Tale of the Federal Hospitals in Karachi

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Tale of the Federal Hospitals in Karachi
Prof. Ghulam Asghar Channa*

In the meeting of Council of Common Interests, held early in the April 2021, on the request of C.M. Sindh, Syed Murad Ali Shah, the Prime minister has asked his advisor on health to solve the issue of Federal Hospitals affected by 18th amendment in Karachi. A hope has rekindled in the employees and friends of these institutes that Dr. Faisal Sultan being himself an eminent clinician and administrator will deal with this matter with diligence which is due for these Hospitals.

It was as early as the year 1948, a British Army hospital was taken over by the federal government to provide a medical facility for its employees in the Capital, and named it Jinnah Central hospital, with the consent of the father of the nation. Quaid-e-Azam gave the approval for his name to be used, with the condition that healthcare would be provided to people without discrimination and their ability to pay for it. JPMC has the honor of continuing to provide quality health care free of cost even today. JCH was re-designated as the Jinnah Postgraduate Medical Center for provision of postgraduate training in clinical sciences, Masters and Doctorate in the basic medical sciences. The institute has continued to provide state of the art specialized treatment and academic services to patients and health professionals from all over Pakistan.

In the year 1956 doctors working in ward 10 of JPMC (Cardiology ward), conceptualized a separate hospital for cardiac diseases and a Hospital under the name of National Institute of Cardiovascular Diseases was established. With active support of technical staff of JPMC, federal government, USAID, and the Japanese government the facility started functioning as an independent tertiary care cardiac hospital on 14th August 1979. The national institute remained under the administrative control of the Federal government for most of the time after its inception. After the 18th Amendment the institute came under control of the government of Sindh, the Chief minister Sindh being Chairman of Board of Governors. NICH, also was established on almost similar lines, Doctors and staff from JPMC continued to work in NICH and it remained under the control of the Federal ministry of health till the time of devolution. Mentioning the Graduate medical college, which was launched in 1971, will not be out of place here, as it shares its fate with these institutes. Sindh Medical College was started without its own hospital for teaching, as the college was a provincial entity and the JPMC hospital was under the control of the federal government. After two years of basic education, the college was attached to the federal hospital without any formal package for the staff and teaching faculty of the JPMC for teaching services. The faculty members used to teach the students on a voluntary basis.

Sindh Medical College remaining as the constituent college, Jinnah Sindh Medical University was established without its own teaching hospital, which is the essential requirement to get recognition from the regulatory body. In this arrangement one of the Professor of the hospital was appointed as the founder Vice Chancellor by the Government of Sindh. The hospital with the federal management is headed by the Director, appointed by the federal Government. Without legal wedlock of the institutes the Vice Chancellor has no authority in academic or administrative issues of the hospital, and the Director has no say in university matters. Due to litigation initiated by some employees against devolution, since 2012, no appointments and promotions have taken place in JPMC and NICH, excepting those who opted to join the University were promoted.

Tertiary care University teaching hospitals with super specialization, post graduate training, research and quality health care are complex organizations from financial, technical and management stand points. A lot of time has been wasted due to indecisiveness on the fate of these institutes in Karachi.

In the historical background explained above no adhoc formula will work for a long time. In a solution aimed to improve the status, the Clinical, Research and Academic autonomy should be given priority, fresh recruitment and promotion be made, University and the Hospital must be locked in a definite set of working relation. For financial support, in case of dwindling funds from both Governments and surge in demand for health needs Public private partnership is considered a panacea by some experts. To maintain the spirit of words of the father of nation, provincial and federal governments must maintain their budget with careful monitoring of the private parties in health care. Prevailing situation is not the objective of 18th amendment which has created problems for health workers and working of the institutes, it is the limbo due to lack of prioritization for health which like a spell of magician has prevailed over these institutes.

*Former Vice Chancellor, SMBBMU
Larkana, Sindh.

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