July 16, 2008	Wednesday	Rajab 12, 1429

KARACHI, July 15: The Pakistan Medical Association, Karachi chapter, has called for reforms in the basic health delivery system to bring it in line with the present needs and problems of the ailing masses, the majority of whom live in the rural areas.

The government should not withdraw itself from the responsibilities of providing health care facilities to its people in the name of public-private partnership and refocus on the functioning of the basic health units and rural health centres, which are badly in need of doctors, midwives, nurses and paramedical staff besides increased budgets, the PMA office-bearers said.

Addressing a news conference on Tuesday, Dr Abdul Aziz Tank and Dr Samrina Hashmi, the PMA Karachi president and general secretary respectively, talked about the 100-day performance of the new government in the health sector.

They observed that dispensaries, clinics and basic health units located across the province should not be handed over to the private organisations because the ailing communities had failed to see any change under the new arrangement. “Be it the privatized health units or those being run by the government almost all of them, with some exceptions, are not performing up to the mark. There is a need to monitor and evaluate the working and achievements, if any, of the units being run by NGOs,” said Dr Hashmi.

About the absence of qualified government doctors in the health care facilities in the interior of Sindh, Dr Tank said if the government was serious in retaining the health professionals in their respective districts of appointments it should increase incentives and residence allowances for the doctors and premedical staff working in the rural areas, besides provision of good educational facilities for their children and security to them and their wards.

Accompanied by PMA (central) general secretary Dr Habibur Rehman Soomro, the office-bearers were of the view that there was no change brought in the ongoing practices by the new government in the health sector.

“We have always laid emphasis on the provision of primary health care and strengthening of basic health care system, but we were disappointed to note that the government’s spending on the primary health care system was not beyond 15 per cent of the health budget despite the fact that 90 per cent of the country’s population depended on this system,” they said.

They said that the tussle for power and jurisdiction between the federal, provincial and district governments had also been a reason behind the non-effectiveness of various health initiatives. The accountability of health personnel cannot be ensured with a shadow management running under the whims of political groups, it was remarked.

They said there was no foolproof system regarding the procurement of machines and criteria for the supply of medicines for government hospitals at any level and huge government exchequer went down the drain due to the absence of accountability and corrective measures.

The association also raised the issue of exploitation of young doctors by the private, charity and welfare hospitals and dispensaries as well as the government hospitals, both in terms of duty hours and remunerations and demanded of the government to look into the matter.

“They are paid minimal salaries and forced to work in unhealthy environment in the private sector, while on the other hand the house-doctors working in Sindh government hospitals were also being paid an amount not matching to what was being paid to the doctors of their category in the hospitals of the federal and Punjab governments,” Dr Hashmi said.

Talking about the security of doctors, she said that even general physicians, working in the private and public sectors, were not safe. Doctors were being killed or threatened of consequences every now and then, she remarked.

“In our part of the world, after a clinical mishap a doctor is arrested by the police on hearsay without conducting proper investigations, while sometimes relevant information is also leaked to the media, which is surely an unethical practice that needs to be addressed properly,” the PMA office-bearers observed.

Talking to Dawn after the press conference, Dr Habibur Rehman Soomro condemned the harsh government action of placing seven doctors of Mayo Hospital, Lahore, under suspension following the death of a girl last week.

Terming the action inappropriate, he was of the view that the doctors had been subjected to ‘political expediencies’ without completing a ‘technical probe’. He demanded the government reinstate the seven doctors at the earliest.