ISLAMABAD: While there are rumours that the government is planning to convert Pakistan Institute of Medical Sciences (Pims) into a medical teaching institution (MTI), the employees say they would resist any attempt to privatise the hospital.

Special Assistant to Prime Minister on Health Dr Zafar Mirza said MTIs were used across the globe as tertiary care hospitals and given autonomy to take decisions rather than suffer because of bureaucratic hurdles.

But the employees fear that if the hospital was converted into an MTI, not only they would lose job security but would also face financial losses as they would be deprived of scholarships for children and other benefits.

Representative says govt should take employees on board regarding Medical Teaching Institution Act

Moreover, they said patients would suffer because the hospital management would have to increase treatment and lab tests charges to generate revenues on its own.

The employees of Pims have been protesting against the government plan to privatise the hospital. Not only a delegation of employees led by Dr Asfandyar Khan met Dr Mirza but they also held protests against the Medical Teaching Institution Act.

Mr Khan appealed to the government that employees should be allowed to participate in meetings regarding the Act.

Leader of the employees association Chaudhry Riaz Gujjar told Dawn that it was unfortunate that the employees were not being taken into confidence on the issue.

“We have been hearing that the draft of MTI Act has been forwarded to the prime minister and soon it would be sent to the president to promulgate as an ordinance. We had a meeting with Dr Mirza but he was not aware of the issue. We believe that the Health Task Force (HTF) is working on the MTI. However, Dr Mirza had assured us that he would be working as a bridge between the employees and the HTF,” he said.

When asked why the employees feared that the MTI Act would be promulgated, Mr Gujjar said MTI was introduced in Khyber Pakhtunkhwa in a similar way.

“According to our understanding, after promulgation of MTI Act a Board of Governors (BoG) would be established to run the hospital. A number of employees have been working in the hospital for the last three decades and they have job security and other benefits. They have been living in official residences and their children also get scholarships.”

He said patients would also suffer as they would have to pay for the treatments and lab tests.

“The government does not have funds due to which it is being considered to increase the age of superannuation from 60 years to 63 years so that funds which are given as gratuity could be saved. It is being planned to run the hospital from its own revenue and the employees should be delinked from the Accountant General of Pakistan Revenue (AGPR), which pays our salaries,” he said.

A public health expert, Dr Ayaz Kiani, said there was a split opinion with two groups in favour and against the MTI.

“I believe that both groups are worried for doctors and staff rather than the patients. I suggest that better and cheaper healthcare should be provided to patients.”

He said during Pervez Musharraf’s regime, a proposal for the Pims Medical Tower was floated by Dr Mirza with a suggestion that private practice should also be introduced in the tower.

Dr Kiani said according to his own survey 85pc patients treated at Pims should be treated at primary healthcare centres so they won’t have to pay for the treatment.

“It was also mentioned in Alma Ata Declaration 1978 that governments should focus on primary healthcare system,” he said.

The Declaration of Alma-Ata, co-sponsored by the World Health Organisation, is a brief document that expresses “the need for urgent action by all governments, all health and development workers, and the world community to protect and promote the health of all the people of the world.”

When contacted, Secretary Ministry of National Health Services Dr Allah Bakhsh Malik said MTI was a new concept which stresses for better service conditions for doctors and patients.

“It is a concept and will be discussed with all stakeholders. There are misconceptions about it. It has better salary structure and service,” he said.

Dr Mirza said though medical superintendent (MS) and executive directors (ED) were appointed in hospitals they cannot take decisions. They cannot purchase medicines, cannot start new facilities and even cannot hire a nurse. However, in MTI the BoG would be established and a chief executive officer would be appointed at a market-based salary. “The CEO would hire his own team to ensure service quality. Private practice would be allowed in the hospital,” he said.

Replying a question, Dr Mirza said the employees would be given an option to opt for a contractual job which would have much more salary. But they will have another option to continue as government servants till the age of superannuation.

“However, those employees who refused to opt for a contractual job can be transferred to any other public sector hospital. MTI is the best system and would not only improve the service delivery but would also allow hospitals to generate revenues,” he said.

Published in Dawn, August 16th, 2019