Doctors in the dock

The only hospital where some sort of system exists to check on such cases remains Aga Khan University Hospital


Kamal Siddiqi July 24, 2017
The writer is the former editor of The Express Tribune. He tweets as @tribunian

As we move from one day to another watching the  Panama Papers proceedings, a number of more important issues continue to be ignored.  For example, at a recent seminar on health, reporter Kifayat Ali Shah disclosed how there is an typhoid epidemic raging through many parts of Sindh but is more or less not reported as Panamagate takes precedence.

One such story that seemed to have escaped public attention was the case of twelve people who were misled by private laboratories in Khyber-Pakhtunkhwa  and declared to have tested positive for HIV/Aids. While testing positive for HIV/Aids is not an uncommon thing, in this case what later came out was that they had received incorrect test results which were later rectified when another set of tests were done at a government-run Aids centre. And the story seems to have ended there.

The government did not take action against even one of these private laboratories. Many of these are owned by senior medical practitioners or business people. These powerful people are, in turn, closely linked or related in one way or another to government or public officials. The question of accountability does not arise.

The health ministry has stayed quiet. The bigger issue of course would be who runs such labs and what procedures they follow. If they have given incorrect test results for one set of people, one can only wonder how many others may have suffered.

The PTI government should have started by shutting down the labs and investigating the matter thoroughly. Are competent and professionally qualified people employed here? What is the system in place to avoid mistakes? These are basic questions.

The most tragic part of this episode is that private labs charge exorbitant amounts of money for such tests. As compared, government facilities charge one-tenth of the same. And yet there is no system in place for accountability of private laboratories. They can charge what they please and work as they want.

The larger picture is that of a health sector that has gone out of control. And this is not only true of the K-P province but all over the country. Medical malpractice has become such a common phenomena and yet little is done from the regulatory side to try and address the issue. One way the health ministry defends itself is to say that such practices occur all over the world. That is true. But at the same time in other countries, there is a system for redress. In Pakistan there is none.

A number of high-profile cases remain unanswered. Take the untimely death of PPP politician Fauzia Wahab at one of Karachi’s top hospitals in a surgery gone wrong. Five years have passed and her party remains in power and yet there are no answers. Or Shanul Haque, the innovative owner of a school, whose case was misdiagnosed at another such premier hospital.

There are thousands of such cases — both of high profile persons as well as those who don’t count. The great leveller in this has not been the mainstream media where stories of malpractice are usually removed or sanitized. It is social media that has played some role in exposing the rot.

And yet the government has not acted. Doctors are not removed. No system is in place to check medical specialists overstepping their boundaries or being criminally negligent in their work. The only hospital where some sort of system exists to check on such cases remains Aga Khan University Hospital. But that is just one amongst thousands.

If accountability is the flavour of the month, then we should start focusing on the accountability of different professions, not just politicians who seem to be in the dock all the time. And with the medical profession touching the lives of millions, I believe this is where we should begin.

Whether it is laboratories giving the wrong test results or doctors and surgeons making a mess of their patients’ cases, it is time for us to work out a system that protects the rights of both. As patients, we still do not know what our legal rights are.

More important is to regulate ancillary services as well. In Punjab, for example, no one knows how many blood banks operate and how many of those are licensed. This is true of other provinces as well given that blood supply is a highly lucrative business. Let us open Pandora’s box. It has remained shut for too long.

Published in The Express Tribune, July 24th, 2017.

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