ISLAMABAD: After passage of the Pakistan Nursing Council’s (PNC) amended bill by the incumbent government, the Pakistan Medical and Dental Council (PMDC) has written a letter to the health secretary, expressing its fear that it would promote quackery across the country.

The Pakistan Medical Association (PMA), which is a representative body of doctors and health practitioners, has also expressed concern over declaring nurses as “practitioner”, saying that it would serve as a legal cover for quackery.

The letter written by the PMDC registrar, Dr Azhar Ali Shah, to the National Health Services (NHS) secretary and available with Dawn, stated that the PMDC council in its meeting noted with concern section 2 (m) of the Pakistan Nursing Council Act, 1973 which says: “NP means nursing practitioner a registered advance practice nurse, who having been enrolled to a Master Degree in Nursing (MSN) recognised by PN&MC, is registered with PN&MC to practice autonomously and in collaboration with other under section 15(c) (i) of this Act within defined scope of practice.”

“The council has the view that this is a matter of serious concern whereas there is serious shortage of nurses in the country and it is unanimously assumed by the council that all the nurses will start practicing as doctor which Pakistan can ill afford at this time. A resolution to this effect be presented to the Government of Pakistan Ministry of National Health Services (NHS),” the letter stated.

Word ‘practitioner’ in bill can provide legal cover to nurses to do medical practice

Talking to Dawn, Mr Shahsaid the issue was taken up in the council meeting and the participants were of the view that declaring nurses as practitioners would open the gateway to quackery in Pakistan as those who could not practice would start it and there would be a legal cover for them.

“We frequently hear that paramedics do medical practice in rural areas of the country. Because of the Act, it will become difficult to stop them from doing practice or taking any action against them. That is why I have written a letter to the health secretary to look into it,” he said.

A senior doctor, requesting not to be named, said nurses were part of paramedical staff which were not allowed to do independent practice as they had to implement instructions of qualified doctors.

“However declaring nurses as practitioners will allow them to do practice. It will be nothing but abuse of profession and will promote quackery in Pakistan. Currently in Pakistan and some other countries, midwives are allowed to deal with deliveries. However, how a nurse working in the intensive care unit (ICU) be allowed to do independent practice? It will not serve the health sector, instead it will promote quackery,” he said.

The senior doctor said chances of accidents in clinics would increase because of the decision and ultimately the health ministry would be blamed for it.

PMA Secretary General Dr Ghafoor Shoro told Dawn that nurses were only allowed to work in the presence of doctors.

“Paramedics can administer injection and give medicines to patients but it can only be done under the supervision of a doctor. It requires eight years of education to become a doctor. How can a diploma holder nurse or those who do a four-year course can be declared equal to doctors,” he asked.

“However some sections in the amended Act, such as upgradation of nursing institutions and appointing them in Basic Pay Scale (BPS) 17, are appreciable but it does not mean that nurses can be allowed to do independent practice,” he said.

Dr Ghafoor Shoro urged the NHS ministry to look into the issue as the present decision would promote quackery which was already rampant throughout the country.

When contacted, the NHS ministry spokesperson, Sajid Shah, saidhe was not aware of the issue at present and would look into it.

Published in Dawn, August 7th, 2023