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The healing touch

Published Jul 09, 2013 04:13am


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A FAMOUS doctor runs a clinic set up in a house in a posh sector of Islamabad. She even carries out surgical procedures on her patients there.

The treatment area is on the first floor and since there are no elevators in the building, patients, usually pregnant women, are made to go through the ordeal of climbing highly uncomfortable stairs to the first floor. This is not the only thing; after surgery, patients are brought down to the ground floor by guards at the gate who lift the chair carrying the patient and climb down the same set of stairs.

It is akin to a tragic scene from a film when a newborn needs oxygen and everybody runs helter-skelter searching for a cylinder; the receptionist finds one somewhere and dusts it with the cloth used for dusting tables at the reception area. The doctor I am referring to is no ordinary soul. She practises in England half the year and her charges are exorbitant.

Exploitative businessmen in the garb of health service providers are no different from the notorious bhatta mafia as both of them ask for considerable amounts to ensure one stays healthy. Under the 18th Amendment, health has become a provincial subject and to ensure better coordination the government has recently formed the Ministry of National Health Services, Regulations and Coordination, but its scope and charter of duties remains sketchy.

The focus seems to be on projects like the Federal Drugs Surveillance Laboratory and the National Maternal, Neonatal and Child Health Programme, which is good, but the regulation of private hospitals is an area nobody seems to be interested in.

A regulatory body should be established under the ambit of this ministry which works with each provincial health ministry to aggressively take up the following three issues which do not require great spending, but strong will.

First and foremost is the lack of infrastructure at private health facilities. These clinics and hospitals are using humans like guinea pigs to carry out procedures without any proper facilities. During my cursory research for this piece I personally visited several private clinics in the Rawalpindi-Islamabad area and found more than 50pc to be lacking in basic facilities like oxygen cylinders, instrument sterilisation etc.

A regulatory body needs to ensure that the minimum requirements are fulfilled before it allows a clinic, where major medical procedures are to be carried out, to operate.

However, care should be taken so that the sole purpose and function of such a regulatory body does not become that of a permit-issuing entity after collecting hefty fees, or less hefty bribes, like so many other regulatory bodies in the country. The purpose should be improvement of standards and not revenue generation.

Secondly, hardly anyone points out the skewed service charges of business ventures that are mostly owned by doctors and investors who earn their money abroad and come to Pakistan to augment their income. They do so because here health laws are so lenient that they can get away with medical murder without anybody even noticing.

There is no proportion in the treatment cost and the charges. What a regulatory body needs to do is to link the charges and cost. There should be a list of standard costs for most procedures. Barring very complicated cases, most medical procedures can be covered in such a list.

The list should take into account the fact that these ventures earn reasonable profits. Also, the hospitals should be categorised based on their infrastructure, quality of human resources, contribution to research, training of employees, compensation of employees etc and charges should be in proportion to that rating.

Linked to the above, another important factor is the exploitative treatment of employees of such medical institutions. So many private hospitals, in order to evade taxes, do not offer a written contract to employees, no medical cover is provided to even the doctors working there and no annual vacations are granted. The pay is meagre and working hours are inhumane.

Health is not just another sector; it is a matter of life and death. Just as the aviation authorities have rules that limit consecutive duty hours for pilots and associated staff, the health sector requires similar measures otherwise deaths can occur. The problem with such deaths is that they do not make the headlines and the problem with us is that we take notice of only the deaths that do.

Lastly, a regulatory body must carry out annual technical audits to assess the hospitals in various categories and recommendations must be made in light of the performance of hospitals (both public and private) in the annual technical audit.

With the same party ruling in the centre and in Punjab, the largest province in terms of population, such a system of checks and balances is not a dream but can be very much a possibility. Other provinces would follow suit.

Allocating huge funds or building government hospitals is appreciable. But a bit of lateral thinking and forthright spirit is also needed to heal the health sector of Pakistan.

The writer is a civil servant.


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The views expressed by this writer and commenters below do not necessarily reflect the views and policies of the Dawn Media Group.

Comments (12) Closed

Dr. Tehreem Younus Jul 09, 2013 09:57am

Excellent piece of writing i must say. The private hospitals you pointed out that don't give a written contract with extremely low salaries also treat the professionals as laborers and accuse them of insulting things. Also very renowned hospitals are doing surgical procedures, some in order to make extra money and others due to their lack of clinical acumen

Dr dalpat Jul 09, 2013 11:49am

In addition to healing touch, it is terrible that technicians are running private hospitals here at sindh kunri, doing cesarean section and other surgeries, even they give anesthesia on their own. No one here to ask, comlications and mortality rate is very high, but still every thing is going on.

Meher A irtaza Jul 09, 2013 11:59am

A very good point raised in this piece of writing. Medical murder is something that goes without a notice in our society. hardly there is anyone who don't know a person who died or left with a life long paralysis and other sort of illnesses due to the negligence of so called expert doctors, who run their shops (as they can not be called hospitals), without giving any regard to human life and its value to the immediate family.

Dr. Tehreem Younus Jul 09, 2013 12:25pm

Excellent article i must say.The point raised of the private hospitals not giving a black and white contract is absolutely right. Doctors whether working in a government or private sector suffers a lot of work load at extremely low wedges.

shahzain Jul 09, 2013 12:32pm

I think the doctors should be aware of their prestige and understand that they deal with human lives.

Hina Jul 09, 2013 03:06pm

Really tragic. A doctor or a quack.

Hina Jul 09, 2013 03:27pm

Doctors should be responsible enough to treat patients in the humane manner.

Nadeem Ullah Jul 09, 2013 03:36pm

Well, sir, you are talking about the spirit which we couldn't find in PMLN's Punjab govt in last 5 years :-) The situation in health sector in Punjab is obvious. The must had preferred the health & education over the roads & bridges. But really sad thing is, their next 5 year plan also seems to be focusing on roads construction, taxi schemes, housing schemes, laptops, metro buses, bullet trains etc.. They don't really care the condition of health facilities for poor, because they are sure they have their good family doctors in London, so they themselves are safe. No need to care the poor.

shakeel Jul 09, 2013 10:58pm

who is forcing u to go there and wat is forcing others too,,,, u ppl have option to go anywhere where there are facilities.....

BRR Jul 10, 2013 03:27am

When healthcare becomes a business and not a service, quite a few doctors turn to profit maximization.

Ali Khan Jul 10, 2013 08:52pm

An educated man does not necessarily make a civilised man - evidently.

This is a gem of an article. Well done, Syed Saadat.

Aneeza Younus Jul 11, 2013 09:23am

Outstanding effort! Absolutely awesome. The flow of the article was very tactfully handled by giving better example and facts instead of just saying that weak areas existed.