Employees of Pakistan Institute of Medical Sciences (PIMS), the only state-operated tertiary healthcare facility in Islamabad have been protesting on the streets for the last few weeks. They are protesting against turning the biggest government-operated health facility of the city into a corporate body through an ordinance.

The federal government promulgated the Medical Teaching Institute (MTI) Ordinance for the PIMS last November. The ordinance gives the PIMS an independent board of governors (BoG) that will run it as a corporate body. The government will allocate only a limited and one-time a year budget for the health facility. The BoG will have control over all administrative functions and clinical operations of the hospital.

“All employees, whether opted-for or directly-appointed prior to the Act or pursuant to the Act, shall at all times be governed exclusively according to the terms and conditions of the board; employees aside from the dean, hospital director, medical director, nursing director and finance director will have the right to appeal to the board against any penalty, censure or termination unless it is by the order of the board itself,” the ordinance reads.

The health ministry will establish a board of arbitration if an employee is aggrieved by a decision made by the BoG. The ordinance allows private practice and private patient billings. A share from the institutional charges shall be distributed between the employees based on performance and productivity, according to a format that will be prescribed by regulations to be framed for the purpose. The ordinance also provides that all civil servants serving in the PIMS, within a period to be notified by the government, may exercise a one-time irrevocable option to become employees of the institution. Civil servants opting for such employment shall be subject to terms and conditions of employment as may be prescribed, including but not limited to, their service structure, promotion and disciplinary matters. Such employees shall be entitled to post-retirement benefits as per existing laws and rules.

The Outpatient Department (OPD) of the hospital has been closed for more than two weeks now. The employees come and protest in the grounds every day, and a couple of times, they have also protested in front of the parliament but their demands are still unheard. Rather, the BoG and a new system have been made partially functional.

“The government officials are not listening to our demands but we will not end our protest unless there is a good result”, says Dr Asfandyar... Last week, the faculty of PIMS met Dr Faisal Sultan, special aide on health to prime minister, and expressed reservations on this new model.

“This is absolutely an attempt to privatise the hospital and take away the people’s right to free healthcare. It also affects job security of the employees serving here for the past several years”, Dr Asfandyar, chairman of the Grand Health Alliance, a coalition of several unions and groups of PIMS employees, tells The News on Sunday.

“The people appointed to the board are businessmen or are known for their political loyalties. None of them is a healthcare expert. This clearly shows what their motive is and how they want to make money in the name of healthcare,” he says, adding, “We will never accept this model of healthcare and will continue to protest unless our demands for true reforms are met and employees are given job security.”

He says a similar model of corporatisation of teaching hospitals has “failed badly” in Khyber Pakthunkhawa and “rather than learning from mistakes, the government is repeating them”. He says that during the Pervez Musharraf regime, there was an attempt to make hospitals “autonomous” but “this time it is a deliberate effort to turn these into corporate bodies”.

“The government officials are not listening to our demands but we will not end our protest unless there is a good result”, he adds.

Last week, the faculty of PIMS met Dr Faisal Sultan, special aide on health to prime minister, and expressed reservations on this new model. They suggested that the PIMS be made an autonomous body rather a corporate one. The faculty also suggested that those who do not exercise the option of MTI should remain civil servants, and for all practical purposes, should be considered and treated as employees of the Ministry of National Health Services under the Civil Servant Act 1973.

A PIMS spokesperson says that talks are under way and the government is trying to restore all clinical services as soon as possible. He says it is also considering some of the demands of the employees and the faculty.

At the moment, the PIMS has nearly 3,600 employees (including doctors and paramedics) and almost 700 posts are vacant. Daily average number of patients visiting the PIMS is around 15,000.

This is not the first attempt to change the administrative and operational system of the PIMS. The MTI scheme was also part of the discussions in 2019. When it was established in 1986, the government had made it an autonomous body. Later in early 1990s, it was made a fully government-owned health facility. In 2013, the government gave it the status of a university and a teaching hospital. However, in 2016, the Supreme Court of Pakistan separated the hospital management from the university.

Till now, there is no move by the government to present the ordinance on the floor of the parliament. The PIMS stakeholders have also moved Islamabad High Court against this ordinance and a hearing is scheduled towards the end of January end. The ordinance, if not enacted by parliament, will lapse by the middle of March.

The author is a staff reporter. He can be reached at vaqargillani@gmail.com