Need for new strategy by Punjab Health Department

Prof. Eice Muhammad FCPS Former Chief Executive & Principal
Allama Iqbal Medical College, Jinnah Hospital Lahore

Punjab Health Department has taken some administrative actions in the recent past whereby the Chief Executive (CEO) Mayo Hospital Lahore and Principal of Allama Iqbal Medical College and Jinnah Hospital Lahore were removed on basis of patient’s complaints, lack of supply of drugs to the patients and poor sanitary conditions of hospitals. Earlier Principal, MS and others had faced similar actions in Sahiwal Medical College.

Prof. Eice Muhammad

These unfortunate administrative steps indicate a deep-rooted illness and the manner in which the Health Departments are being run in Punjab. Having been associated with teaching and administration in five Medical Colleges and five tertiary care teaching hospitals (as Principal and CEO) in Punjab. I offer my views on the present state of affairs.

1. Both Mayo Hospital and Jinnah Hospital Lahore are autonomous medical institutions (AMI) having Boards of Management with chairman and members with distinct duties assigned to them in the Autonomy Act, 2003. Have Boards of these institutions been asked about the prevalent state in their hospitals?
2. The MS and CEO of Mayo Hospital Lahore had informed the Health Department about pending liabilities. Why action has not been taken against concerned Health Department Officials for this
3. The jobs of Principal and MS are administrative jobs, the Principals being the Chief Executive officer of the medical college and affiliated teaching hospitals. Are they given any administrative insight into financial and service matters? Not at all. It was only done once when f Mr. Ismail Quresh was Punjab Health Secretary, I was one of the participants in that refresher course when I was appointed Chief Executive of Jinnah Hospital and Allama Iqbal Medical College, Lahore in 1998. This course gave us insight into the financial and day to day running of the medical institutions. No such courses are now held.
4. The newly appointed Principals and MS’s are novices and they heavily depend on Account Officers, Head Clerks, storekeepers for guidance. These officials are seasoned manipulators and play with the Principals and MS’s. There is need for immediate arrangement for refresher courses as mentioned above.
5. The Jobs of Principal and MS are whole times jobs. At the moment they are present in the institutions in morning hours only and hospitals are left at the mercies of junior officials and sanitary inspectors who themselves do not visit the emergency and indoor departments. These night and Sundays are the most dangerous hours for the patients as there is no one to check and guide in these hours.
6. Question can he asked from Health Department that during evening and early night hours, what the Principal’s and MS’s are doing. Do they take evening and night rounds? Do the Professors take the night rounds of their wards? The answer is no.
7. If the Principal spend their evening and night in doing private practice, then one can imagine why the chaos in there.
8. Previously an undertaking was obtained from Vice-Chancellors and Principals that if selected they will not indulge in Private practice in Private hospitals and will be allowed “Institutional Private Practice” as stipulated in Autonomy Act 2003. But this commitment is being openly flouted. Has Health Department taken any action on this breach of commitment?
9. Even many MS’s also do private practice and some Principals, Vice-Chancellors and MS’s have built their own private hospitals. If this conflict of interest will be allowed to continue this will be the result which we have.
10. Actually these officials are part time government servants and whole-time private practitioners. Has Health Department taken cognizance of this state of affairs?
11. For redressal of patient’s complaints, there is need to set up “Department of Medical Counselling” in each hospital. I gave this proposal to Health Department many times but no one is interested in that concept.
12. There is need for programs of “Ethical Orientation” for medical Teachers, MS’s, Senior Registrars, Medical Officers, Nurses and allied medical staff. Again, I gave this proposal many times to the Health Secretaries, but they are not interested in this.

It may be mentioned here that for a very long time after independence in 1947, the departments of health at federal and provincial level were headed by experienced and senior doctors and there used to be fairly good number of doctors in the administrative posts in the Health Departments. But under a well-planned strategy, these departments have been handed over to civil service officers who do not know ABCS of health matters and medical education. These are naive people and results are before you.

How long the worthy Punjab Govt. will take these harsh actions against doctors. There will be no results unless a fundamental paradigm shift is not enacted as briefly mentioned above. I will request the worthy Chief Minister to constitute a committee to suggest ways and means to resurrect the present dismal state of affairs in Health Department Punjab.