It is 10 in the morning. The emergency ward of Shaikh Zayed Hospital (SZH), Lahore, is immensely crowded with patients. The hospital is considered one of the biggest and well equipped public facilities in the provincial capital. However, the emergency staff, despite its efforts, is helpless in tending to the patients rushing to the hospital.

Surraiya Altaf, a woman in her 50s, is in great pain but has to wait for her turn. Abdullah, her son, says they have been waiting for half an hour for their turn but have not been attended by any staff member. Due to fewer staff members on duty, they have been asked to wait. "We’re facing the same situation in acquiring medicines, because the pharmacy is not completely operational and has limited stock [of medicines]," he tells TNS.

Muhammad Ghafoor is an aged man, heading out of the ward with the assistance of another person. He looks annoyed. When prompted, he begins to complain about the dearth of hospital facilities. "I am an asthmatic, and suffering from a lung disease," he says. "This is unbelievable; the hospital which used to be our first choice for treatment and which had a very good reputation has now become the worst in terms of facilities. no medicine is available; the cost of tests is unimaginable for the poor; facilities in the emergency are reducing day by day."

Failing to receive any encouraging response over his annoyance, he looks at his helper and says, "We should not come here again," and moves on.

The Shaikh Zayed Postgraduate Medical Institute (SZPMI), commonly known as Shaikh Zayed, was established under a trust formed on November 6, 1973. Its control was given to a board of governors under the resolution of May 29, 1986. This semi-government hospital owns 1,031 beds and has in-patient and out-patient facilities. It offers emergency services, specialist OPDs, surgery, pediatric and orthopedic care and treatment, and comes equipped with ICUs.

In 2012, the federal government handed administrative control of the hospital from the cabinet division to the provincial government through a notification under the 18th Constitutional Amendment. Nevertheless, the employees of the SZPMI did not accept the decision and challenged it in the Lahore High Court.

It took seven years to get the final decision from the top court. The Supreme Court in January 2019 handed the ownership of the Shaikh Zayed Hospital in Lahore to the federal government, ruling that the Centre reserves the right to build and run hospitals.

"This seven-year-long tussle between employees and the Punjab government has destroyed all the best practices in this hospital," says Nasir Ud Din, employee of the hospital, and the chief petitioner in the case. Din is also a senior member of the All Pakistan Paramedical Staff Federation. "During that time, the Punjab government shuffled the management, squeezed the budget, demolished the Board of Governors, and put a halt to hiring and promotions."

Since January 2019, the hospital’s affairs have been transferred to the federal government. However, the expansion of the emergency and other medical wards, new hiring, establishment of the Board of Governors, availability of medicines and other medical facilities have been halted because the new government has yet not released the due funds. Sources in the hospital claim that since the passage of the 2019-2020 annual budget, the federal government has not released funds for a single salary.

"Regrettably, the financial and management condition has become worse since the Supreme Court’s decision because the new government has not yet taken ownership of this hospital. Consequently, hospital’s employees and its patients are the direct victims," says Dr Sarfraz Latif, senior member of the hospital management.

"No funds have been released to the hospital for the last one and a half year, first by the Punjab government and then by the federal government," he says. "For the last seven months, we have been told by the federal government that under the instructions of the Prime Minister Imran Khan, a committee would first be constituted but at the right time so that the Prime Minister can take a decision based on the findings of that committee."

Nasir Ud Din claims that the federal government has decided not to take ownership of the hospital, which is why flow of funds has been stopped. "Nonetheless, the federal government cannot surrender the management of this hospital to the provincial set up as the Supreme Court’s order is crystal clear on it. In case of disowning the hospital, the federal government has to satisfy the full bench of the apex court."

Halt in promotions, backlog of salaries, unavailability of funds for medicines and other facilities, coupled with increasing workload have multiplied the level of anxiety among the hospital staff. The task of running the day-to-day business while also catering to the cumulative concerns of the employees has put the current management under immense strain.

"The deterioration that initially started during the previous provincial government’s tenure is continuing," says head of department Plastic Surgery, Dr Muhammad Ali Rafique Mirza. "Financial constraints are getting worse even during this transition period in which the federal government is supposed to cater to all pertinent hiccups.

"We can only hope that the government does not ignore this issue anymore. The administrative control should be given to the cabinet division, a board of governors must be established as early as possible, and the required funds should be released. This indecisiveness may lead to serious troubles in the future."