Asif Chaudhry investigates what ails the physicians in Punjab.

Health professionals launched a struggle for increase in their salaries a couple of years ago; this struggle was spearheaded mainly by young doctors who also staged a hunger strike earlier this year. Though the strike has ended, the doctors have given the government an ultimatum to revise the service structure and accept their demands.

They are demanding provision of a service structure and better salary status for their colleagues who belong to all cadres.

The young doctors had announced a strike to protest against the lodging of a criminal case against their colleagues who had allegedly thrashed the medical superintendent of the Gujranwala District Headquarters Hospital in January 2013. All efforts made by the Punjab government to bring normalcy back to its health facilities proved ineffective and scuffles between the police and the doctors, arrests, lodging of criminal cases against them, departmental punishments including terminations, suspensions and transfers in the aftermath of the Gujranwala-incident led to an escalation in tension.

Finally, a week-long hunger strike observed by the young doctors in Lahore, in February  this year with the full support of the opposition forced the Punjab government to accept all their demands.

Though the Punjab government is making allocations these days to elevate the salary status of doctors of all cadres, it has no plan to address other serious issues which are also being termed as the main cause of desperation among doctors.

“One of the major issues is the security threat to doctors especially when the death of a young patient takes place at any state-run health facility in Punjab,” said Dr Salman Kazmi, general secretary, Young Doctors Association Pakistan. He said that physical violence at the hands of patients’ attendants, particularly in critical care departments like emergency, ICU, CCU and operation theatres has become a frequent nightmare for on-duty doctors. He cited the example of Mayo Hospital, Lahore, where on-duty doctors were tortured seven times during the last two months by patients’ relatives. Though the government has deployed two to three policemen each at teaching hospitals for security purposes, their numbers are insufficient to maintain the law and order situation, he claims.

“We have met the Punjab IG, Lahore Capital City Police Officer and other authorities to request them to upgrade police chowkis and increase the number of security personnel but nothing concrete has been done so far,” says Dr Kazi, adding that the health department has no policy yet to meet this crisis.

Due to fewer doctors on duty, Dr Kazmi points out that the chances of medical error or mistakes, especially during emergency and surgical procedures, have increased manifold. This situation has also multiplied the problems of doctors on duty, who are then held responsible for medical negligence.

He said the gravity of the situation can be gauged from the fact that the Institute of Child Health, the only dedicated paediatric health facility in the provincial capital, is short of 85 senior doctors and consultants. In order to cover this shortage, he said, the health institutions have no option other than to accept the services of inexperienced house officers (HOs) and medical students during emergencies.

According to Dr Kazmi young doctors are also facing the problem of long duty hours. HOs and postgraduate residents are forced to work for 48 hours to 56 hours consecutively, once a week, which takes a heavy toll on their health and family life. He further said the posting of inexperienced and junior doctors in violation of the merit policy on administrative posts at teaching hospitals has also added to the problem as the majority have no ability to resolve these complex issues.