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“A few years to my sum of years,/ I am still stuck in the in-between./ A relic in this vale of tears,/ A reluctant ‘was’, ‘has-been’.” — Chris Z. Abbas
THESE verses were penned by a dear friend describing old age, three years before her death in 2009. Chris was 88 when she departed from what she called “this vale of tears”.
The fact is that medical science boasts of its success in prolonging the age of man — life expectancy in Pakistan has grown from 45 years in 1950 to 67 today. But society and state have done precious little to improve the quality of life for their senior citizens.
Hence it gave me great satisfaction when I learned recently that in 2014 the Sindh Assembly had adopted the Senior Citizens Welfare Act (SCWA) — the first province in Pakistan to do so. Lawyers dub it as a ‘model’ law, cut and pasted from the social welfare law of a West European state but without any plan for its implementation.
The story thereafter is the typical one full of disappointment commonly experienced in Pakistan’s legislative history. It took two more years for the law to come into force. The Senior Citizens Council which alone could make the law effective was constituted in 2017.
The chairman of the council died soon after his appointment and no substitute was nominated to replace him. The council for social welfare was not allocated any funds and remained non-functional for nearly three years. The Azadi Card scheme so essential for giving senior citizens access to their entitlements has still to take off, notwithstanding the large number of applicants. Abandoned by its patron, the PPP government, the SCWA was on the verge of lapsing into oblivion when the Legal Aid Society decided to pursue it in December 2019. It filed a petition in the Sindh High Court asking for the implementation of this progressive piece of legislation.
Senior citizens have yet to receive the benefits the law promises.
The SCWA focuses primarily on the financial dimension of healthcare, transport fares and purchase of goods. It also makes it incumbent on the government to set up a fund to meet the needs of senior citizens and establish old-age homes for those of them who are indigent. These are essential needs of the elderly though their priorities may differ depending on their socioeconomic status.
As the ‘seniority’ of a person increases it is healthcare that consumes the biggest chunk of the family budget for all classes. For the marginalised, concessions in bus fare, a home and a pension would obviously be welcome, given the constraints they face in generating savings in their working life. The better off would obviously appreciate the tax cuts and discount on air travel fare proposed.
The Act makes it mandatory for public- and private-sector hospitals to provide concessions — some as high as 50 per cent — on services to those who are 60-plus years. This would be of benefit to all.
The Legal Aid Society is to be commended for taking up this bold initiative. By creating public awareness about this Act and badgering the authorities, it has managed to kick-start the process of implementation. The government has been forced to get its act together as the Legal Aid Society has wisely focused on the health needs of senior citizens in the age of Covid-19. As is well known, the elderly are more susceptible to this infection.
As a result, the government informed the court at the last hearing that a provisional vice chairperson has been appointed to attend to the Council’s administrative duties and a sum of Rs30 million was allocated for its working.
But we still have a long way to go before senior citizens in Sindh can hope to receive the benefits that the law promises them. The indifference and lethargy of the powers that be are not the only obstruction in the way of implementation. Resistance from the affluent private healthcare sector to any concessions is another major factor jeopardising the welfare of senior citizens. The Legal Aid Society has therefore filed a petition against six private hospitals of Karachi for allegedly resisting the responsibilities imposed on them by the SCWA.
The ploy adopted by private hospitals of shifting the blame onto the government and accusing it of not carrying out its functions will not help their cause. The government’s failure in the matter does not absolve the hospitals of their own moral duties. They have already earned a reputation of charging exorbitant fees — running into hundreds of thousands of rupees.
The hospitals’ case is not very convincing. Unsurprisingly, the society’s case is gaining clout and petitioners are joining hands in seeking relief as the petitions are clubbed together. It is also being asked why the hospitals should bank on the inefficiency of the Senior Citizens Council that has yet to issue the Azadi Card when age — the main qualifying criterion for the holder — can be ascertained from the patient’s CNIC.
Published in Dawn, January 1st, 2021
