THE wrangling over three major Karachi hospitals between the Sindh and federal governments continues, with both sides trying to retain control of the facilities. In the latest developments, the Sindh administration has sought an agreement with the centre to run the JPMC, NICH and NICVD after Islamabad issued a notification calling for setting up a board of governors to manage the tertiary care facilities. The Supreme Court had in 2019 given the federal authorities control of the hospitals, while Islamabad later said they would be returned to Sindh due to “financial constraints”. Now it appears a fresh move is being made to micromanage these Karachi hospitals from Islamabad. This tug of war has had a negative effect on the smooth running of the facilities as their management status remains ambiguous.

In this scenario, the suggestion made by the Sindh health minister in a letter written to the prime minister’s special assistant on health — calling for the signing of a management contract between the centre and Sindh to run the medial facilities — can perhaps provide a way for both sides to reach a compromise. The fact is that health is now a devolved subject, while the Sindh government has improved the running of some of its medical facilities, such as the NICVD. However, it is also a fact that the province’s basic health structure remains in abysmal condition. A mutually agreeable solution must be reached between the centre and Sindh so that the hospitals are run in optimum condition, and patients can gain maximum advantage from the public health facilities. Private healthcare is prohibitively expensive, and the masses have no other option but to turn to such facilities in the public sector. Therefore, both the federal and Sindh governments must avoid protracted legal and administrative battles over the three hospitals and reach a solution which allows the facilities to run smoothly and improve on their service delivery. Along with claiming ownership, the provinces must also strive to improve their health systems from the bottom up.

Published in Dawn, March 26th, 2021