off record
Shaukat Ali Jawaid

Let us not
politicize Health

In Pakistan every new government when takes over, its first and the most favorite job is to criticize the previous government and blame them for the mess which they have created in every field, health services being no exception. It is said there are no funds as they have all been plundered because of rampant corruption everywhere. I have been hearing this from every health minister for the last over fifty years but time has come that we should stop all this blame game. It is essential that we must give credit to the good work which the previous governments have done in every field including healthcare and try to plan for future and further improve upon that is currently available.

If one starts from the 1970s after the tragic events of break-up of the country when East Pakistan became an independent country Bangladesh, it was Prof. Naseer Sheikh the DG Health in the PPP government headed by Mr. Zulfikar Ali Bhutto which for the first time introduced some meaningful reforms in health sector. Credit goes to Prof. Naseer Sheikh and the PPP Government for bringing in the Drugs Act 1976, introducing Drug Registration and Licensing of Drug Manufacturers. It also came up with the idea of Dispensaries in villages, Basic Health Units, Rural Health Centers which were all proposed to the linked with the Tehsil, Taulka District Hospitals for the provision of basic and primary health services while secondary care was provided at DHQ hospitals. Teaching Hospitals were supposed to cater to tertiary care. Prof. Naseer Sheikh also introduced reforms in the field of Medical Education after the Medical Education conference held at King Edward Medical College Lahore when for the first time almost 40% of doctors working in general cadre were promoted to the next grade, medical profession was also promised a service structure. A few new medical colleges were also established to overcome the shortage of healthcare professionals but then the political events which unfolded after the election results which were alleged to be manipulated, they could not complete their reforms. PPP government was toppled by Gen. Ziaul Haque which introduced Martial Law and thus PPP could not implement its whole health scheme.

PPP again got a chance to govern after the death of Gen. Ziaul Haque in plane crash when it won the elections and under Prime Minister Benazir Bhutto, PPP came up with the People’s Health Scheme but again failed to implement it due to political instability.

Pakistan Muslim League in its tenures did invest a lot of funds, improving, expanding healthcare services available, building new hospitals, healthcare facilities, setting up new medical colleges and medical universities. It also established a few state of the art healthcare facilities, tried to improve the rural health services by offering lucrative remuneration to those posted in Rural Health Centers but still a lot more needs to be done particularly in training nurses, paramedics and other technicians. When again PPP and PML formed a collation government, it was the brainchild of Mr. Ishaq Dar who came up with the Benazir Income Support programme to help the poor families. When PML formed its own Government after elections in 2013, it did introduce Health Cards a form of health insurance for the poor and also continued with the BISP. All drugs in Emergency were provided free while cancer patients also got free drugs in designated hospitals. A chain of Danish Schools were also established and increased enrollment in primary schools were ensured. In order to ensure minimum standards of healthcare being provided, Punjab Health Care Commission was constituted which has over the years done quite a commendable job. Sindh Government also formed the Sindh Healthcare Commission though its performance so far is not so promising for various reasons. This compelled PTI Government in KPK to forma Healthcare Commission of its own and its delegation sought help and guidance, training from Punjab Healthcare Commission. All these are positive developments.

Shahbaz Sharif proved to be the most active and dynamic Chief Minister Pakistan has ever produced and under his leadership a record number of development programmes were completed in the province of Punjab. In view of the epidemic of Hepatitis, Government of Punjab also started a hepatitis control programme besides helping establish state of the art PKLI at Lahore collaborating with well-known Liver Transplant surgeon Dr. Saeed Akhtar in a record time. It is pity that this institution was destroyed by actions by a former Chief Justice before it could flourish and start an active liver transplant programme.

The PTI Government in KPK also started the Health Insurance and now after forming government in the Centre and other three provinces it is pursing it further. Health Insurance card was an initiative of the PML (N) which was also taken up by the PTI government. It first tried to do away with the BISP but finding resistance, reduced its allocation and also started a parallel EHSAS programme with the same aim and objectives. According to Dr. Zafar Mirza Advisor to the Prime Minister on Health, the government is focusing on Universal Health Coverage for which it has made elaborate programme and a pilot programme will be launched soon in Islamabad. Later this programme will cover the whole country. They wish to concentrate on prevention, preventable diseases, immunization and vaccination, primary healthcare as well as secondary and tertiary healthcare. It is all laudable and one hopes they will start implementing these programmes as soon as possible. It is also important that instead of criticizing the previous government for everything, give them the credit which is their due and try to improve upon what is available. If they won’t give credit to their predecessors, they should not expect any credit for whatever good work they do from future governments. It is high time that we bring about a positive and healthy change in this culture and instead of all the time indulging in criticism of political opponents, let us concentrate on positive things and work as a team ensuring greater cooperation and collaboration between provincial and federal governments.

While we still continue our efforts to control Polio and other communicable diseases, NCDs are also emerging as an epidemic. The performance of the PTI government during the last eighteen months is not at all satisfactory but highly disappointing. Their incompetence and inability to ensure good governance is being exposed every day. They are faced with crisis after crisis, the shortage and increase in prices of essential commodities like Ata and Sugar are the latest one. Let them concentrate on good governance and try to deliver. There have been two importance incidents in the health sector during their tenure so far, one was injuring a faculty member of Khyber Medical College by the Guards of provincial Health Minister and Lawyers rampage of Punjab Institute of Cardiology which resulted in closure of services and death of a few patients. Such incidents had never occurred anywhere in the world before and PTI government will have to live with these unfortunate incidents for all times to come. Governance in Punjab is the worst and it will be a very tall order for any future Chief Minister to match the competence and capabilities of Mian Shahbaz Sharif. Let us hope PTI leadership has learnt some lessons and have made sure that such ugly incidents will never occur again.