Cardiac Centre was inaugurated by former prime minister Raja Pervez Ashraf in 2012. The other picture shows patients in the centre’s Out-Patient Department. — Photos by the writer
Cardiac Centre was inaugurated by former prime minister Raja Pervez Ashraf in 2012. The other picture shows patients in the centre’s Out-Patient Department. — Photos by the writer

Orders issued by the Prime Minister’s Office for the immediate removal of all staff from the Cardiac Centre at the Pakistan Institute of Medical Sciences (Pims) who are involved in private practice could not be implemented as the doctors have obtained a stay order from the Islamabad High Court (IHC) against adverse action.

According to sources in the Ministry of Capital Administration and Development Division (CADD), the Prime Minister’s Office has been informed about the stay ordered and a request has been made about guidance on the status of the staff in the Cardiac Centre.

Pims Vice Chancellor Dr Javed Akram said he is aware of the orders issued by the Prime Minister’s Office but he has so far not received any official orders from the ministry which is why he will not direct his staff to stop practice.

“Operations and the outpatient department at the Cardiac Centre are functioning according to routine and students are also being trained. Patients are getting treatment without any problems as all the staff who are conducting private practices are working [here],” he said.

Dr Akram said he met with Secretary Finance Shahid Mehmood on Nov 16 and requested him to address the issue as it will become a huge problem if doctors of the Cardiac Centre are stopped from practice. He said he will be meeting with the secretary finance and the secretary Establishment Division on Tuesday, Nov 21 to discuss the regularisation of staff and solve the issue for good.

Last month, the premier had directed CADD to hold an inquiry into private practices being conducted in Pims’ Cardiac Centre and send a report to the Prime Minister’s Office. Additional Secretary CADD Jamal Yousuf visited the hospital and in his report confirmed that private practice does go on in the centre.

On Nov 11, the Prime Minister’s Principal Secretary Fawad Hasan Fawad issued a letter directing the immediate removal of all staff of the Cardiac Centre. The order, available with Dawn, said nine people involved in illegally conducting private practice at Pims be immediately removed from the hospital premises.

It said the Auditor General of Pakistan should hold a special audit to ascertain the illegal money received by the nine individuals directly in the form of fees as well as the money received by other Pims officers who permitted them to use Pims premises and facilities for conducting medical procedures.

It was further directed to institute legal proceedings against all these persons through the Federal Investigation Agency (FIA), including the recovery of the money received by them and taking action against any person who is found involved in corruption or misconduct during the special audit or the FIA’s proceedings.

A CADD official told Dawn that last year, the ministry had moved a summary for regularising all doctors as the ministry wants to retain them and that the process of regularisation is also underway.

“The Prime Minister’s Office has been informed that the ministry cannot take adverse action against the employees as they have obtained a stay order from IHC and doing so will be contempt of court. We are bound to follow court orders but we are also looking towards the Prime Minister’s Office to guide us in dealing with the situation,” he said.

He explained that the ministry did not forward the orders from the Prime Minister’s Office to the Pims administration as it will be contempt of court.

The Cardiac Centre started in 2005 and was to be completed in 14 months but took 10 years to complete. Three prime ministers have placed plaques on it.

The staff was appointed through the PC-1 and were being paid their salaries but after the completion of the project in 2015, the employees had to be dismissed but the hospital management requested them to keep on working without salaries and promised their dues will be paid off after their services are regularised. The staff could, however, not be regularised as they had become overage and special permission was required from the prime minister.

A doctor at the Cardiac Centre said the matter was not as simple.

“The Cardiac Centre is running under the [Shaheed Zulfikar Ali Bhutto University] and the vice chancellor heads the university. A few years ago, the Federal Ombudsman had directed the Pims administration to start private practice at the hospital to facilitate patients. The university syndicate also gave approval due to the decision of the Federal Ombudsman,” he said.

After the decision, private practice was started across the hospital in the evenings, he said, and that private wards had been functioning in the hospital for long before that as Pims does provide treatment to private patients.

Since 2015, almost 900 bypass operations have been conducted at Pims of which 70 were of private patients. A private bypass at Pims costs Rs200,000 when private hospitals charge Rs450,000 for the same operation. He said this amount is deposited in the Pims account and doctors are given their share from it.

“Doctors at the Cardiac Centre have not been paid their salaries for 30 months because their case is pending in the ministry as approval from the Prime Minister’s Office is needed to regularise the services of the doctors. We survive on the small share from the private practice like other doctors at the hospital but now it is said that we are not employees of the hospital and we therefore cannot conduct private practice here,” he said.

Talking to Dawn, Dr Akram said he was worried by the issue and that he had started efforts for addressing the problems because patients will suffer if the doctors are removed.

“Though CADD has not forwarded the orders from the Prime Minister’s Office to me but service at the Cardiac Centre can be stopped at any time. I am sure CADD will also convince the Prime Minister’s Office that the doctors should not be removed or free treatment to patients will be stopped. The only solution is to regularise the doctors because we cannot afford to let the trained doctors go,” he said.

Published in Dawn, November 19th, 2017

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