All is not well with hospitals running under public-private partnership

Substandard medicines, truant doctors, non-provision of food reported by inspection teams

KARACHI: The provincial health department is not satisfied with the functioning of hospitals running under public-private partnership mode in Sindh.  According to evaluation reports prepared by the department to gauge the performance of hospitals under the public-private scheme, many such hospitals have not been able to deliver desired results under private administrations.

The process of handing over public hospitals to non-governmental organisations (NGOs), which include allowances for both budget and staff, continues under the management of the Public-Private Partnership Board. The inspection reports of the health department, however, have raised several concerns regarding the efficacy of hospitals running under public-private partnership.

The reports have raised objections on the performance of 34 health centres operating in District Malir in Karachi. The health department has also identified administrative failures at the Sindh Government Ibrahim Hyderi Hospital, Karachi, Memon Goth Hospital, Malir, Civil Hospital, Thatta and Sindh Government Children Hospital near Nagan Chowrangi in Karachi.



 

Ibrahim Hyderi hospital

The administration of the Sindh Government Ibrahim Hyderi Hospital was handed over to an NGO, the Health and Nutrition Development Society, under the public-private scheme in November, 2016. A three-member health department team visited the hospital, which has 54 doctors on its payroll, on October 28, 2017 for performance evaluation.

The inspection team pointed out severe flaws and even fraudulent practices in the operations of the hospital.  In its evaluation report, the team stated that the 120-bed hospital had substandard medicines and clean water was not being supplied to patients. Moreover, provision of food to patients had also been halted. The report further stated that there was no facility for pregnant women at the hospital and the women were asked to visit Jinnah hospital instead.

The report alleged that a majority of the doctors did not attend to their duties at the hospital. Among the 16 female doctors on the hospital's payroll, most remained absent, due to which pregnant women were referred to Jinnah hospital, the report stated. It was also revealed in the report that a female gynaecologist had performed only one surgery during the past eight years of her service.



According to the report, clean drinking water was not available at the hospital. During its visit, the inspection team also found that even the toilets were devoid of water. On inquiry, the team came to know that the NGO procured one water tanker a week, which obviously did not fulfil the hospital's water requirements. According to the report, non-availability of water was one of the reasons why the hospital refrained from admitting new patients.

The report also pointed out fake patient records at the hospital. It was stated in the report that when the inspection team arrived, the hospital records showed that 35 patients were admitted to the hospital at the time. However, the team found only two patients. Upon inquiry, the hospital administration said the patients had been discharged but failed to provide any treatment record of the missing patients.

The report also revealed absence of a qualified pathologist at the hospital's laboratory. The laboratory was being run under the supervision of a technician.

A member of the inspection team told the Daily Express that substandard medicines were being used at the hospital and no life-saving drugs were available. He also stated that a budget of Rs76 million had been allocated by the provincial government to the hospital of which Rs.18.5 million had been released for the first quarter.



 

Other cases

Upon visiting other hospitals handed over to private administrations, inspection teams found that many such hospitals were not functioning properly.

After visiting the Memon Goth Hospital, an inspection team found that the 50-bed hospital did not have enough medicine and no food was being supplied to patients. Some of the medicines found at the hospital were of poorest standards.

A team also visited Sindh Government Hospital, Thatta which has been handed over to an NGO, Medical Emergency Resilience Foundation. The hospital's condition was found to be not up to the standard. The emergency ward had hardly any medicines and there was no provision of food for patients.

Similarly, an inquiry is being held for unsatisfactory performance of the Sindh Government Children Hospital near Nagan Chowrangi.