It may be too naïve to think that anything worthwhile will happen that will improve healthcare in Pakistan. So far, it seems as if an aimless and reactive approach is being adopted. Healthcare for more than two hundred million people of Pakistan is a significant undertaking and cannot be fixed by appointing part-time advisors who are clueless about ground realities.
Since the time of the present government like their predecessors, the focus remained on controlling the drug prices in Pakistan no matter what instead of looking at healthcare as a whole? This resulted in an unprecedented rise in the cost of medical treatment, where drug component is approximately 15% of the overall cost. The ever increasing lab costs, the consultancy charges and the rise of private hospitals is a response to the slow and steady decline in the quality of medical care available in the public sector, which is similar to the education sector where private medical and dental institutions dominate.
The ground reality today is that there is no free or affordable healthcare for anybody, and whatever is available leaves a lot to be desired.
As a result, the moneyed class choose the elite boutique hospitals in the country, and the middle class is forced to beg, borrow or steal to get treated at a private hospital. And the less privileged ones end up searching for some help in state-run hospitals and after being disappointed end up at quacks, non-qualified healthcare workers.
The Ministry of National Health Services headed by an advisor brought in from WHO Eastern Mediterranean region shows a complete disregard of the pharma industry and focus remains the price freeze in the pharma industry which at the most is 15% of the total hospital cost. Amid the COVID pandemic, he seems to be busy balancing the economy with complete disregard to what is best to control this pandemic as a healthcare professional.
The Covid-19 has exposed the healthcare sector around the globe, and it is now a proven fact that the world had misplaced priorities, and healthcare was never considered high with most of the governments. In Pakistan, a lot of money to the tune of 500 Billion rupees has been set aside to fight this epidemic. However, it looks more of an eyewash. The private hospitals are having a field day with charges skyrocketing to 150,000 per day to treat Covid-19 patients. Patients seeking treatment in these hospitals have to deposit at least a million in advance to get admission into the hospital.
Most of these hospitals are constructed on amenity plots, and yet they are charging top money. Similarly, the doctors are charging whatever they feel like, and there is no check and balance on their skyrocketing consultancy fees. The lab testing is another money-making scam which is bringing something like 120 crore revenue per day if the average per day testing is 15000 people. Companies involved in anti-infective, sanitizer and other cleaning things have doubled their prices. The same companies claim to have very extensive CSR initiatives but not when the country needs it the most.
However, those who are blamed for reaping profits in these challenging times are the vendors like fruit, vegetable or meat. Nobody is seeing the upsurge in the prices of other commodities sold by the elite manufacturers. There is no discussion on controlling the costs of the new essentials like the sanitizers, masks and disinfectants. The companies making these have tripled their prices, and the retailers are selling them in black.
It has been debated that if we start limiting what remuneration an individual physician or a hospital can charge a private patient then should we not also start limiting the same for lawyers, accountants, architects etc. but everyone does not need these professionals like they need doctors and hospitals. The government or the courts have limited the school as to how much they can charge then why not the healthcare sector?
It is time that the government starts to strengthen the rural healthcare system, including the Basic Health Unit (BHU), the Rural Health Centre (RHC) and the Tehsil Headquarter Hospitals (THQ). These centres lack adequate staffing, equipment, medicines and laboratory resources which must be made available, and that would be a giant leap for our healthcare.