s Pakistan Tehreek-i-Insaf (PTI) leadership appears likely to dissolve the Punjab Assembly by the end of this month, the future of its flagship public welfare project, the Sehat Sahulat Programme (SSP), seems to hang in the balance.

Earlier, during the brief takeover of the Punjab government by Hamza Shahbaz Sharif of the Pakistan Muslim League-Nawaz, the project had hit a snag, even as the authorities directed all hospitals on the panel to continue to accept the health insurance cards like before. However, amid complaints of delayed payments for their medical procedures, and an unsustainable pricing mechanism, the private hospitals across the city quietly stopped taking SSP patients.

After the removal of Hamza Shahbaz’s government, the Parvez Elahi-led Punjab government brought the focus back to its pet project. But just as things were being set in order, came Imran Khan’s announcement to leave the assemblies, in an effort to put pressure on the federal government to hold early elections.

The PTI government had launched the Sehat Insaf Card in Khyber-Pakhtunkhwa (KP) in 2020, allowing those eligible to avail free medical treatment worth up to Rs 1 million. The programme was later extended to the Punjab and Islamabad.

According to the official data, between January 1, 2022 and April 8, 2022, an estimated 419,181 patients had used health cards for admission to various hospitals across Punjab against claims of Rs 8,497,838,788. Of these, 121,017 admissions were in public hospitals with claims of Rs 2,285,831,676; while 298,084 admissions were to private hospitals against claims of Rs 6,212,007,112.

The programme was hailed by the authorities as “a milestone towards social welfare reform, ensuring that the identified under-privileged citizens across the country get access to healthcare in a swift and dignified manner without any financial obligations.”

The idea of the programme is that the poor get access to quality medical services, through a health insurance scheme. However, in the weeks leading up to the vote of no-confidence that concluded with Imran Khan’s ouster, several private hospitals across the country stopped entertaining patients showing up with the Sehat Cards. Many private hospitals in the city were said to be considering terminating their affiliation with the programme, ending thousands of patients back to public hospitals.

Lamenting the fact that the programme had been mismanaged, hospital administrations identified the government’s pricing mechanism, delayed payments and refusal to accept the input of the private sector as major issues hampering its smooth functioning. For instance, Ghurki Trust Teaching Hospital, best known for its department of orthopedic and spine surgeries, terminated its operations under the pretext that unreasonably low treatment rates were being offered by the government for surgeries and the hospital was unable to bear the cost of medicines, surgical tools and operation theatre protocols and infection controls.

Some hospitals have “started to adopt a pick-and-choose policy, in order to avoid heavy losses. As such, they reject patients who need costly procedures in favour of those requiring low-cost treatments.”

Dr Ejaz Ahmed, who practices at Jinnah Hospital, Lahore, says that during the brief tenure of Hamza Shahbaz Sharif, most private hospitals located along Jail Road had started refusing admissions against Sehat Cards. Uncertainty about the continuity of the programme in the current political scenario coupled with the previous government’s inability to revise the packages for the treatment of surgeries in private hospitals are the main reasons due to which the future of the programme remains doubtful, he adds.

Dr Ahmed highlights another issue with the programme, “the manner in which hospitals were empanelled in remote regions.” He says in far-flung areas, only periphery hospitals where the owners are themselves surgeons are making profits or treating patients on Sehat Cards, as they can easily escape the checks on use of substandard medicines and low-quality equipment. The government hospitals are in a pathetic condition. Instead of pumping money into private hospitals for the medical services, the government should have upgraded the public facilities, he says.

hmed Rao, a patient seeking treatment at a private hospital in Shadbagh, says that private hospitals are either refusing patients on Sehat Cards or manipulating procedural matters to the extent where the patients have no choice but to go away. “It’s sad that an excellent programme like this should have failed.”

According to him, the programme has failed “because it was devised by non-technical people who did not plan it considering the ground realities.”

He says some hospitals have “adopted a pick-and-choose policy, in order to avoid heavy losses. As such, they reject patients who need costly procedures in favour of those requiring low-cost treatments.”

Health Minister Yasmin Rashid says that efforts are being made to resolve all problems with regard to an easy and affordable access to quality healthcare facilities for the poor.

She also warns of strict action against empanelled private hospitals if they do not entertain patients on Sehat Cards. “Through your paper, I appeal to people to let us know in case they observe or experience any aberration.”

The writer is a senior journalist. He can be reached at ahsanzia155@gmail.com