Unnecessary controversy

Questions about how to implement the 18th Amendment on provincial autonomy have still not been settled. With a case ongoing in the Supreme Court over the control of three major hospitals in Karachi, the federal government has notified that it will take over the hospitals. The Sindh government has raised the battle cry – with PPP Chairman Bilawal Bhutto leading the charge. The three hospitals caught up in the battle – the Jinnah Postgraduate Medical Centre, the National Institute of Cardiovascular Diseases, and the National Institute of Child Health – are some of the most important public hospitals in Karachi. With the matter still in court, it is unclear what the emergency was that necessitated the notification. The federal and provincial governments have different views on the status of the case and the question of what falls under provincial control in lieu of the 18th Amendment. This being the case, would it not have been better for the federal government to let the provincial government retain its control? Especially given the fact that the federal government is likely to be making cuts in the health budget, along with a slashing of most of the social sector budget in its next budget.

Although both the Sindh government and the Young Doctors Association oppose the move, there has been little attempt by the federal government to explain why it wants to take over these three hospitals so badly. Since the provincial takeover, there has been significant investment in improving facilities in the three hospitals. The Sindh government may have a chequered record in terms of health across the province, but this is no excuse to take over some of the best run public-sector facilities in Sindh. Bilawal Bhutto has warned that resistance to the takeover will be a serious thing, but one can expect that the scope of any protest might be limited. However, this is not a decision taken in the right spirit. The federal government should not be meddling in provincial affairs, unless it is done amicably. Taking over hospitals should be the least of its priorities. Doctors have warned that it is patients who will suffer after the federal government gets involved. The Sindh government is right in noting that health has always been a provincial subject. It would be best for the federal government to listen to the Sindh government, instead of creating a controversy on the matter.