Monday, May 20, 2019

Business Recorder Editorial May 20, 2019

Doctors’ agitation

The dust had not yet settled on the doctors’ strike in public hospitals in Punjab when an unfortunate incident occurred in Peshawar, Khyber Pakhtunkhwa that has resulted in a doctors’ strike breaking out in KP too. First, the latter incident. Khyber Teaching Hospital (KTH) Peshawar’s Assistant Professor Dr Ziauddin Afridi had some service issues that he wished to discuss with Professor Dr Nausherwan Burki, who unfortunately did not accommodate his request. Dr Afridi then took the unusual step of procuring some eggs, bursting into the conference room of KTH where Dr Burki was chairing a meeting, and proceeded to ‘crown’ the latter with ‘egg on his face’. Dr Afridi next encountered KP Health Minister Hisham Inamullah Khan in the corridor and, allegedly after an exchange of hot words with the minister, was soundly thrashed by the minister’s guards. The KP doctors have since gone on strike and demanded an FIR be registered against the minister, pending which the strike will continue. The minister has threatened the striking doctors with ‘action’ unless they return to work. As it is, the doctors’ strike in Punjab, spearheaded by the Young Doctors Association (YDA), has been ongoing for about two weeks. While patients (mostly poor, some having travelled to city hospitals from great distances and small towns or rural areas where healthcare is inadequate) are inconvenienced and perhaps the critically ill run risks to life and limb because of such strikes, it must be noted that media coverage by and large focuses on public inconvenience in such situations without bothering to get to the bottom of the matter by reflecting the striking doctors’ viewpoint. Practitioners of the medical profession, young or old, are not likely candidates for being dubbed ‘irresponsible’. Given our public hospitals’ inadequate and crowded facilities, doctors who work long hours and sometimes round the clock are to be appreciated and dealt with differently from the way the KP health minister wishes to, or earlier Punjab Health Minister Yasmin Rashid threatened to. The latter has gone a step or two even beyond her KP colleague and asked the intelligence agencies to prepare lists of young doctors who are responsible for the agitation, while rounding on senior doctors of the College of Physicians and Surgeons, the top professional body of the medical sector, for ‘instigating’ the young doctors’ agitation and strike.

And now to get to the bottom of this issue. What is the beef of the Punjab YDA? It is the attempt by the Pakistan Tehreek-i-Insaaf (PTI) government to impose the Medical Teaching Institutions (MTI) Act 2015 of KP in Punjab too, preparatory to extending it to the rest of the country and reforming the structure, rules and management of the MTIs throughout the country in a uniform manner. The rub is in the detail that the MTI Act offers contractual service only to doctors, a measure seen by the Punjab YDA as a step in the direction of the privatisation of public hospitals, which they believe will make medical care unaffordable by the vast majority of poor people who throng such institutions. Now the Punjab YDA has been joined by the KP striking doctors in their stated opposition to the MTI Act. Reports say Dr Nausherwan Burki, a cousin of Prime Minister Imran Khan, was the architect of the KP MTI Act 2015, which has reportedly not to date been properly implemented even in KP. Two things are inexplicable in this whole fracas. One, why are the PTI provincial governments oblivious (despite having a seasoned professional as health minister in Punjab) to the difficult conditions in which doctors work day and night in the public hospitals? Why are they unwilling to talk to and consult the very doctors who are crucial to the running, let alone reform, of the public hospitals? Do they believe they can railroad what is proving to be unacceptable legislation through over the objections of the doctors and still come out with an improved functioning public health sector? Surely the path to take, sans threats and warnings of dire action, is to sit down with the agitating doctors in Punjab and KP and thrash out their differences in a civilised manner. Any other course, particularly harshness, may not achieve the goals the PTI has set itself and may end up causing a further deterioration, if not collapse, of the public healthcare sector. Surely no one wants that.

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