THE health delivery system in Sindh and the rest of Pakistan depends on three components:

Primary healthcare which covers health services from the basic health unit to the taluka hospital.

Secondary healthcare which provides services at district headquarters hospitals and all major hospitals having more than 100 beds.

Tertiary healthcare which provides services at medical institutions.

The services in the first two components are unsatisfactory because of negligence and malplanning by the provincial health department, while tertiary care provides a bit of relief.

Tertiary care depends on highly qualified faculty, including doctors, trained paramedics and nursing staff, with the latest equipment.

After the mushrooming of private medical colleges and self-finance schemes in public sector colleges, the standard of education at the graduation and postgraduation levels has gone down.

The majority of doctors and paramedics cannot attend to medical emergency properly. The opening of private medical colleges has become an extremely profiteering business and is easier than establishing a primary school.

None of the private medical colleges and institutions except rare ones have faculty as laid down in Pakistan Medical and Dental Council rulings, and obviously it is not possible, since even the majority of public sector institutions do not have adequate faculty.

Basic medical institutes should have been established in all old established public sector institutes to produce postgraduates in basic sciences to fulfil the requirement of PhDs, MPhils, MDs, MS and FCPS.

Many of the faculty members are hired temporarily. They come only once or twice a week.

Many postgraduate degrees were recognised temporarily by the PMDC to adjust children of some faculty members and then the same degrees were derecognised after a year so that some other candidates may not be selected.

The PMDC team’s visits to these colleges are well-arranged, well-managed and well-entertained.

The fees charged for the registration of degrees were at a minimum in the 1960s and were a lifelong process. Now the fees are tremendously increased for graduation, postgraduation diploma/degrees, even for being faculty members, and are being charged on an annual basis.

There are private medical institutes, which have conferred MD, MS in various disciplines within three months without fulfilling the proper requirement and research work.

A year back the PMDC also floated the novel idea of evening classes in medical colleges on self-finance schemes so that there may be no difference between an arts faculty and a medical college.

If they are sincere about medical education, why don't they recommend abolishing the self-finance scheme and in place of that admissions on a merit basis so that the poor and deserving candidates may get admissions.

None of the private medical colleges have more than 25 per cent students’ attendance except a few. However, the results obtained are nearly 100 per cent because after all they are the highly paid guests of the college.

Millions of rupees have been spent on injudicious foreign tours of PMDC members.

The most devastating step the government has recently taken is by passing an act dissolving the PMDC and in its place giving power to a six-member body, including disputed personalities. People believing in taking shortcuts through political influence will spoil the residual image of medical education and institutions.

Please have some pity on the country and the medical profession.

Dr FATEH M. KHAN Former director-general, Health Services, Sindh Karachi