RAWALPINDI: The Special Monitoring Unit (SMU) of the Punjab chief minister has exposed a comprehensive governance failure at Benazir Bhutto Hospital marked by gross administrative negligence, exploitative practices, absence of basic patient facilitation, unhygienic and unsafe infrastructure, pharmaceutical influence and financial malpractices.
It recommended that the scale and severity of violations required urgent intervention to restore service delivery, enforce disciplinary measures and realign operations with the Chief Minister’s Health Reform Agenda.
In a report after a snap inspection of the hospital, the SMU revealed severe lapses across all operational tiers, including malpractice, extortion, neglect, pharmaceutical influence, overcharging, unhygienic conditions and infrastructure decay.
It stated that besides staff absenteeism and neglect of duty, multiple doctors and paramedic staff were found absent from duty.
CM’s monitoring unit says severity of violations requires urgent intervention to restore service delivery
Hepatitis clinic attendants and doctors were absent; patients were forced to collect TB and hepatitis medicines directly from the hospital instead of receiving home delivery via Pakistan Post. ICU-1 had no doctor or nursing staff present; patients were left unattended with blood-stained bed sheets. It said that the ortho OPD duty doctor was absent, and surgical ICU was found without any doctor.
About pharmaceutical influence, it stated that the additional medical superintendent (purchase)’s table contained over a dozen pharma company visiting cards.
Bundles of pharma brochures and medicine samples were found in the Head of Urology Department Room 13, gynecology and other doctors’ rooms. A pharma company calendar was also present in the medical superintendent office. Medical representatives were present in the gynecology ward during duty hours.
Multiple doctors and nurses were observed using mobile phones during duty hours, including cardiology ward nurses and a lady doctor in the emergency department. Female medicine ward staffers were engaged in socialising during duty hours.
Several doctors were heard using abusive language, including direct verbal abuse toward SMU team members. Token counters were issuing slips out-of-turn to acquaintances and individuals paying bribes or coming with reference. A hospital staff member was seen taking money to give protocol to patients for skipping queues. Upon being recorded, he became aggressive and snatched the mobile phone.
A security guard took medicines directly from the pharmacy without waiting in line. A patient reported being asked to pay Rs90,000 for surgery. Pregnant women were referred by doctors to private laboratories for tests instead of hospital labs.
There was no biometric attendance system for doctors; manual registers were used in emergency. The HMIS system was only partially operational (OPD &emergency only). Tokens were issued on plain paper without patient tracking, undermining accountability.
CCTV in directors’ office was non-functional due to a damaged LCD. Only two OPD counters were operational despite the high patient load, leading to severe crowding. There were no waiting areas for attendants in wards.
No ceiling fans in OPD; most corridors lacked both lights and fans. No seating arrangements in OPD, outside emergency, at token counters, or in wards; patients and attendants were forced to stand for extended periods. Poor temperature control in several areas causing severe discomfort was also noticed.
It stated that official parking fee was Rs30 but parking staff charged Rs50 per car. Overcharging stopped only when being recorded. Private individuals charged Rs20 for washroom use. Canteen prices were inflated: Roti Rs20, 500ml water Rs60. Public canteen prices exceeded actual rates.
Medicine shortages
The report stated that based on patient feedback, 80 per cent of prescribed medicines had to be purchased from outside. Medicines in skin ward were completely unavailable. Short-expiry medicines were found in large quantities in OPD pharmacy in violation of Drap regulations.
No pharmacist was present in the OPD pharmacy. Dormicum injection was absent from emergency pharmacy stock. Calcium and vitamin supplements had to be purchased externally. Pregnant women were given 15-day delays for ultrasound appointments. Surgery patients were not given confirmed dates, leaving them in uncertainty for weeks.
Security guards spoke inappropriately with female visitors and denied ward entry unless money was given. Paying visitors were allowed multiple entries at a time.
Filthy conditions
Across OPD, wards and ICUs, presence of flies, foul smells and accumulated waste were seen. Blood-stained, dirty, unwashed bed sheets were lying in ICU-1, medical wards and OPD. Waste bins were overflowing with human, medical and solid waste.
OPD, ward, dialysis centre and laboratory washrooms were extremely dirty with inadequate water supply. Ward washrooms were in an unhygienic and unusable condition. Poor sample collection, handling and disposal practices in OPD laboratory were observed. Blood stains and scattered medical waste were also observed. The laboratory washroom was in filthy condition.
The ward water filtration plants were out of order. Drinking water was unfit for consumption; patients and attendants brought their own water from outside. OPD, revamped only a year ago, was already in bad shape: broken ceiling, seepage, water leakages and open electrical wiring. No drainage for AC units, leading to water pooling and mosquito breeding risks.
Published in Dawn, August 22th, 2025