H for Hassles; H for Healthcare

H stands for Hassles; H stands for Healthcare.

Prevention is better than cure and, in our country, prevention is also cheaper than basic cure. My encounter is past few months led me to pen down my experience with private hospitals and quality healthcare in Pakistan.

“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition” … WHO.

According to the above statement, right to healthcare facilities for all people means that everyone should have access to quality healthcare without any discrimination or bias and/or without suffering financial strain. Poor should not have to compromise on the quality healthcare because they cannot afford it; while the elites rush to foreign countries even to address their sneezing allergies or for cosmetic procedures.

This wide contrast of status gap for H.care in Pakistan is concerning; where we rank 154th amongst 195 countries in terms of quality and accessibility of healthcare. In an underdeveloped country like ours, where population growth rate is amongst the highest in the world, the government allocated PKR 12.7 billion budget to public healthcare in 2022; which was a decrease from PKR 13.3 billion allocated in the previous fiscal year.

Healthcare in Pakistan has been developed on the pre-partition British healthcare system. It comprises of public and private sectors providing primary, secondary and tertiary care centers. Under public sector, we have local dispensaries, basic healthcare units (BHUs), sub-healthcare centers or rural healthcare centers (RHCs) in rural and peri-urban areas.

In Pakistan, private healthcare sector comprises of both “for-profit” and “nonprofit” organisations. Approximately 70% of Pakistanis turn towards private healthcare sector for better healthcare facilities. Private hospitals are charging exuberantly for these facilities from doctors’ OPDs to lab testing and admission for any medical procedures; they do ensure comfort and quality healthcare but at a staggering cost which everyone can not afford easily.

Even the remaining 30% of the population that do use the public sector health care facilities do not do so free of cost. A nominal charge is always applicable on anyone using the public sector healthcare facilities.

Those who have no choice other than using the public health care facilities are forced mainly by two factors i.e. the availability and the affordability. Provision of health care facilities in the rural areas and far flung places in the country is quite costly and cumbersome for the government, hence it relies mostly on the welfare organisations that are busy providing such facilities in the remote areas. Secondly, private sector H.care facilities are going out of reach for many due to increasing costs.

Upon a cursory glance on these healthcare systems, one is bound to notice the glaring difference in the quality (and of course the price!) of the services provided in the private H.care sector. The mere appearance of the buildings and the facilities & hygiene are quite noticeable but do they justify the excessive price tag attached to them? The public sector hospitals are mostly in a dilapidated condition and the long ques of patients awaiting their turn to see the physician or get tested are heart wrenching.

The equipment in use doesn’t seem to have been serviced in years while many supplies that are consumed in the testing laboratories are inadequate. The system of providing healthcare in the public sector is marred with inefficiencies and lack of controls. Hence the public is unable to optimize the benefits it can derive out of the system.

Pakistan has and is producing one of the finest doctors in the world. Our doctors as well as paramedics are highly trained, hardworking, experienced.

The world has recognized their performance during COVID and has promoted it as an example to all the nations. However, apart from the flight of good human resource in the field of medicine, most of the doctors have been running private practices along with their public sector commitments/jobs which is not only a conflict of interest but also an ethical question mark.

These doctors charge unwarranted amounts and almost all of them prescribe nth number of medical tests that in itself cost a fortune. So one has to have a considerable amount of personal wealth to enjoy the fruits of good healthcare.

In an equitable society, its people’s right to have access to world class healthcare system. We, on the other hand, are still struggling to develop a system that can cater to all the citizens of Pakistan in a just and non-discriminatory manner. The rich have access to world class medical facilities due to their strength of affordability of such facilities while the poor have to rely on the ineffective and inefficiently managed public sector health care system. This divide has not only caused the private H.care sector to become financially lucrative to investors as well and has thus resulted in establishment of private hospitals.

There are, but a few, exemplary institutions that have surfaced due to philanthropic efforts of people of Pakistan where the doctors devote a certain amount of time free of cost and the world class laboratory and testing services are available at a highly subsidized rate. The government and the people have to both work hand in hand to develop an efficient and cost-effective healthcare system for the generations to come.