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January 6, 2015

Passing Health Reforms Act in original shape a tough task


January 6, 2015

PESHAWAR: The Khyber Pakhtunkhwa government has finally decided to present the long-awaited Health Reforms Act in the provincial assembly but passage of the bill in its original form is going to be a tough task for the Pakistan Tehreek-e-Insaf-led coalition government.
Even if the bill is passed, its implementation in letter and spirit would be a daunting task for the government as there are only a few good managers in the province. It is feared some of the health workers might try to fail it.
There is a steady countrywide decline in provision of healthcare services in the public sector hospitals, but it is particularly visible in Khyber Pakhtunkhwa due to a host of issues, including the presence of millions of Afghan refugees.
Though it is considered a noble deed to help the Afghan refugees in terms of providing them health services, it is difficult for the government to provide civic and healthcare services to the people in KP compared to other parts of the country.
The decline in the provision of services over the past three decades has led to the mushroom growth of private hospitals and clinics in the private sector.The patients also prefer to visit the private hospitals to avail better treatment facilities. The public sector healthcare institutions give a deserted look in the evening as patients flock the private hospitals and clinics.
The doctors love to go to private clinics in the evening as they earn enough money there.This conduct has invited undesirable phenomena within the private sector such as rising cost of services, patients’ abuse by the support services, compromise on patients’ safety and attracting employees of public sector hospitals to provide healthcare services in private institutions after their duty hours.
Both diagnostic and therapeutic support services are fleecing the patients in absence of effective regulatory mechanisms. Safety of the individual patient and community at large is blatantly compromised by most

private health institutions.
There is no quality control in terms of conducting diagnostic and therapeutic procedures in properly sterilised manner that is the major cause of hepatitis B and C.Most private hospitals and health centres do not have properly staffed and equipped Coronary Care and Intensive Care units, yet major surgeries are performed there.
When things go wrong, the patients are horridly transported to a public sector tertiary care hospital in private vehicles as these health institutions do not have ambulances.Most private hospitals don’t have the facility for safe disposal of hospital waste, putting at risk the whole community. This should be a major cause of concern for the government when reforming the healthcare services in the province.
As private hospitals are run as businesses, the patients are brought there from the public sector hospitals for surgeries.The government has put health sector reforms on its priority list. It is believed that legislation in this regard would be introduced soon.
The passage of the Health Institutions Reforms Bill would be a litmus test of the commitment of the government and its lawmakers.It is feared that lobbies of doctors are so strong that they can influence people who have the power to make changes in the proposed draft law to their advantage or delay the process and render the bill ineffective.
So far the government seems firm on its obligation to reform health sector come what may.Currently, people knock at the doors of elected representatives to seek treatment at the public sector hospitals. Some of them might prefer status quo so that people should come to them for help.
In the proposed draft law, doctors in public sector will be given a choice to provide paid patient service at the public sector hospital or at their private facility.This would revitalise the public sector health institutions and the hospitals would become alive in the evenings too.
It will provide another option for paid healthcare services and encourage healthy competition between public and private sector. The ultimate winner would be the patient, the care providers and the institutions.
The proposed law also gives more weight to merit and competence which is another reason it would succeed and achieve the desired goals of improving patient care and healthcare services.
The success of the reforms will put private sector under strain for some time as far as human resource is concerned.They shall accept this challenge as an opportunity and come out with plans to end their dependency on public sector employees.
This would also help stop brain drain from the province. If one can make reasonable living at home, why would one go anywhere else? It will also address the issue of unemployment of healthcare workers to a certain extent.

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