Healthcare meltdown

A piñata hangs in the middle of a birthday party. Blindfolded kids take turns to hit the piñata with a bat. The piñata receives multiple blows but does not give way. Our healthcare has been battered similarly by politicians and policymakers who act as aimless birthday goers. How long the healthcare piñata would survive remains to be seen.

The sudden change of power in Islamabad has brought forward a mindset and leadership which is motivated by blind political rivalry between elitist groups and which has no choice but to think and act in the direction opposite to its predecessor. They have to take the 180 degree route on the far end and prove their way the ideal way even if it leads into an endless pit. This sudden shift has reduced our health sector to a joke, a joke so bad that we cannot help but laugh.

The first joke is the National Licensing Exam (NLE). This exam was introduced during Pakistan Tehreek-e-Insaf’s (PTI) three and a half years of power with the aim that it would help build more competent and practically safe doctors. The medical students took this exam as an additional and unnecessary burden in the already overstretched journey to become a doctor. Following previous trends, the voice of doctors was ignored so they took to streets to protest, roads were blocked and courtroom doors were knocked at but in the end supporters of NLE won.

The first batch who had to sit the NLE exam were fresh medical graduates who had just completed their MBBS and were working in hospitals as house officers. They had to work day and night as house officers (junior most doctors) in busy emergency departments and overflowing wards and also had to fight with time, energy and motivation to study for an exam which they thought of as something useless. The might of the elites is real: the new Pakistan Muslim League Nawaz (PML-N) government just recently abolished the NLE exam simply with a flick of the wrist. How convenient has it become to play with the future of our healthcare? What kind of health policies are we subjecting our doctors to?

The joke has a follow through: We all know the hassle which the PTI government went through from dissolving PMDC (Pakistan Medical and Dental Council) to giving birth to PMC (Pakistan Medical Commission). From PMDC to PMC and now once again back to PMDC thanks to the PML-N. All these U-turns are giving us motion sickness. Pakistan’s new ruling dynasty obviously has to show the public that the previous elitist government was steering our healthcare sector in the wrong direction. It is ‘oh so obvious’ that they have to abolish all health policies and acts of the previous government.

The joke seems to never end: Pakistan is not a big spender when it comes to health. For the fiscal year 2022-2023, the proposed allocation for the Ministry of National Health Services (NHS) has been reduced by nearly eight times from 154 billion rupees to only 19 billion rupees. To put things into perspective, according to estimates done in 2017-18, Pakistan spent $45 per person on health, while Iran and Qatar spent $484 and $1716 per capita respectively. Our health sector has been left to play with crumbs.

We have taken “ignorance is a bliss” all too seriously. Our health sector is gradually melting down and the earlier we realise this the better.

Now is the time for me to show you my psychic abilities: as this article ends, the ordinary reader is going to make a straight face and ponder for a second or two about the gravity of the circumstances our health sector is in and then would get up and get on with his/her life leaving this discussion for fancy dinners and gatherings to boost his/her self-confidence and self-worth. And if the sacred eyes of our current PML-N policymakers fall on this article, they would immediately open Reham Khan’s book and bury their heads in sand as if all is well.

Published in The Express Tribune, June 15^th, 2022.

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