Bridging the trust gap

In what seems like an alarmingly oft-repeated scenario, the doctors at Sobhraj Maternity Hospital were assaulted by attendants of a patient who had just delivered a stillborn child. According to various media reports, the relatives of the lady, after attending the baby's funeral, came back to the hospital and physically attacked the women doctors on duty.

As a protest, the doctors observed a three-day strike, which ended after guards were provided to ensure security of the hospital staff. Incidents of manhandling hospital staff by patients or their attendants have become increasingly common in the last couple of years. 

The momentum of public outrage against alleged malpractices by doctors was initiated when a young girl died after she was given a wrong injection to treat a burn wound in a private hospital in Lahore. The media coverage of the incident, fuelled by the family's relentless drive to find justice for their deceased child, brought the subject of medical negligence to the forefront. But following the incident, instead of institutional mechanisms of accountability being introduced in health sector, the trend has turned towards the public taking the law into their own hands by threatening the doctors and other medical staff.

Physical attacks on any healthcare professional must be unequivocally denounced and condemned. Yet, it is equally important to explore the root cause of such violent behaviour targeted towards those who provide healthcare services. The private and public healthcare industry in Pakistan is in need of a massive overhaul. According to various estimates, a whopping 74 percent of Pakistanis prefer private healthcare units over the government-run facilitates. There is a good reason for it too. Studies published in newspapers show that approximately 70 percent of the budget for a typical public hospital is spent on administrative purposes. Coupled with the fact that Pakistan already spends a measly 0.8 percent of the GDP on health, these statistics are demonstrative of the quality, or lack thereof, of healthcare being provided in the public sector. The consequent lack of public's trust on government-run healthcare is not surprising.

Therefore, with the government's area of focus remaining on public healthcare, there is an urgent need to form regulatory bodies that can develop policies regarding private healthcare facilities, a check and balance on the existing service charges currently employed by medical practitioners, and a strict accountability process for medical negligence. The purpose of such policies will not be aimed at curtailing the profitability of the medical industry but to ensure provision of quality healthcare services to citizens at a reasonable cost. 

The past few months have seen doctors in public sector all over the country observing extended strikes for better wages and working conditions. Whereas the demands of these young doctors are legitimate, and require necessary action, the cost of the deadlock between the doctors and the government has been borne by the patients. Although, a few doctors made themselves available to provide services for emergency cases, lives were still lost due to their absence. Non-terminal patients have also miserably suffered as different hospitals came to a virtual halt because of the strikes.

The current scenario of public and private healthcare has fuelled the public's mistrust and, in some cases, caused simmering hostility for medical practitioners. The fact that the relatives of the patient who lost her baby at Sobhraj Maternity Hospital automatically blamed the duty-doctors for this misfortune is just one manifestation of this mistrust. There is an urgent need for regulatory policies for quality control and accountability in public and private health sectors. In this regard, all stakeholders should be brought on board for consultation.

A slightly modified version appeared in in Business Recorder  (6 September 2010).