THE penalty the Punjab Healthcare Commission (PHC) has recently imposed on a Faisalabad doctor held guilty of negligence has pronounced the rift between the commission and the Pakistan Medical Association (PMA).

The PMA alleges government interference and says a court such as this required a truly autonomous status to work towards improving the health services in both the private and public sectors.

The PHC officials maintain that a system is being evolved in consultation with the PMA, which represents the doctors. A PMA office-bearer, however, is so incensed by the situation that he accuses the commission of cheating and double-cross.

The Punjab Healthcare Commission started properly functioning in 2013 even though it had got its board of governors in 2011. It is a one-of-its-kind forum in Pakistan which was set up under the Punjab Healthcare Commission Act 2010. Currently, it is in receipt of 250 complaints of negligence and it has decided many cases.

In August last year, the PHC recommended action against three public-sector doctors in Lahore after a woman patient died because of alleged negligence. The PHC explained the procedure of its working in such cases when it said the ruling had come in the light of an inquiry by senior doctors, backed by legal opinion.

Around the same time, the PHC called for action against the superintendent and a staff nurse of a tehsil headquarters hospital for misbehaving with a woman patient and in another case, it shut down a privately-run hospital in Multan.

In the latest incident, a since retired professor of surgery in Faisalabad was found guilty of negligence during a surgery. The PHC recommended to the Pakistan Medical and Dental Council (PMDC) to cancel his registration and imposed Rs100,000 fine on the hospital where the surgery was performed.

The surgeon was held guilty of performing a wrong operation on a BSc student on Dec 17, 2012. The surgery paralysed the girl. The surgeon (as well as those held guilty in the earlier instances) was penalised under the 2010 act which prescribes a maximum fine of Rs500,000.

Dr Shabana Haider, head of the communications at the PHC, tells Dawn the commission’s recommendations are to be implemented just as the orders of any other court: For example, if professional censure is what PHC is looking for, the PMDC will be the authority to contact but in case there is an FIR, it is the police which will be the implementing authority.

She says that with greater awareness the number of complaints will rise, but hastens to add that addressing these complaints was only one of the mandates of the commission whose aim was to improve health services through various means.

But it seems that action on complaints of negligence is going to be a dominant PHC theme. Already the frequent invoking of the 2010 act points to the widespread prevalence of malpractices in the health sector in Punjab, indeed in the whole of Pakistan.

Complaints of negligence are routine in the country and they have often enough led to tense, even violent situations, in both public-sector and privately-run hospitals. These situations had been building a case for the setting up of an organisation for some expeditious relief.

Punjab is the first province to take the initiative, whereas Sindh is also mulling over a similar commission for some time now. However, even in Punjab, this beginning in the right direction was somewhat clouded by the damp reception it got from the doctors.

The provincial government has had a tough time dealing with the doctors in recent years. The doctors, especially the young cadres, have developed a strong suspicion of the government over the Shahbaz Sharif setup’s failure to meet demands and keep promises.

This lack of trust made it even more necessary for the government to work cautiously and by consensus over the commission. The doctors in the PMA say this is exactly how it has not been.

An office-bearer of the PMA in Lahore is all praise for the appointment of a former judge as the PHC’s head, but he loudly protests ‘encroachment’ by the government which he accuses of planting its men in the commission. And while Dr Shabana Haider of the PHC seeks to dispel the impression of an arbitrary flight at an evolutionary stage, the angry PMA office-bearer ups the ante by asking which doctors’ organisation did the PHC consult before framing the laws?

He appears dead set on a fight that could lead to some unfortunate controversy surrounding a desperately-needed forum for patient relief.