FOLLOWING a legal battle, in which the apex court had given control of three major hospitals of Karachi to the federal government, Islamabad has now said that the health facilities will be returned to the Sindh government. This was decided in a federal cabinet meeting last month, the special assistant to the prime minister on national health services recently confirmed. The issue of the health facilities — the JPMC, the NICVD and the NICH — had become a source of discord between the centre and Sindh, with the former saying the Sindh authorities were not ‘capable’ of running the hospitals, while the provincial authorities said that in the aftermath of devolution, Islamabad had no right to run health facilities in the province. The centre has said “financial constraints” are amongst the reasons it has decided to return the facilities to Sindh, while the provincial authorities are saying their stand has been ‘vindicated’ by Islamabad’s decision to return the hospitals to them.

While the centre’s reversal of its decision should be welcomed, as it is in line with the spirit of the 18th Amendment, one wonders why Islamabad had pushed to take over the facilities in the first place when it did not have the finances available to run them. This indicates a lack of foresight and planning on the part of those at the helm of affairs in the federal capital. However, while Sindh has done a good job in spreading a network of cardiac facilities in different districts in the shape of the NICVD, there is no time for the provincial authorities to bask in their ‘glory’ and savour this ‘victory’. The situation in many tertiary-care units in the province is abysmal, with critical equipment missing and a shortage of staff. The condition of basic health units and rural health centres is even worse. While it is true that the province is facing a funding crunch — which the chief minister says is mainly due to a cut in federal transfers owed to the province — beyond money, better management of health facilities in Sindh is needed. The provincial government’s stand may indeed have been vindicated, but much work lies ahead to improve the public health infrastructure. If the NICVD, and indeed SIUT — both facilities in the public domain — can deliver quality healthcare to the masses, then other public hospitals and clinics can also be transformed in order to give quality free-of-cost care to the people of Sindh.

Published in Dawn, July 9th, 2019