ISLAMABAD: While the health ministry has been considering outsourcing the radiology department of the Pakistan Institute of Medical Sciences (Pims), the hospital employees believe patients will face the brunt of this decision.

They have pinned their hopes on the newly-appointed coordinator to the Prime Minister on National Health Services (MHS) Dr Malik Mukhtar Ahmed Bharath and a draft has been prepared to share the factual position with him.

According to the draft, even though 90 per cent of the services were free the department earned Rs5 million which went to the national exchequer. Moreover, the draft termed the department a “jewel in the crown”.

According to documents available with Dawn, the ministry has been considering outsourcing the diagnostic unit of Pims.

Staffers believe it will impact patients, term department ‘jewel in crown’

As per the draft, the radiology department provides services to 500,000 patients a year through the latest equipment which includes a 1.5T MRI by Siemens (2023), 128 slice CT scanner by Canon (2021), mammography machines by Hologic and Helianthus, ultrasound machines, and digital X-ray machines.

These data are integrated and stored by the latest picture archiving system (PACs) from Boston with servers capable of over five years of data storage.

“The radiology department comprises 12 fellow consultants comprising a professor, two associate professors, three assistant professors, five senior registrars, and a senior consultant headed by Prof Ayesha Isani Majeed (Fellow of the Royal College of Radiologists, UK and PhD public health), 30 postgraduate students (FCPS and MD with a number of them in the dual process of sitting for the FRCR), and 40 paramedical and support staff,” it stated.

Breakdown of patients

In 2023, the total number of X-rays performed was 247,745; out of which, 90.8pc were free. The total number of ultrasounds performed was 58,133; out of which, 97.6pc were free. The total number of Doppler’s performed was 2,975; out of which, 95pc were free. The total number of CT scans performed was 51,441; out of which, 98.8pc were free. Similarly, over 80pc of MRI were provided free of cost.

Even though less than 5pc patients charged for the radiological services paid nominal amounts the department still made Rs5m. The hospital charges only Rs70 for the X-ray, Rs200 for ultrasound, Rs300 for Doppler, Rs2,500 for a brain CT scan, Rs3,000 each for HRCT Chest, CT Abdomen, and Rs4,000 for MRI.

The letter also provided a comparison with the private sector. For instance, private health facilities charge Rs1,000 for the X-ray, Rs 3150 for the ultrasound, Rs5,000 for Doppler, Rs6,450 for a CT scan of the brain and Rs 9,450 each for HRCT Chest, CT Abdomen and MRI.

“However, despite the subsidy the department has earned Rs 5 million for the government of Pakistan which goes into the exchequer and if a viable financial model is made the amount earned by the radiology department at Pims can contribute towards the budget of the hospital for its upkeep and renovation,” said the document.

According to the draft, the Radiology department conducts multidisciplinary meetings where oncologists, surgeons, pathologists, and Gynae among others for the best outcome for the patients which is decided by consensus of all speciality experts.

“Multiple research projects on artificial intelligence on chest X-rays and mammography are underway. Similarly, breast cancer genetics, tuberculosis, HIV research have been conducted through grants and different academic platforms with multiple publications in international and national journals,” it stated.

“The first ever holistic breast cancer screening centre of the public sector has been established. Similarly, paediatric imaging facilities are provided at the children’s hospital, Pims, and maternal and fetal imaging facilities at Maternal and Child Hospital. The department performs X-ray chest around the clock for the burn centre,” it stated.

Health coordinator visits NEOC

Meanwhile, Dr Malik Mukhtar Ahmed Bharath, accompanied by Health Secretary Nadeem Mahboob, visited the National Emergency Operations Center (NEOC) for Polio Eradication to review the progress of anti-polio efforts.

According to NEOC Coordinator Dr Shahzad Baig, “We have set two goals for this year. First, to interrupt transmission of the local YB3C poliovirus genetic cluster, by the middle of this year, and the second is to close all outbreaks of the imported YB3A virus and interrupt its transmission by the end of this year.”

“Since last year, we have implemented an intense vaccination schedule which we will continue this year to ensure children have high immunity against polio infection,” he added.

Published in Dawn, April 18th, 2024