off record
Shaukat Ali Jawaid


Health and Education should
remain with the Provinces


The Honourable Members of the Supreme Court have dismissed the Sindh Government’s appeal and its claim on three main hospitals in Karachi i.e. National Institute of Cardiovascular Diseases (NICVD), National Institute of Child Health (NICH) and Jinnah Postgraduate Medical Centre (JPMC). The judgment was not unanimous and Mr. Justice Maqbool Baqar has written a dissenting note wherein he has emphasized the need for interpreting the Constitution in a way to preserve the provincial autonomy than to dilute the same.

In his note Justice Maqbool Baqar has stated that “The very spirit and essence of a federal constitution is the distribution of legislative powers between the federation and the provinces”. It may be mentioned here that after the passage of the 18th constitutional amendment the management of these hospitals had been handed over to the Sindh Government. Similarly the Shaikh Zayed Hospital at Lahore was handed over to the Government of Punjab. The Sindh Government’s appeal was dismissed by the Supreme Court Bench headed by former Chief Justice Mr. Justice Saqib Nisar. The court also ordered transferring the ownership of Sheikh Zayed Hospital Lahore to the federal government with an observation that the Centre reserves the right to build and run hospitals in any province.

On the other hand Justice Maqbool Baqar in his dissenting note has stated that “the subject of public health and public hospitals throughout our legislative history remained exclusively with the provinces”. Under the 1973 Constitution with 18th amendment contains only one legislative list- the federal legislature list- also confers such powers and authority on the provinces as the same again do not find place on the federal list. As such the subject of Public Health and Public Hospitals falls within the legislative competence and executive authority of the provinces only. Article 142 (c) clearly prohibits parliament from legislating on the subjects not mentioned in the federal legislative list.” Justice Maqbool Baqar has further stated that “Our Constitution prescribes well laid down role and limits of every organ of the State”.

NICVD and NICH, are the babies of JPMC which was named after the Father of the Nation Quaid-e-Azam Mohammad Ali Jinnah. JPMC and All India Institute of Medical Sciences (AIIMS) in New Delhi India started their journey together in 1947. While the AIIMS which remains with the Federal Government has made tremendous progress since then and is known as a Centre of Excellence in the World, JPMC could not make any worthwhile progress during the last over seventy years. Had it not been due to the commendable efforts of Patient’s Aid Foundation, kind hearted conscious healthcare professionals and faculty members of the JPMC like Prof. Hassan Aziz and Prof. Tariq Mahmood who keep on persuading the donors and philanthropists to come forward and help start, improve and expand the teaching, training and healthcare services at the JPMC, it would have been converted into a district hospital. The Federal Government all these years have never been interested to improve these healthcare facilities despite the fact that we have had numerous political governments by different political parties as well as military dictatorship spread over many years. One of the major complaints has always been that these institutions were being run and managed through remote control from Islamabad. Many posts remain vacant for years and years and there has been no substantial increase in funding to cope with the ever increasing workload and number of patients. Hence, it will be much better if all healthcare facilities should remain with the provinces and efforts are made to improve their performance with strict monitoring and constant evaluation.

Let us also not forget the ground realities. JPMC remains the affiliated teaching hospital with the Sindh Medical College ever since its establishment. Political sentiments in the country should also be taken into account. In not so distant past, all the political parties including the PPP and Tehreek-e-Insaf ran campaign against the PML (N) Government taunting them and inciting the people to get rid of “Takht-e-Lahore”. Not only that even the slogan of South Punjab Province by splitting the biggest province of Punjab was propagated by all the parties contesting against PML ( N ) with Mian Nawaz Sharif and Mian Shahbaz Sharif as the main targets. There is a demand for a separate Hazara Province in Pukhtun Khawa. The demand for a separate province of Karachi alongwith Hyderabad is also raised from time to time. The sentiments in Baluchistan are well known. Overall there is a demand for decentralization of authority. In subjects like Health and Education, the Federal Government should just confine itself to framing the policy and guidelines whereas the implementation i.e. building and running of educational institutions, hospitals should be left to the provinces. Let us give the provinces their due rights and do not wait for the day when they start asking for much more. After losing half the country in 1971 when East Pakistan became Bangladesh, we should have learnt some lesson but it appears this is not the case. Let us hope that better sense prevails and instead of creating further hatred, we resolve all these issues amicably through dialogue. The major responsibility lies with the politicians who should think of future. Instead of promoting and protecting their petty personal political interests, they should support any move and action which results in national integration and cohesion. They should refrain from sowing the seeds of hatred but promote love and affection among all sections of the society.


  1. Supreme Court rejects Sindh Govt’s claim to three Karachi Hospitals. Daily DAWN January 17th 2019. Page-1.
  2. Supreme Court Judge Stresses need to preserve provincial autonomy. Daily DAWN January 18th 2019. Page-3.


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