For the sake of full disclosure before saying anything on this topic, I want to state that I myself am a young doctor, working in a public sector hospital of Punjab. The following blog contains my view on the issue of the recent wave of protests by young doctors and I have tried to remain as balanced on this issue as I possible can.
The medical profession is considered to be a noble profession but doctors are back in the news, for all the wrong reasons. After the long strikes of last year which were caused by a deadlock between the government of Punjab (because there is no health minister since the last four years) and young doctors, things were supposed to be settled by now. The showdown from last year caused tragic incidents leading to numerous casualties due to intransigence of both parties. Last year, there were three basic issues of doctors which were an increased in the pay of post graduate trainees and medical officers, regularization of seats and the implementation of a proper service structure for doctors.
We all know that the health sector is given little importance in Pakistan’s power circles. As a result, the share of budget allocated for health purposes is less than two per cent of the total budget. Due to constant neglect by the government, the private sector has bloomed in our country. According to an estimate, about 80 per cent of doctors in Pakistan are working in the private sector. The issue of payments was resolved last year and the other two issues were supposed to be resolved by the formation of committees to deal with them. After one year and multiple committees, no solution has been finalised by the government of Punjab. As a result, the young doctors started boycotting the Outdoor Patient Departments (OPDs). It should be made clear that the indoor departments and emergencies (where serious and admitted patients are dealt with) are working full time in all public sector hospitals. The propaganda that patients are ‘dying’ is plainly wrong. The main problem this time is the demand for a service structure, similar to other public servants. A civil servant who passes the CSS exam gets promoted to the next pay scale in a maximum period of 10 years, while doctors do not have this opportunity. I have personally seen doctors who have served for more than 18 years and still remain in the same pay scale. Despite the order by Supreme Court of Pakistan in February 2012, no concrete steps have been taken to formulate a service structure.
At the hospital I work, patients are re-directed from OPDs to the emergency department where most of them are treated accordingly. There is no particular crisis as has been portrayed by the government. Recently, a misinformed campaign has been launched by the erstwhile Punjab government portraying doctors as ‘mercenaries’. I wish the amount of money paid for those front page advertisements was allocated for the package of doctors, but as it turns out, wishes are not horses. Sadly, the electronic media has largely played a negative role in this whole issue and they have tried to establish the establishment’s point of view in various talk shows and programs. After the leaked video scandal, we all know about the ‘integrity’ of our dear media personnel. The same media that tries to strike a rebellious stance in different matters, turns into the devil’s advocate in this one.
Orders have been issued by the health department that leaves of all doctors are being cancelled and anyone who does not perform their duties will be arrested. Doctors from the Army Medical Corps are also being deployed at government hospitals. This heavy handedness and constant negligent behaviour will serve the public no good. According to sources in the Young Doctors Association, the government is planning to privatize the health sector and that is why they are reluctant to reach a solution with the doctors. Mr. Shahbaz Sharif is not willing to decrease the number of his protocol cars or to spend some of the public money on public servants but is happy dishing out money on useless projects such as the Laptop Scheme (Punjab's Over Draft limit was Rs.27 billion and the Punjab government spent almost 40 per cent of the OD sanctioned by the State Bank of Pakistan to Punjab on giving away laptops), the Muslim Town overhead bridge or the Sasti Roti scheme (authorities in Punjab scrapped the Sasti Roti scheme after the Rs.7.85 billion loan debt accrued from commercial banks was left unpaid by the food department owing to non-provision of funds earmarked in the financial years 2009-10 and 2010-11) or his own publicity (an amount of Rs.80 million was spent just on the publicity campaign initiated under the Khadim-e-Ala government). According to the government figures from 2005, it spends 5 lacs on a single medical student in five years. Two days ago, a ‘senior official’ in the Punjab Health Department cited the figure of 2 million. Another juxtaposition of facts to suit their stance.
Matters are getting worse and worse. Thousands of doctors have left Pakistan because of lack of facilities and money. Eight out of 10 new doctors want to leave the country and pursue greener pastures because of the behaviour of government towards the health sector. Something needs to be done and it has to be done fast because young doctors cannot be coerced or tamed by using power tactics. The only people that are actually suffering in this fight are the poor patients who cannot afford private health care and have no option but to depend on government hospitals for treatment. An early resolution of this mess will benefit those poor patients and they should be the priority of both the government and the young doctors.
The views expressed by this blogger and in the following reader comments do not necessarily reflect the views and policies of the Dawn Media Group.