Healthcare ethics: ‘New doctors should serve one year in rural areas’
The federal government believes it should be mandatory for young doctors to serve in rural areas for at least one year before they can get a licence to set up a private practice.
Fresh MBBS graduates should be made to serve at basic health units, rural health centres, tehsil headquarters hospitals and district headquarters hospitals in “hard areas” for a year in order to gain registration as private practitioners with the Pakistan Medical and Dental Council (PMDC), Federal Minister for Regulatory Affairs Firdous Ashiq Awan said on Monday. All provincial governments would be consulted on the proposal, she added.
Hospitals outside the big cities are often understaffed because doctors are reluctant to serve in rural areas. The minister said the health sector couldn’t be reformed without addressing this problem.
She was addressing a seminar titled ‘Ethics in healthcare’ organised by the Pharma Bureau, a body representing multinational pharmaceutical companies operating in Pakistan.
Awan said she would seek to “free” the Central Research Fund from the clutches of the bureaucracy, as it was not currently being used for research purposes, as intended. The money for the fund, currently worth Rs600 million, comes from a one per cent levy on the income of pharmaceutical companies.
The minister said spurious, counterfeit and sub-standard drugs and quackery were a growing problem. The newly formed Drug Regulatory Authority of Pakistan would put in place codes, rules and regulations that would ensure a minimum standard of medicines, she said, so tragedies such as the deaths of over a hundred patients at the Punjab Institute of Cardiology and 19 deaths due to Tyno syrup were not repeated.
Pharma Bureau Chairman Asif Jooma said in his welcome speech that ethical healthcare simply meant doing the right thing for the patient: provide safe and effective treatment that delivers health benefits.
Jooma said there was a general perception that pharmaceutical companies were motivated by profit as opposed to patient interest.
“If we, as manufacturers and marketers of pharmaceutical therapies, believe our products provide genuine benefit to patients, there is no reason why doctors will not promote your products, which in turn will translate into higher sales and economic profit,” he said.
Jooma stressed the need for strong vigilance of pharmaceutical companies to ensure the safety of clinical trials. Post-marketing surveillance was also important, he said.
Published in The Express Tribune, December 18th, 2012.
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@concerned citizen: All over the world, people have to serve in underserved areas as part of their education. And no, the vasy majority of Punjab is very safe and secure so I think you are just looking for an excuse to let people get away from their duty to serve in deserving parts of the country.
It is usually equal to the number of yrs the student is in medical school. This can be applied to those medical student who are graduating from madical schools where federal or state govt is paying for their education. They should be given their degree after completing their job in rural area.Registration with PMDC is no big condition.this kind of scheme will work only if it is applied to every body.this should be applied to the first yr student when he joins the medical school. There must be a contract signed between the student and state or federal govt. this kind of scheme can not be applied to the present medical students or doctors in training.
In usa usually it is four yrs. A contract will be signed between the govt agency and the medical student. Upon graduation student will serve. If he does not want to in that case he has to pay back all the tution , interest and penality for breaking the contract. These things are specified in the contract. amount could easily reach up to half a million dollars.to keep it simple in pakistan one could write down fifty lakh rupees but every thing has to be in writting.
Who is going to think about the rights of doctors here? These over-stuffed and over paid beurocrats and ministers bring up ideas which fall as flat as this one. Shame
New doctors are dangerous and rural area is the last place they should be allowed to work on their own! Firdous Awan (and most of the bureaucracy) does not have a clue as to how projects should be planned. If they were capable they would have done something about it five years ago and not now when they are on their way out.
there's a reason why they're reluctant to serve there: security. is the government going to provide security to all young doctors that serve in these areas?
There is nothing new about it. The previous health policies also had these conditions, but (a) the primary health care system is (almost) non-existent; (b) there is no proper monitoring system in place through which the government could keep a check whether young doctors are actually delivering for what they are paid for or not; and (c) considerable number of medical graduates leaves the country after registering with PMDC and the remaining prefer to pursue their career in urban areas due to higher income opportunities. The solution is not just to condition the medical service, rather to translate policy into action through uplifting primary heath care system and proper incentives.