Improving healthcare at Public Hospitals: Without checking population growth and proper


 Improving healthcare at Public Hospitals:

Without checking population growth and proper

 Referral system, it will remain a dream

Monitoring and accountability is good but actions should not
undermine respect and dignity of the healthcare professionals

LAHORE: Death of a diabetic hypertensive elderly lady who was also suffering from kidney disease at Jinnah Hospital Lahore few days ago which was highlighted in the media, has prompted the government to initiate action against some healthcare professionals and the Medical Superintendent of the Hospital. While initiating measures to ensure monitoring and accountability of the healthcare professionals is a welcome step but great care needs to be taken to ensure that their respect and dignity is not undermined under any circumstances.  There is no denying the fact that most of the healthcare facilities in the public sector are overburdened and such mishaps do occur every day but taking such an action may not achieve the desired results of improving healthcare until we check the population explosion and introduce some sort of a referral system.

Pakistan has miserably failed to reduce its fertility rate and we are also far behind in health indicators as compared to other Muslim countries.  Even if we build more hospitals in the public sector, the speed with which our population is increasing, we will never be able to provide satisfactory healthcare to our people. Firstly why every patient should come to a tertiary care facility travelling long distances? Why they are not being entertained and looked after the local hospitals. Every effort should be made to improve and expand healthcare facilities at the Basic Health Units, Rural Health Centers, Tehsil Hospitals and the District Hospitals. Then we need to establish some sort of a referral system. Only those who are first examined at least at the local Tehsil and District Headquarter Hospitals and are referred to higher level of care should come to the teaching hospitals and other tertiary care facilities in big cities. Only then the health professionals will be in a better position to look after them properly.  Serious patients like those with diabetes, hypertension kidney disorders do not have a good prognosis and these aspects must also be kept in mind while taking any punitive action against the health professionals who should only be reprimanded and punished if there has been some professional negligence.

On the other hand, the administration of the healthcare facilities also needs to be tuned up. So far monitoring and any sort of accountability of the healthcare professionals and healthcare facilities was lacking. However, the situation has now changed a lot. While the media is always keen to project negative things and such mishaps, the public has also become more aware and knows their rights. Their expectations have increased and they demand quality of care but somehow empathy is lacking at least in certain segments of the healthcare professionals. Some of them are overworked and complain symptoms of burn out. There is urgent need to improve their communication skills so that they can handle difficult and demanding patients and could satisfy their attendants. Patients and their families need to be involved in decisions making regarding care of the patients. They should be explained the likely prognosis, any complications of treatment, surgical procedure, advanced stage of the disease where not much can be done. Not only that, healthcare facilities should also create a complaint cell, investigate the complaints received and make efforts to redress the grievances of those visiting the healthcare facilities. Gone are the days when the Medical Superintendents used to administer these facilities sitting in their cozy offices. They need to be fully aware what is happening in their institution, take regular rounds of the Out Patients Departments, Emergency, ensure presence of technicians and paramedics, punctuality of the health professionals so that  they come in time and  do not leave the healthcare facilities  too early.

Professional societies and associations of healthcare professionals also need to start monitoring the attitude and behavior of their members, make sure they regularly attend CME and CPDs to keep them abreast with the latest developments in their respective fields. Any agitation is not going to help them because they will not get any public support and sympathy. Hence, they should better discuss the issues they are confronting and work out some sort of a referral system connecting all tiers of healthcare starting from Basic Health Units, Rural Health Centers to Tehsil, DHQ Hospitals leading to teaching hospitals and other tertiary care facilities. Such reforms are long overdue and the bureaucracy should also take steps in that direction before it is too late.  At the same time, we need to promote  family planning, ensure proper birth spacing, reduce fertility rate and check the population growth which is having its own impact on  not only healthcare but also all other services as well. The society as a whole including health professionals   need to play its role to check this population growth.

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