KARACHI: The conflict over the recent cancellation of a multibillion rupee tender of robotic systems further widened on Thursday when Chief Minister retired Justice Maqbool Baqar took a strong exception to the statement released a day earlier by Health Minister Dr Saad Khalid Niaz in which he had accused the former of ‘interference’.

The day also saw a statement on behalf of the Pakistan Medical Association (PMA) emphasising that investment in high-cost machinery without first bringing improvement in the primary healthcare system would be a waste of resources.

In a rebuttal, the chief minister stated that the budget for the robotic systems was approved by the last government and that the caretaker government was not authorised to end or stop any projects approved by the previous assembly and the government.

“Dr Saad wants to divert these funds to his favourite schemes and is trying to hide his illegal actions by raising allegations [against the chief minister],” the statement released by CM House claimed.

PMA urges govt to focus on primary healthcare

The health minister, it pointed out, had failed to improve the performance of facilities under his department and was highly offended “when he was made accountable” and that the minister issued “irresponsible and baseless statements” which needed to be clarified.

“The chief minister keeping in view the poor and pathetic condition of health facilities decided to convene four meetings to review their performance [in a similar manner] he reviewed [performance of] the management of schools, colleges and revenue offices.

“Surprisingly, the health minister had three review meetings concerning his department cancelled. Finally, when the fourth meeting was held, he did not attend it, so that his performance could not be evaluated.”

It also alleged that the health minister was trying to post his favourite secretary of health so that he could carry forward his ‘personal agenda’.

“The caretaker health minister Dr Niaz instead of focusing on the performance of the health facilities was wasting his time and energy to settle his personal scores with his counterpart doctors/professors and did not spare the prestigious Sindh Institute of Urology and Transplantation (SIUT) from his criticism,” it said.

The chief minister also censured the minister for the language he used against him.

“It was deplorable and reflects his mindset. A professional doctor, professor, civilised person, or a minister cannot use such derogatory language and it is beyond comprehension and shocking.”

Justice Baqar also justified what Dr Niaz had described as ‘interference’ in his departmental affairs.

“As a matter of fact, the chief minister has always supported the ministers and their departments so that they can perform their best for the public. However, the caretaker chief minister issues necessary instructions from time to time for the efficient performance of the departments.”

‘Insufficient funds for govt hospitals’

A day earlier, the health minister had released a detailed statement explaining his differences with the chief minister that led to his boycott of the meeting held on Wednesday at CM House.

The disagreement pertained to a tender for purchasing four robotic systems for the Jinnah Postgraduate Medical Centre (JPMC), Gambat Hospital and Liquat University of Medical Sciences Hospital. The health minister had cancelled the tender last month on the grounds that the robot-assisted procedures were too costly and should not be used for routine surgeries.

In his statement, he questioned the government’s decision to purchase costly robots when it didn’t have sufficient funds to increase budgets of government hospitals. “Daily over 8,000 patients report at JPMC and CHK and their total budget is below Rs15bn, which isn’t sufficient to meet their needs.

“No robotic surgery is being conducted at the city’s most reputed private hospitals. Even the Aga Khan University Hospital is conducting the surgery for the gallbladder for Rs250,000 whereas the government is spending Rs400,000 to Rs450,000 on the same procedure through a robotic system,” he stated, adding that the costly treatment through costly robots didn’t make any sense.

The decision to stop the purchase, he emphasised, was taken in the light of expert surgeons’ opinions. He pointed out that irregularities were also noted in the purchase of robotic systems bought in the past.

“In the financial year 2023-24, an amount of Rs5,497m was allocated for purchase of the robotic system. In 2013-14, a single robot was purchased for Rs370m for Civil Hospital Karachi.”

The health minister maintained that he needed support from the chief minister and not ‘interference’.

Meanwhile, the PMA in a statement emphasised the need for improving the primary healthcare system in the country instead of investing in high-cost machinery for tertiary care without an improvement in the former.

“We acknowledge that tertiary care and investment in technology is important. But, our first priority should be to improve the primary healthcare system — the backbone of Pakistan’s health sector that caters to 70-80 per cent of patients.

“Unfortunately, this system is too weak, forcing patients to seek treatment at tertiary health facilities. The burden on tertiary care centres will decrease if the primary healthcare system including basic health units and rural clinics is improved,” it says.

Published in Dawn, November 10th, 2023