the federal health ministry is to maintain certain standards at all the public sector hospitals, the lack of which also left a negative impact on the private sector health facilities.

After the implementation of the new law, all the hospitals would be required to seek a licence from the regulatory body by ensuring cleanliness, patient-friendly atmosphere, suitable diagnostic facilities, and induction of properly trained and experienced doctors. The regulatory body will also have the power to penalise, or in some cases advise closing down of, some institutions which fail to conform to the standards set under the new law, the source said.

The Gateway Paper on Health Systems in Pakistan developed by Pakistan Health Policy Forum, a civil society organisation, had asked the government to reform functioning of hospitals to increase their efficiency.

Poor performance of hospitals is often attributed to several factors like paucity of resources, limited management expertise, lack of staff training, absence of formal management and human resource tools, and misunderstandings between administrators and clinicians.

Poor quality of services at the basic healthcare facilities is the single most important contributor towards burdening tertiary hospitals in the country, the forum pointed out, adding that gaps at the management level had also resulted in declining efficiency over years.

Likewise no mechanism of accreditation or quality maintenance existed for the private sector hospitals and nursing homes in Pakistan.

As a result, there is no incentive for ensuring or not ensuring optimal quality of services, specially when such facilities seem to make a high return on investments.

Baring few exceptions, private hospitals, clinics or nursing homes do not follow facility design standards, and usually tradeoff between quality and costs. Besides, private clinics are more than often set up in unhygienic environment and employ rudimentary medical technology, and once facilities have been established, no formal mechanism exists to ensure continued quality of care through yearly or biennial inspections by local health authorities.

The information regarding development of stringent regulatory rules for the hospitals was revealed during a meeting between Health Secretary Anwar Mehmood and a delegation of Association of Physicians of Pakistani Descent in North America (APPNA), led by its President for the year 2007 Dr Nadeem Qazi, in Islamabad on Saturday.

Prospects of cooperation between the health ministry and APPNA were also discussed for improving human resources, infrastructure facilities and practise of medical profession in Pakistan.

The association offered assistance in areas like continuing education of doctors; registration and regulations of hospitals; regulations of diagnostic laboratories, and trainings in trauma and life-saving skills.

Dr Nadeem Qazi said under the patronage of APPNA-supported Life Saving Foundation, 5,000 health service providers had been trained in basic life support and advance life support skills.

He, however, emphasised the need for expanding the scope of training, and extending it to the teachers in all educational institutions with a view to preparing general public to respond correctly in emergency situations.

APPNA has been playing the advocacy role for relaxation in visa policy for Pakistani doctors in the US, and the percentage of those getting waiver of J-I visa has increased from 27 cent to 93.