KARACHI: The Sindh High Court has come down heavily on the provincial health authorities for not extending even basic health facilities, including cardiac treatment, at tertiary care hospitals, except for the provincial metropolis, and directed them to take initiatives to provide such facilities and these hospitals must not be used as referral hospitals in future.

A two-judge bench headed by Justice Salahuddin Panhwar also took exception to the executive director of the National Institute of Cardiovascular Diseases (NICVD) as he was also holding charge of Sindh Institute of Cardiovascular Diseases (SICVD) units despite the fact there were two different boards and laws.

The court ordered the health secretary to appoint a new administrators/managers for the SICVD.

When the matter came up for hearing, the medical superintendents (MS) of the teaching hospitals were in attendance as on the last hearing the bench had directed them to inform the court as to what facilities they were providing and how much funds they needed in ensuring free medicines and other basic facilities to the public.

NICVD chief censured for holding additional charge of SICVD

The MS of the Civil Hospital Hyderabad (tertiary hospital) submitted that the health facility was affiliated with the Liaquat University of Medical and Health Sciences and it had two units comprising 1,700 beds in Jamshoro and Hyderabad.

However, he said that since its foundation, they had not carried out any bypass surgery and their cardio ward was like a chest pain assessment unit, which may be considered as a referral ward.

He said the budget of the hospital was Rs5.3 billion whereas more than 10,000 people arrived at the outpatient departments of the hospital.

The MS of the tertiary hospital in Larkana submitted that the 1,600-bed hospital’s budget was Rs1.38bn, but they didn’t have the facility of cardio.

The MS of tertiary hospitals of Nawabshah, Khairpur and Sukkur submitted that they started cardiac procedures just a year ago.

The MS of the Civil Hospital Karachi, which is affiliated with the Dow University, said that the hospital comprising 1,932 beds got Rs5.7bn budget yearly and different cardiac surgeries, including major surgery, were being conducted at the health facility.

The bench noted that earlier the SHC had directed the Sindh government to hand over all tertiary hospitals to their affiliated universities/colleges and thereafter the provincial government introduced the Tertiary Hospitals Management Board Act and now the board of tertiary hospitals were working under the vice chancellors/principals of medical universities/colleges concerned.

The bench deplored that apart from Karachi no cardiac treatment facility was available in whole Sindh for years which was burdening the major public-health facilities of the provincial metropolis with heavy flow of patients, though it was the obligation of these hospitals and their universities to ensure all basic medical health facilities under one roof at every tertiary hospital.

It directed the government and other authorities concerned to take initiatives in assuring required basic health facilities including bypass and other major surgeries for every common man at the tertiary/civil hospitals and they must not be used as referral hospitals in future.

The bench further said it was very shocking that Liaquat Medical College established in ‘50s and other universities in Larkana were very old, but they had failed to provide basic facilities in the public-sector hospitals particularly in the field of the cardiology.

About the NICVD, it noted that after NICVD Act 2015 the provincial assembly had also legislated SICVD Act 2019, which specified that the headquarters of the SICVD will be at Karachi or Sukkur while it units established by the government in Hyderabad, Tando Mohammad Khan, Sukkur, Sehwan, Khairpur, Mithi, Larkana and Nawabshah will be deemed to be its branches/integral parts.

However, the bench said that surprisingly, apart from Tando Muhammad Khan and Sukkur, the units were not providing required facility for cardiovascular diseases as was the requirement of the act itself and it called an explanation from the secretary of health at the next hearing.

It surfaced during the proceedings that the executive director of the NICVD was also holding charge of SICVD units though there were two different boards and laws as the SICVD board was under the health minister and NICVD board was under the chief minister and there were also different mechanism of operation / function as well.

When confronted, the health secretary submitted that he was a member of both the boards and would deliberate the issue with the authorities concerned.

The bench asked him to ensure that within three months new administrators and managers were appointed.

Published in Dawn, October 16th, 2021