PTI’s health policies
Least we can do is avoid putting unnecessary hurdles in the already prolonged professional journey of young doctors
The writer is a doctor based in Islamabad. He tweets @drkhalidshab
In a recent bid to reform Pakistan’s health sector, Imran Khan’s government has introduced the Punjab Medical Teaching Institutions (MTI) Ordinance 2019; dissolved the Pakistan Medical and Dental Council (PMDC); and introduced the National Licensing Exam (NLE) for fresh MBBS graduates.
Punjab’s MTI ordinance envisages “privatising” major public hospitals across the province. Many have opposed this while reiterating that our poor public would be unable to pay for medical treatment. The MTI ordinance has not been implemented yet, but what people don’t know is that patients in government hospitals are already paying a lot. After a complicated surgery, it is essential to administer patients with a potent but expensive antibiotic which is unfortunately not provided by the government to public hospitals. It is impossible to use less potent antibiotics which are available in government hospital pharmacies for such patients. Thus, they have to purchase the medicine themselves. Similarly, to perform a CT scan a contrast agent is administered to the patient to enhance the scan’s quality. This contrast agent costs approximately Rs4,500 and is not provided by the government. Often, young doctors personally arrange the required money for poor deserving patients.
While it’s a fact that majority of the people live under the poverty line and cannot cope with the “privatisation” under the MTI legislation, it is also impossible for a healthcare system to run successfully while providing services free of cost to the public. Even the health system in the UK charges its patients.
Furthermore, Punjab’s Young Doctors Association (YDA) has rejected the MTI ordinance for trying to bring the doctor community under the government’s control. The ordinance proposes for a Board of Governors (BoG) comprising private sector officials to be given complete authority over government hospitals including appointment and termination of doctors. This resulted in YDA Punjab protesting and— which when went unanswered — closing government hospital OPDs across the province.
Last month, Pakistan’s medical community was in a panic when the PMDC was dissolved through a Sunday morning presidential ordinance. In what is termed as an undemocratic decision by the Pakistan Medical Association (PMA) — the representative body of doctors —this would dampen our health sector’s progress. Dismantling an established governing body instead of improving it is neither wise nor economical in a developing state like ours.
The PMDC was responsible for regulating all medical and dental colleges of Pakistan and maintaining a standard of teaching. All graduating and practicing doctors were registered with the PMDC which issued medical licences. We are well versed with the private medical college mafia. The PMDC put a limit to the unchecked fees charged by private medical colleges and closed institutions providing substandard medical education.
The introduction of the NLE exam left young MBBS students in a whirlpool of uncertainty. It takes 13 years to become a consultant doctor from a first-year medical student. During this time, doctors’ competency is tested through numerous written, oral and practical exams. The news of yet another exam has strengthened the resolve of young doctors to move abroad?
The sincerity of Imran Khan’s team to bring a medical revolution in Pakistan goes without any doubt, but these steps are detrimental to our healthcare’s future. The representatives of Pakistan’s doctor community should be taken on board before taking such consequential steps.
In terms of medical research, technological advancements and treatment, we are 150 years behind Europe and America and 50 years behind India. The least we can do is avoid introducing legislation which is backed by political interests; dissolving established institutions; and putting unnecessary hurdles in the already prolonged professional journey of young doctors.
Published in The Express Tribune, November 23rd, 2019.
Punjab’s MTI ordinance envisages “privatising” major public hospitals across the province. Many have opposed this while reiterating that our poor public would be unable to pay for medical treatment. The MTI ordinance has not been implemented yet, but what people don’t know is that patients in government hospitals are already paying a lot. After a complicated surgery, it is essential to administer patients with a potent but expensive antibiotic which is unfortunately not provided by the government to public hospitals. It is impossible to use less potent antibiotics which are available in government hospital pharmacies for such patients. Thus, they have to purchase the medicine themselves. Similarly, to perform a CT scan a contrast agent is administered to the patient to enhance the scan’s quality. This contrast agent costs approximately Rs4,500 and is not provided by the government. Often, young doctors personally arrange the required money for poor deserving patients.
While it’s a fact that majority of the people live under the poverty line and cannot cope with the “privatisation” under the MTI legislation, it is also impossible for a healthcare system to run successfully while providing services free of cost to the public. Even the health system in the UK charges its patients.
Furthermore, Punjab’s Young Doctors Association (YDA) has rejected the MTI ordinance for trying to bring the doctor community under the government’s control. The ordinance proposes for a Board of Governors (BoG) comprising private sector officials to be given complete authority over government hospitals including appointment and termination of doctors. This resulted in YDA Punjab protesting and— which when went unanswered — closing government hospital OPDs across the province.
Last month, Pakistan’s medical community was in a panic when the PMDC was dissolved through a Sunday morning presidential ordinance. In what is termed as an undemocratic decision by the Pakistan Medical Association (PMA) — the representative body of doctors —this would dampen our health sector’s progress. Dismantling an established governing body instead of improving it is neither wise nor economical in a developing state like ours.
The PMDC was responsible for regulating all medical and dental colleges of Pakistan and maintaining a standard of teaching. All graduating and practicing doctors were registered with the PMDC which issued medical licences. We are well versed with the private medical college mafia. The PMDC put a limit to the unchecked fees charged by private medical colleges and closed institutions providing substandard medical education.
The introduction of the NLE exam left young MBBS students in a whirlpool of uncertainty. It takes 13 years to become a consultant doctor from a first-year medical student. During this time, doctors’ competency is tested through numerous written, oral and practical exams. The news of yet another exam has strengthened the resolve of young doctors to move abroad?
The sincerity of Imran Khan’s team to bring a medical revolution in Pakistan goes without any doubt, but these steps are detrimental to our healthcare’s future. The representatives of Pakistan’s doctor community should be taken on board before taking such consequential steps.
In terms of medical research, technological advancements and treatment, we are 150 years behind Europe and America and 50 years behind India. The least we can do is avoid introducing legislation which is backed by political interests; dissolving established institutions; and putting unnecessary hurdles in the already prolonged professional journey of young doctors.
Published in The Express Tribune, November 23rd, 2019.