The MTI reforms

Published: September 8, 2019

One of the priority areas identified by the incumbent government, while taking control more than a year ago, was health. Prime Minister Imran Khan — who has the unique credit of creating and successfully running a large and modern cancer hospital in the country — is keen to overhaul hospitals in the country as part of his agenda of social service reforms to improve service delivery system in the country. Having already instituted a new system for teaching hospitals — called the Medical Teaching Institutions (MTI) reforms — in Khyber-Pakhtunkhwa province, the Prime Minister now wants the same system replicated in Punjab. Under the new system — on which the Shaukat Khanum Memorial Cancer Hospital and Research Centre is also based — government hospitals would be run by a fully empowered Board of Governors consisting entirely of members from the private sector.

The opponents of the new system of health reforms are primarily doctors, paramedics and other hospital staff, besides the political parties that now form the opposition. These opponents contend that the new measures are equivalent to privatising the state-run hospitals. The dissatisfied staff of the hospitals in question argue that working under the new system will strip them of their government employee status as well as the benefits that come with such employment, hence robbing them of their due rights. The alternative that the government is willing to offer is the purgatory of repatriation to the health department — something that is least acceptable to most of these civil servants.

The Punjab government — which has locked horns with the powerful doctors’ lobby in the past as well — anticipated the furious resistance it would face and decided to circumvent the trouble — and the democratically elected parliament too — through a presidential ordinance issue earlier this week. The new system has promised dividends but the jury — from the evidence in Khyber-Pakhtunkhwa — is still out on its efficacy. Punjab and its doctors are not known for taking things lying down, and unless the government can convince them on the new system, it should get ready for some fireworks. Patients have been warned.

Published in The Express Tribune, September 8th, 2019.

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