ISLAMABAD, Aug 28: The federal cabinet has shelved a plan for institution-based private practice of doctors in government hospitals owing to an expected adverse reaction from the country’s doctors’ community ahead of elections, it is learnt.
Informed sources told Dawn on Tuesday that a recent meeting of the federal cabinet considered a proposal of the ministry of health for institution-based practice of doctors in public sector hospitals that were prepared on the directives of the Supreme Court of Pakistan.
A two-member Supreme Court bench comprising Chief Justice Iftikhar Muhammad Chaudhry and Justice M Javed Buttar had taken a suo motu notice of the private practice among doctors of public hospitals. On August 6, the attorney general had informed the Supreme Court that a summary seeking gradual improvement in medical practice had been submitted to the cabinet for approval. He, however, did not inform the court that the federal cabinet had already shelved the summary in its meeting of August 1, 2007.
A cabinet member said the meeting discussed the proposal in detail but deferred a decision when some ministers pointed out that lawyers’ community was already up in arms against the government and joining of another influential community like doctors would not be affordable given the fact that election activities were speeding up.
He said the ministry concerned apprised the cabinet that the doctors’ community had been consulted on the initiative but some political ministers were too sensitive about the timing. The ministry of health even assured to introduce institution-based practice as a voluntary scheme but of no avail.
The health ministry also stated that the scheme had been designed on the pattern of army hospitals and would be beneficial for the general public and also for the medical professionals and hospitals. The converse view was that almost all hospitals are facing the problem of shortage of beds and there are capacity constraints.
The cabinet was informed that this practice was earlier tried in the NWFP but failed when most of the A-grade doctors left their government jobs. Some of the members said the proposal had several implications and timing was not right to introduce it.After detailed discussion it was agreed that the timing for the implementation of these proposals was not conducive.
Informed sources said the doctors’ community and the ministry of health had agreed to introduce the scheme for regulating the private practice of public sector doctors and offer wide-ranging facilities and diverse services under one roof to the general public. The health ministry claimed that revenue generation through institution-based practice could be used for improving health facilities at hospitals, enhancing the income of doctors and re-gaining the public trust in government hospitals.
They had also agreed to introduce the scheme in a gradual, phased and voluntary basis, starting with Pakistan Institute of Medical Sciences (PIMS) at the federal level and one each tertiary hospital in all the provinces. Under the scheme, the entire revenue was to be shared by the doctors and hospitals on 50:50 basis. In Punjab, institution-based practice is already in vogue in two hospitals -- Sheikh Zayed Hospital, Rahimyar Khan and Punjab Institute of Cardiology, Lahore. A rule that barred the government hospitals from directly utilizing this revenue was, however, seen as a legal hitch and the ministry of finance was not ready to given away its authority of controlling revenues.
During the hearing the CJ observed that except Pakistan almost every country including India had legislation on institution based private practice and referred to institutions like the Aga Khan University Hospital and Combined Military Hospital (CMH) and the Military Hospital (MH) which have allowed such practice.
Earlier a committee under the Inspector General (Hospitals) Ministry of Health after consultations with the provincial health secretaries, the Pakistan Medical and Dental Council (PMDC) and the Pakistan Medical Association (PMA) had recommended a phased institutional-based private practice after normal hospital hours.
They had agreed that utilities should also be made up from the hospital share and the utilisation of revenue/income should be monitored in each hospital by a vigilance committee.
