Thousands to suffer as Centre, provincial govts pull back grants

Support provided to hospitals for liver, kidney transplants was lifeline for underprivileged patients

KARACHI: The grants provided by the federal and provincial governments to hospitals have been pulled back, leaving the lives of several patients in limbo. The federal government used to provide grants for the liver and kidney transplant, treatment of cancer, and other severe diseases, under the Prime Minister Grievance Cell supervised by former principal secretary Fawad Hasan Fawad. The cell closed down on May 31, 2018, when the previous government's tenure ended. On the other hand, the Sindh government expressed its reservations over the performance of some NGOs and also stopped funds provided to different NGOs running government hospitals.

According to the Sindh Health Department, while some NGOs performances were questionable, the contract of People's Primary Healthcare Initiative (PPHI), under which more than 1,200 government health centres in rural Sindh were running, has ended. Efforts are being made for the renewal of the contract.



The federal government allocated funds for liver and kidney transplant and treatment of five types of blood cancer for underprivileged patients. A Grievance Cell was established under the former prime minister in this regard. The grant provided by the federal government through this cell had been suspended since 2016, while the medical facilities were provided till May 30, 2018, after which the current government didn't reactivate it.

The newly-elected federal government of Pakistan Tehreek-e-Insaf (PTI) hasn't been able to make it functional yet. Several patients have been deprived of medical treatment due to the shutting down of this cell.

Sindh health funds 

The Government of Sindh has been providing funds to different NGOs to extend support to private and government hospitals for the treatment of poor patients. The government claims to have stopped these funds due to the unsatisfactory performance of some NGOs. The government hospitals of the province were handed over to eight NGOs in the name of public private partnership, in which 1,200 health centres are under PPHI, Badin Civil Hospital is under Indus Hospital, Sindh Government Children's Hospital Nagan Chowrangi is under Poverty Eradication Initiative (PEI), and 34 health centres of Malir district are under the NGO called Health and Nutrition Development Society (HANDS), including Sindh Government Ibrahim Hyderi Hospital. Integrated Health Service (HIS), a national healthcare organisation, has the responsibility to deal with the lack of requirements of about 111 hospitals in rural Sindh.

With the provincial government's reservations over the performance of some of these NGOs, the Sindh Health Department has handed over health centres of 19 districts of Sindh to PPHI in the name of public private partnership.

Government stance

According to sources, about 60% of the total budget of the Sindh Health Department, approximately Rs106 billion, is provided to PPHI. The focal person of the Health Department, Dr Sikandar Memon, told The Express Tribune that PPHI's contract ended last year. Two contracts of five years each were made before that. The summary has again been sent to the Sindh Chief Minister. Until the contract is renewed and then approved, the funds are suspended.

Memon said that the Sindh government issued Rs300 million to the National Institute of Blood Diseases (NIBD) where bone marrow transplant service had been initiated in 2017 for the treatment of blood cancer patients. Around 150 patients were to be accommodated with the bone marrow transplantation with that money. However, the institute had accommodated 159 patients for the transplant. According to Memon, the use of government funds to accommodate third parties is the reason why the grant was stopped.

Memon also said that the grants of those NGOs have been suspended that have been misusing the government funds. He said that the Sindh Government Children Hospital was handed over to PEI. This NGO was given Rs420m yearly to run this hospital with 200 beds but the Health Department has expressed dissatisfaction with the inefficient performance of PEI, thus suspended the funds.

An inquiry committee has been set up, headed by the National Institute for Children Health Director Prof Jamal Raza, to decide whether the NGO should be given contracts further or not. Memon said that the department was also dissatisfied with the one-year performance of HANDS, which was handed over 34 health centres and hospitals of Malir district. No improvements were seen after the centres were handed over to the NGO but the government hasn't suspended their funds.



Memon claimed that NGOs were seen taking funds in the name of patients but supplies them to other hospitals. Children's emergency ward was started under the Child Life Foundation in Karachi Civil Hospital, National Institute of Children's Health, Abbasi Shaheed Hospital and government hospitals of rural Sindh. The performance in all these facilities was still questionable.

Dr Tahir Shamsi, bone marrow physician of NIBD, told The Express Tribune that around 10,000 blood cancer patients need bone marrow transplant every year in Pakistan while only 250 such patients are being provided with this facility currently. Dr Shamsi further said that Pakistan only has 11 bone marrow physicians. "There is an extreme lack of bone marrow physicians in Pakistan. Only four institutions provide this facility, including NIBD, Shifa International, Agha Khan University Hospital and Combined Military Hospital Rawalpindi.

Published in The Express Tribune, January 16^th, 2019.