President Pakistan Islamic Medical Association Prof Sohail Akhtar addressed to a press conference at Peshawar Press Club on 31st March along with Prof Muhammad Afzal Mian (Vice President), Prof Muhammad Subhan (President PIMA KhyberPK), Dr Misbahul Aziz (ex PIMA President) and Dr Kamran Hassan (ex PIMA President KPK). press release is as below;
Through this press conference, we would like to draw attention of authorities to certain burning and urgent issues related to health care system in Pakistan and demand urgent actions and offer our support.
GOVERNMENT SHOULD GIVE MORE PRORITY TO HEALTH:
Allocation on health in budget should be raised from a dismal 0.42% of the GDP to at least 4%. Most of this budget should be spent on primary care, strengthening of basic health units, immunization, and disease prevention. There has been an exponential rise in non communicable diseases in the world as well as in Pakistan in the last decade; common man should get relief in provision of care for diabetes, hypertension, hepatitis, tuberculosis and other common diseases. Tobacco is the leading cause of preventable deaths and diseases; full implementation of laws against tobacco need to be enforced, including ban on its use in public places, restriction of sale to under 18 years and in educational institutions.
AVAILABILITY OF ESSENTIAL DRUGS SHOULD BE ENSURED
In recent months there has been an acute shortage of essential drugs, including anti-TB medicines, leading to a catastrophic situation for patients. Government should ensure this matter is sorted out, including if there is pricing issues with pharmaceutical companies. These differences should not let the patients suffer.
NEED FOR REGULARIZATION OF INSTITUTIONS (EDUCATIONAL AND HOSPITALS).
Provision of health is duty of the government. In Pakistan, the load of health care delivery is shared only one-fifth by the government, whereas 80% is provided by the private sector. Similarly in medical education, there are 91 private and 50 government medical and dental colleges in the country. Health is a provincial subject after the 18th amendment and this has generated a lot of confusion among the masses as well as among the administrator. Regulation of medical/dental colleges and health care institutions eg hospitals is still job of the government and the PMDC.
There has been a mushrooming of medical colleges in the last five to ten years with little emphasis on fulfillment of requirements and standards. This lead to dissolution of the PMDC among other reasons last year. The newly formed elected body is expected to wipe out the loopholes and irregularities in short time. Similarly government should ensure standard of care in hospitals by a strict mechanism to ensure curb of malpractice and protection of patients’ rights through standardized care.
PMDC and CPSP should be ensured to be non political with no government interferences, and accountable. There should be advocacy role of organizations and institutions including PIMA.
DOCTORS BENEFITS; SECURITY; JOB STRUCTURING
Doctors cannot be expected to work with full concentration, if their future and life is unsafe. In the recent years doctors have suffered by way of lack of job structure, lack of employments and lack of security. There has been a massive brain drain in the last ten years; factors have been multiple but the above are overwhelming. The number of doctors emigrating for jobs has risen almost fourfold since 2009 (589 in 2009 vs 2276 in 2015). Doctors are nation’s biggest assets and should be encouraged to return after further studies and be safe to serve their own people.
DISPARITY IN FEMALE AND MALE MEDICAL SEATS.
Up to a few years back the allocation of female seats in medical colleges was around 30%; after a supreme court’s decision few years ago allowing open merit in medical/dental college seats, number of female students has been almost 70%. On one hand, the earlier scenario was also discriminatory for females; now another serious issue has arisen as a result of this, that of acute shortage of doctors for hospitals and BHUs. This is because after graduating almost half to three fourth female doctors do not opt for, or continue practice. Reasons for females not opting practice and government jobs are understandable; family reasons, lack of security in far areas are prime reasons. Certain districts of Punjab for eg, have almost 50 to 90% seats vacant despite opportunities of walk-in interviews. There is a need to revisit the strategy, and without gender discrimination, provide a solution, eg allocate 50% of seats to male students, or opening of male medical colleges. This, along with provision of security in jobs and working area, may bring some relief in the acute human resource shortage in a few years.
