- No Regulatory Authority exists to check fee structure at private hospitals
ISLAMABAD: The mushroom growth of private practice-cum-business in the federal capital has raised eyebrows over the incumbent government’s claims of bringing about revolutionary changes in the health sector.
Private hospitals/clinics with medical stores and laboratories have been set-up in large number in various areas of the metropolitan, where specialist and well-qualified doctors are available round the clock. On the contrary, patients are seen complaining about the absence of senior and qualified doctors in public sector hospitals.
Pakistan Institute of Medical Sciences (PIMS) and Federal Government Service Hospital, more popularly know as Poly Clinic Hospital, are the two major hospitals in the federal capital, where patients are often seen complaining of being treated by the junior doctors, as seniors pay little attention to patients in public sector hospitals.
Hence, owing to the sluggish attitude or the absence of senior qualified doctors, coupled with insufficient facilities and accommodations in public sector hospitals, the number of patients visiting public hospitals is fast dwindling.
The number of patients visiting private hospitals and clinics has witnessed a sharp rise because of the availability of senior doctors and their lenient and sophisticated behaviours along with the availability of better health facilities.
National Health Services, Regulations and Coordination (NHSR&C) Minister Saira Afzal Tarar in her written reply to the National Assembly accepted the bitter fact that people in Islamabad preferred the private sector. According to the Pakistan Social and Living Standard Measures (PSLM) survey, 68.19 % of the population consulted private hospitals and only 23.84% consulted public sector hospitals.
A senior official in CADD ministry told Pakistan Today, that there is no check and balance system in the federal capital, as anyone with a medical degree can open a clinic or a hospital.
He said it is true that there is no law that bound doctors to do practice only in their specialized areas hence under-training doctors could be seen treating all patients especially in the suburbs of the federal capital and never any action could be taken against them.
Besides, no Regulatory Authority for the fee structure of various medical tests, consultation fees, investigation and procedures in the private hospitals in Islamabad Capital Territory (ICT) exists which is why the doctors charge whatever they please.
As a result, there is no parity in consultation fees which range from Rs 2000 to Rs 5000.
Saira Afzal in her written reply to the NA accepted that there is no authority for the regulation of fee structure of various medical tests, investigations and procedures in private hospitals in Islamabad at present.
However, she said that the NHSR&C is cognizant of the issue and has already developed, processed and tabled the bill on November 9, 2017, titled as “Islamabad Healthcare Regulation Act, 2017” in the National Assembly. The Bill has been approved in principle by the National Assembly Standing Committee for NHSR&C for further necessary action.
She said that currently there is no regulatory mechanism for charging consultation fees in private hospitals. Once the above mentioned Bill is approved regulatory mechanism of the private sector will be in place in ICT.
A senior doctor at PIMS, who chose to remain anonymous, told Pakistan Today that the private practice is no more a practice but it has turned into a “private practice-cum-business” because the majority of the consultants are not only charging colossal consultation fees but they have also opened medical stores and laboratories.
He added that these doctors “often prescribe expensive medicines which are only available at their own stores or at some prominent outlets and they strongly recommend not to take medicines of other companies despite having similar formulas.”
He suggested that the government should make institutional based practice, like in Khyber-Pakhtunkhwa (KP), mandatory. This is also successful in Combined Military Hospital (CMH) where consultants charge a minimal fee of which 70 percent is received by doctors while 30 percent is given to the hospital.
Keeping this in mind, PIMS also initiated an institutional based practice, where doctors are bound to charge Rs 2000 consultation fee. However, the practice failed to give the desired results mainly due to the senior doctors lack of interest in their duties.
Speaking to Pakistan Today, the recently retired PIMS Vice Chairman Javed Akram, who started the institutional based practice in PIMS, said that the doctors should be forced to do institutional based practice, because there are restrictions on them and they could not charge the patients extra.
However, he accepted that the senior doctors are reluctant to sit there and preferred doing private practice mainly due to extra financial benefits it offers. He added that once it is mandatory for the doctors to sit in the hospitals, the private practice would automatically diminish.
To a question about doctors’ presence in the hospitals, Akram said that the government should implement force to ensure that the doctors perform their duties in the hospitals.