A win for the patient

Can you imagine scores of patients suffering for months due to the absence of a commonly used medicine called Flagyl, with demand falling on deaf ears and money lying in the bank, unutilised?

I couldn’t, at least not till a few days back when I made a surprise visit to Sheikhupura District Headquarter Hospital. Patients were subjected to needless agony because the relevant District Coordination Officer did not deem it a priority despite the wailings of the hospital medical superintendent. Standing there in the suffocating heat, I realized that the patients’ whimpers had been muffled by bureaucratic din. And that, without wasting a single day, we had to refocus our health system on one single focal point: patient care.

Healthcare is not about what a politician may desire, or bureaucracy may feel comfortable with, or for that matter what doctors may find convenient to practice. It is only about a single objective: patient care.

For me patient care is not a catchy slogan but an unwavering commitment. Realising that it cannot happen without all stakeholders taking full ownership of this intervention, I convened a Doctors Convention on July 4. The convention was attended by top doctors, vice chancellors and principals of universities and teaching hospitals, professionals of the health department, health sector NGOs, and representatives of paramedic and nursing staff associations. I could not have asked for a better professional constellation.

In our exhaustive four-hours long, no-holds barred interactive session we touched every operational and conceptual aspect of the healthcare system, ranging from fixing broken power generators to mending the career paths of doctors. From empowering the hospital MS to empowering the needy patient, we discussed it all. Many important decisions were taken right there and many more are coming.

To cite a few here, patients’ care allowance of Rs10,000 was announced for doctors and dentists of grade 17 and 18, whereas doctors of grade 19 and 20 will get Rs5000 per month. Under this head, the Punjab government will bear an additional expenditure of Rs3 billion per annum. In a sharp departure from the past, now the hospital MS, not the DCO, will get funds directly along with disciplinary powers to allow for operational and financial autonomy. It was decided to establish the Punjab Healthcare Council, which will consist of doctors, professors and experts.

To encourage better patient care, merit-based monthly awards, certificates and cash prizes will be given to medical superintendents, doctors, nurses and paramedics for outstanding performance. The president of Pakistan will give Pride of Performance awards to top performers among the medical fraternity.

Already the health budget for this year stands at a historic Rs207 billion, a whopping 62 percent increase over last fiscal year. Rs30 billion will be spent this year on provision of clean drinking water while another Rs16.6 billion has been kept for free medicines for needy patients. Rs1.5 billion is there for health insurance and billions more will be spent on upgrading DHQs, THQs and other health facilities.

And the list of initiatives reads on.

If you were to ask for my single line take of learned counsel from that conclave, I would say commitment, or in many instances the lack of it. It was clear that the healthcare system neither suffered from lack of resources nor a serious deficiency of infrastructure and that the biggest contributor to the underserving of suffering masses was the apathy of the people and the system responsible for providing relief. To change healthcare, those attached to the system will have to change their attitudes and levels of commitment.

Doctors are not normal people with normal lives, for theirs are dedicated to patient care and alleviating human suffering. And the majority remembers their oath – the sacred oath to serve humanity selflessly and above all over and beyond their capacity. But sadly, some amongst our doctors have also forgotten their sacred oath.

Unfortunately, visit upon visit to BHUs, THQs and DHQs, I observed the issues that patients face, issues that could be taken care of in no time if some of our doctors remember their sacred oath. It is for this reason that we need to talk about the focus of both the doctors and the government.

Sadly, the story of absenteeism is true. The saga of senior doctors not spending full-allocated time holds water. There are professors and assistant professors who don’t do the requisite number of operations or don’’ take their OPD duties dedicatedly. There are new doctors that qualify more as rabble-rousing union leaders than messiahs.

But to be fair, doctors alone are not to be blamed. The department functionaries have not been great either, for if they had been good, they would not have let this slip so low. If they had done their duties, the sad state of affairs of hospital infrastructure and malpractices around the system would have been nipped in the bud. It takes two to tango.

Today, the focus is to restore this urgently. The patient has to win. In the coming days, I will be consulting with doctors and other frontline care-givers like our nurses, hospital management and medical schools. I will be talking to the department and other experts and we will then invoke a medical emergency of sorts. This much is clear – more of the same will not work.

We need a system that works. This broken system cannot deliver. Thankfully, the overwhelming majority of our dedicated doctors share my concern and from amongst such noble doctors, we will find the leadership of willing tango partners.

The department has a huge budget. Money is not the real issue here; dedication, lack of clarity and lack of a cohesive approach are. I intend to get these maladies removed, to ensure that a paradigm shift takes place.

When doctors ensure selfless patient care, they become our national treasure. No one garners more respect and love than doctors. And I will stand by our doctors as long as they stand by the patient. I will stand by the department for as long as the department stands by the patient.

For Punjab to prosper, its people must be healthy and for that to happen, the patient must win. It is as simple as that.

The writer is the chief minister of Punjab. Facebook: facebook.com/shehbazsharif

Twitter: @CMShehbaz