The State of Health Sector in Punjab - By Beenish Sabir
As per constitution it is responsibility of Provincial Government to provide Health Facilities to the people Punjab but unfortunately, like other departments this department also proved to be a failure of Punjab Govt.
- Unfortunately, the province with area of 205,344 km2 and population of 93,963,240 i.e. about 60% of Pakistan is without any health minister and CM Punjab holding this ministry along with other 17 ministries which shows the non-serious behavior of Punjab Govt. regarding Health of poor people of Punjab and also how fond CM Punjab is to centralize the powers.
- This non-serious behavior of Punjab Govt. makes the life of poor people of Punjab miserable and for last 04 Years there is continuous unrest in health sector of Punjab which leads many lives. There is no doubt that Punjab is the most suffered province in this sector.
- The issues and scandals in last 04 Years are:
Shortage of Medicines:
- Since the current Punjab Govt. taken control of Punjab, the situation regarding availability of Medicines in Govt. hospitals getting worse.
- Due to the dispute between Punjab Health Dept. and suppliers, Govt. hospitals in Punjab was banned to purchase 124 essential Medicines. These medicines were of daily use and patients mostly belonging to the lower and middle class reporting to the said health facilities were forced to purchase the medicines from the open market. The three government hospitals in Rawalpindi have not got any money from the Zakat fund of the provincial government at the start of this fiscal year. Sources said this year the provincial government did not transfer funds in the hospitals’ accounts. Young Doctors Association Rawalpindi President Dr Umer Saeed, who is also working with BBH, told Dawn that 25 heart and 50 diabetic patients visited the hospital but failed to get medicines due to unavailability of Zakat funds. (Published in Dawn, 26-May-2012, http://dawn.com/2011/05/26/ban-on-purchase-by-punjab-government-hospitals-without-vital-medicines/)
Purchase of Medicine without following Rules:
- Punjab Govt. also involve in irregularities in the purchase of medicines which results not only the corruption but lead the health of poor people of Punjab at risk.
- The Jinnah Model Pharmacy – established in 2009 – is purchasing medicines worth millions from manufactures and distributors without adopting the procedure laid down in the Punjab Procurement Regulatory Authority Act, 2009, revealed in a letter of Punjab Finance Ministry. (Published in The Express Tribune, 01-Apr02012, http://tribune.com.pk/story/358023/jinnah-model-pharmacy-not-following-rules/)
- The Punjab government has supplied Hepatitis C (HVC) medicines and injections to 9 teaching hospitals and 36 district headquarters hospitals (DHQs) of the province, while the facility of PCR test (for Hepatitis diagnosis) is available at only two public sector hospitals. The government is putting the cart before horse as it has not yet established PCR labs for Hepatitis diagnose but high cost medicines are being supplied to hospitals. Complete treatment course for 14,699 Hepatitis patients costing Rs 80 million has been sent to 47 hospitals and more medicine is being dispatched for various DHQ hospitals. before qualifying for free medicines for Hepatitis treatment. The government is putting the cart before horse as it has not yet established PCR labs for Hepatitis diagnose but high cost medicines are being supplied to hospitals. Complete treatment course for 14,699 Hepatitis patients costing Rs 80 million has been sent to 47 hospitals and more medicine is being dispatched for various DHQ hospitals. (Published in The Nation, 24-Nov-2009, http://www.nation.com.pk/pakistan-news-newspaper-daily-english-online/lahore/24-Nov-2009/Govt-putting-cart-before-the-horse)
Contaminated Medicines & PIC:
- The issue of contaminated medicine hit Punjab Institute of Cardiology (PIC), which take near 112 lives from Lahore. CM Punjab immediately took his ‘patent’ action of ‘suspension’ of MS PIC Dr. Saleem Jaffer without knowing the cause. This unjust action leads the strike of Young Doctors which make situation even worse. This issue is typical example of CM Punjab ‘panic’ whenever such issues faced by Punjab instead looking into the matter. (Published in The Express Tribune, 30-Jan-2012, http://tribune.com.pk/story/329345/medicine-crisis-who-is-to-blame/)
- Above any political motive, the whole disaster was due to unavailability of Drug Regulatory Authority (DRA) and Mr. Gilani Ex-PM clearly mentioned that the hurdle in establishment of DRA is Govt. of Punjab but CM Punjab denies it. However, on 14thFebruary, 2012 Punjab Govt., the only province left, issue NOC for establishment of DRA which proves that this was the hurdle and poor people of Punjab has to suffer. (Published in the Express Tribune, 15-Feb-2012, http://tribune.com.pk/story/336699/punjab-gives-its-nod-for-federal-drug-authority/)
Dengue in Punjab:
- Punjab Govt. once again failed to take preventive measures against Dengue despite it was striking Pakistan since last few years. Punjab Govt. is use to of fire fighting and adhocism rather to plan and execute any strategy. This fever causes 100s of death across Punjab.
- Punjab Govt. did blunder in anti-Dengue campaign which leads more people on risk. The 10,000-kg imported mosquito control insecticide – Malathion — purchased by the health department contains only 46 per cent shelf life. Hundred per cent shelf life means the drug will expire after three years. Some of the drug batches contain 20 per cent shelf life. WHO standard guidelines and procurement manual policy, the companies were bound to provide imported medicines having minimum 75 per cent and local drugs 80 per cent shelf life. This lead re-procurement which cause 01 month delay at that crucial time and also the waste of public money. This is again typical ‘panic’ mode of CM Punjab having 17 Ministries.
- The AMRI experts, one of the reliable research institutes of test equipments, rejected the hand-carry fogging machine saying that the cut-off device was the most integral part of the equipment without which the fogging machine could not function properly. Again the waste of time and money at that crucial time. ( Published in Dawn, 01-Mar-2012,http://dawn.com/2012/03/01/health-dept-buys-low-shelf-life-dengue-spray/)
Doctors’ Strike and Punjab Govt.:
- Despite PTI doesn’t support strike from young doctors but the it was broken promises, delay tactics and stubborn attitude of Punjab Govt. which lead the pro-long strike and many casualties. The demand of Service structures from doctors is not new but from decade, Punjab Govt. several times and even Rana Sanaullah announced in Year 2011 but the lack of commitment of Punjab Govt. does not lead the issue resolve. Even if CM Punjab had one meeting, the doctors may call off strike but unfortunately, the politicians who nourish by Dictators are not used to of negotiations.
- The Punjab Govt. who crossed its over-draft limit from State bank i.e. Rs. 27 Million and spend Rs. 2 Billion in FY 2011-12 on laptop Scheme, Rs. 4 Billion allocated in FY 2012-13 for laptop Scheme, Spend Rs 8 Billion on scandalized Sasti Roti Scheme, Billion on failed yellow cab scheme, Rs. 80 Million on publicity campaign of Punjab Govt., is not ready to introduce service structure of the literate people of society.
- Punjab Govt. did crackdown on doctors and requested Army Doctors which is clear indication of failure of Provincial Government. In one Year, there were more than 5 strikes of Doctors and for the first time in History of Punjab Emergency & OPD remain closed about 50 Days.
CM Punjab stop development of Wazirabad Cardiology Hospital:
- CM Punjab start playing politics on health and after taking charge as per nature of PML-N leadership, CM Punjab stops the development project like Wazirabad Cardiology Hospital, Khanewal District Hospital and Dera Ghazi Khan Medical College in political rivalry of Pervaiz Elahi make the people victim. The funds are virtually stopped by Punjab Govt. and now when next election is near, they again start making promises from the people of Wazirabad.
- In contrast, Cardiology hospital in Rawalpindi has been awarded fund as it is strong hold of PML-N. ( Published in The Express Tribune, 08-Nov-2010,http://tribune.com.pk/story/73838/govt-playing-politics-on-health-projects/)
- Paramedical Staff remain on streets of Punjab.
- Lady Health workers on streets.
- Surgical Tower Project initiated by Previous Govt. closed.
- Air-Ambulance Project initiated by Previous Govt. closed.
- No Medical College or Nursing College Established between 2008-2012, while between 2002-2007 Nursing Colleges established with Nishter Medical College and Allam Iqbal Medical College.
- In 2011-12 Budget: Rs. 16.5 Billion for Health while in 2007-08 Budget: Rs. 12 Billion forHealth, only 4 Billion increase in 4 Years despite the inflation is almost doubled.
- Shortage of Specialists Doctors in Hospitals.
The poor performance of Punjab Government as per statistics.
Health Institute and Bed Strength in Punjab
Source: Govt. of Punjab,
Rural Health Centre
Basic Health Units
Understanding Punjab Health Budget 2012-13 by PILDAT.
The above Table shows that how the progress of Punjab Health sector either halted or slow down after Year 2008 when PML-N took charge.
Health Facilities per Million Populations in Punjab
Population (Million Persons)
Beds in Hospitals/Dispensaries
Source: Govt. of Punjab http://pndpunjab.gov.pk/
The above Table shows that Progress after CM Punjab took over is halted.
Health Indicators in Punjab
A comparison of Mortality Rates and Expenditure of Punjab on health with other under developed countries.
Punjab and under Developed Countries
Mortality Rate/1000 lives (<5 Yr of age)
Expenditure on Health
(% to GDP)
0.57 (as per Budget 2012-13)
- Ministry of Finance
- Understanding Punjab Health Budget 2012-13 by PILDAT.
- United Nations Development Program (UNDP)
The reason Punjab has been compared to the countries is that as per constitution of Pakistan, the health is the primary responsibility of provincial government. The major indicator which reflects the priority of government in health is the expenditure on health in term of percentage to GDP. As per Govt. of Punjab Budget of 2012-13 and also commented the same by the report “Understanding the Punjab Education Budget 2012-13 by PILDAT”, the Govt. of Punjab allocated Budget for health 0.57% of GDP which is not just very low but indicating that health yet to be in priority list. It has been shown that mortality rate has relation with expenditure and with such low expenditure Govt. of Punjab can not improve mortality rate in Punjab.
Beenish Sabir, Student of Economics and a tour manager by profession. She based in Rawalpindi and can be reached at firstname.lastname@example.org