Private patients in public hospitals: PIMS clamps down on illegal referrals

Policy on admission of attendance, visitors changed

ISLAMABAD: While it is an old practice that some doctors at public institutions refer patients to their private clinics so that they can make an extra buck, some doctors in the capital have started referring their private patients to Pims where they are accommodated on priority.

An incident at a hospital in the capital last week leading to the death of an infant, however, has prompted  the facility to clamp down on this practice with a new set of policies and guidelines for visitors.

As a result, the Pakistan Institute of Medical Sciences (Pims) frequently finds itself short on space — for beds and facilities — with poor patients from far-flung areas getting shortchanged.

The situation is a common complaint at the hospital. Since most of the clinics cannot afford the medical equipment and machinery which is available at Pims, they refer their patients to visit the hospital.



Since private patients can pay for the service, so they demand to be treated first and it often results in scuffles in the hospital corridors.

The latest incident in the malaise took place last week when attendants of a private patient beat up a junior doctor at the hospital.

On December 28, house officer Rehan had refused to provide a ventilator for an infant. The two-month-old child had been referred to the children’s hospital by Associate Professor Maqbool Hussain. The child was admitted to the isolation ward but was later shifted to the intensive care unit after her condition deteriorated.

But with the hospital only having nine ventilators, Rehan argued that a ventilator can only be spared if it is taken off another patient following the consent of parents and approval of senior doctors.

As a result, the two-month-old child died.

On Friday, doctors staged a protest against the assault on their colleague and demanded that they should be provided with security while some standard operating procedures for ventilators and for referring private patients to the hospital should be made.

On December 30, an FIR was registered against attendants of the child for obstructing the official duties.

Doctors at the facility said that there was a shortage of facilities, infrastructure and healthcare staff at Pims.

“Every time any mishap happens, either due to  shortage of facilities or administrative failures, attendants of patients unleash the full force of their fury on the overworked junior doctors, said Dr Fazal Rabbi, a representative of young doctors — who had protested against the assault on Dr Rehan.

After the incident, the hospital’s administration sat down and drafted a set of standard operating procedures (SOPs) for admission of patients, attendants and visitors to the hospital. It was decided that only two attendants and visitors would be allowed into the facility for a limited time.

However, the new policy still does not address the (mal)practice of referring private patients to the hospital.



Meanwhile, Pims Administrator Dr Altaf Hussain explained that after last week’s incident, they had decided that senior consultants — who refer their patients to the hospital — will be responsible for looking after their patients at the facility while the junior doctors will not be asked to take care of them.

Separately, Shaheed Zulfikar Ali Bhutto Medical University (SZABMU) and Pims Vice Chancellor Dr Javed Akram said that they did not have a policy which allowed doctors to refer their private patients.

“It is against the policy of Pims,” he told The Express Tribune.

“No consultant or professor can refer their patients to the hospital for in-patient care,” Dr Akram stated categorically. “So they all violate policy when they refer their private patients to Pims.”

He further said that the professor who had referred the patient in the case has been issued a show cause notice.

“The child should have been brought to emergency since she was already critical. Their attendants really did beat up the junior doctor badly since his kidney has been damaged,” he said, adding that some arrests have also been made by the police in the case.

Published in The Express Tribune, January 2nd, 2018.