THIS is a shakeup Pakistan’s ailing public health sector can do

without. Prime Minister Imran Khan announced on Friday that his

government would shut down all district headquarters hospitals
where government doctors are reluctant to serve and facilitate the
private sector to provide healthcare through the Naya Pakistan
National Health Card to people in far-flung areas of the country.

Mr Khan was speaking at Governor House, Lahore, on the occasion of a

ceremony to launch the health card when he made the surprising declaration.
Pointing out that DHQ hospitals were lying deserted because of a lack of
doctors, he asked, “why should the government spend money if doctors were
not going to the DHQ hospitals to serve the masses?”

The prime minister’s resentment over the wastage of precious resources is

valid, but the remedy is misplaced and short-sighted. It would amount to an
abdication of the government’s duty and make primary healthcare even less
accessible to lower-income families, thereby defeating the very purpose of
such a move.

The PTI government’s endeavours in the public health sector, specifically the
Sehat Sahulat Programme, are commendable. It is clearly an aspect of the
party’s manifesto that it has put some thought and planning into. The card
was first launched in KP in 2016 during the PTI’s first provincial government
and is being gradually rolled out in the rest of the country.

The latest expansion in the scheme, to mark which the event on Friday was
held, makes the health card available to deserving families in the Lahore
division from the beginning of this year, with the facility to be extended to all
of Punjab by March 2022. Describing it as a major step towards the creation of
a welfare state, the prime minister said the government would be spending
Rs400bn to offer health insurance to 30m families in the province. According
to Mr Khan, the private sector would be incentivised in various ways to come
forward and set up hospitals even in areas far from urban centres.

However, to do away with DHQ hospitals or any other part of the

government’s primary healthcare system, including Basic Health Units, Rural
Health Centres and Tehsil Headquarters Hospitals, would likely create more
problems for the underprivileged. For one, the health card covers mainly
inpatient procedures.

Primary healthcare facilities cater to the outpatient requirements which form

the bulk of healthcare needs; where will patients requiring outpatient care go,
especially in rural areas? Secondly, there are thus far around 450 empanelled
hospitals in the entire country, making access to them an expensive
proposition for many people until and unless there is an empanelled hospital
in each and every tehsil. Moreover, if health professionals are absent from
duty in public-sector facilities, it is the failure of the government and one it
should rectify instead of throwing out the baby with the bath water.