Managing hospitals

If government teachers are not turning up to teach, close the schools. When government doctors are reluctant to serve in district hospitals, shut them too. This is the easiest remedy our governments find handy when they lack any other imaginative solution. That Pakistan’s health sector is in bad shape is no revelation, neither is the reiteration that there are district headquarter hospitals where doctors are in short supply. Now the government is planning to ‘facilitate’ the private sector to provide healthcare through the Naya Pakistan National Health Card. Pakistan is the fifth largest country in the world in terms of population. Its 227 million people are scattered across rural and urban areas from deserts to mountains. With over 150 districts, it has to have that many big hospitals to cater to the needs of the people in need of healthcare. With already depleting healthcare facilities and dilapidated clinics and hospitals, the citizens of Pakistan deserve better and more hospitals.

The cards that the government is launching as a panacea to various problems are not going to help if there are no nearby hospitals with proper tertiary healthcare facilities. The private sector the government is trying to facilitate does not have a wide presence in rural areas apart from private clinics run by doctors. If DHQ hospitals are shut, people will have to travel to other districts for treatment at a private hospital. The private sector is more interested in profit maximisation and that too here and now. Private hospitals will be least bothered if they know that the cost of treatment they will not get immediately but after some time, if at all

If DHQ hospitals are lying ‘deserted because of a lack of doctors’, it is the government’s responsibility to develop a mechanism so that the government doctors turn up to work. Running DHQ hospitals should be of prime importance for the health authorities, and the remedy does not lie in closing down the hospitals, but in establishing and running a robust healthcare system in each district supervised by conscientious doctors and medical superintendents. The country is not totally devoid of such government officials who can perform their duties diligently. They need proper resources – both financial and human – to run such hospitals. The government must make quality healthcare accessible to lower-income families. The Sehat Sahulat Programme is yet to prove its success and it is a bit premature to rely solely on the cards working with the private sector. The government must modernise and refurbish the DHQ hospitals with the required resources; their closure is likely to cause more problems than solutions.