Health sector: what went wrong?

Last quarter of 2012 brings good news both for the healthcare providers and suffering humanity with the Punjab Government accepting 43 out of 45 demands of Young Doctors Association Punjab including revised service structure. As in 2011 patients continued to suffer due to continuing deadlock between the Punjab Government and the YDA.  Punjab Government’s measures including posting of army doctors and fresh recruitment on contract basis failed to make hospitals fully functional due to resistance of young doctors with the ‘support’ of their seniors. YDA went on strike several times and called it off after successful negotiations with the Punjab Government.
In a last ditch effort, YDA refused to call off strike in September till the acceptance of all demands. It went to the extent of holding a big rally at Services Hospital. Doctors from other cities also marched to Lahore to participate in a sit-in protest outside the Chief Minister Secretariat. The situation panicked the Punjab Government. On seeing that merely promises will not work to pacify doctors a high level committee headed by Senator Ishaq Dar held series of talks with YDA leadership that led to resolution of the longstanding issue. YDA called off strike after acceptance of majority of the demands and dissolved the body to hold fresh polls for electing new leadership. YDA Punjab council elected Dr Javed Aheer unopposed to replace Dr Hamid Butt as President. Recognising services of Dr Hamid Butt, the YDA council made him lifelong patron of the body.
Normalcy returned to hospitals after resolution of the longstanding issue between doctors and the Punjab Government. It all happened after two years of suffering for the common man. What caused the government to make only promises to end strike instead of making sincere efforts to resolve the issue and ensure uninterrupted provision of healthcare facilities to the poor patients at outdoors, proper functioning at indoors and carrying out surgical procedures as per schedule? Why patients were made to run from pillar to post for such a long time when this committee could have ended the issue much earlier? Delaying tactics on the part of the government not only caused suffering people, who could not afford to go to costly private clinics but also damaged the reputation of doctors. Public at large believe that the government could have avoided inconvenience to patients and their attendants by not allowing the issue to linger on. Timely solution could also have helped the doctors to save the reputation of a sacred profession as they were accused of giving priority to money over service to humanity.
Delay in resolution of the issue and frequent strikes have made the doctors stubborn who believed that the government could be forced to bow down through agitation. Though the government has obtained assurance from the leadership of YDA that it would not go on strike in future, it was not a guarantee that the hospitals would continue to function as per normal routine. YDA believes that it can stop normal working of hospitals and the government will have to accept its viewpoint or demands for the sake of poor patients. As such, united young doctors could force management to accept their legitimate or even illegitimate demands.
Following in footsteps of doctors the paramedical staff have also used the tactics of agitation to convey their demands and even force the government to negotiate and accept. Presently, paramedics are out to press the Punjab government for the demands of revised service structure, health professional allowance and regularization of ad hoc employees. The Punjab Health Department is using the same tactics of delay and keeps pending the negotiations with Punjab Paramedics Alliance instead of resolving the issue. Seemingly, it is least bothered by the agitation of paramedics, may be due to less attendance at rallies and paramedics not disturbing normal functioning of hospitals. Such a huge number of support staff can disturb normal working at hospitals if government continues to annoy paramedics by using delaying tactics and false promises. These paramedics are inspired by the success of young doctors and could also go to the extreme of disturbing the working of hospitals.
Both the Punjab Government and the YDA are holding each other responsible for ugly scenes at hospitals and denial of health facilities to the poor patients. Officials at the helm of affairs insisted that the government gave historic package to doctors and raised their salaries considerably but they continued to demand more and more facilities instead of fulfilling the responsibility of serving the humanity. They, however, believe that the issue has been resolved once for all as the government has accepted almost all demands of young doctors. They said that the department was fulfilling legal requirements to implement all decisions. They expressed hope that all the decisions would be implemented in due course and doctors would be able to serve with peace of mind.
Holding Punjab Health Department responsible for inconvenience to patients and their attendants, YDA spokesman Dr Mudasir Khan said that the government had left no option for the doctors except to go on strike to press for their rights.
“We never wanted to take the extreme step of closing down OPD and Emergency. Government officials continued to buy time by giving false promises. They (bureaucracy) forced us to start agitation and close down health facilities with heavy heart”, he said, adding, sincere efforts on the part of bureaucracy would definitely have avoided the inconvenience to patients.
“Health department was lingering on the issue for over a couple of years. Chief Minister assured YDA at a meeting held in January 2011 that the issue of pay increase and service structure would be resolved at the earliest. It did not happen. After six months, CM again constituted a committee to devise service structure within three months. Nothing happened and the year 2011 ended”, he said, adding, the government officials continued to annoy doctors as they were not sincere in resolving the issue. In the first quarter of 2012, he said, the Apex Court ordered the government to prepare service structure within six weeks. Instead of implementing the court orders the government started transferring YDA leadership to far flung areas to crush the movement. It also terminated ad hoc doctors belonging to YDA while others were allowed to continue duties. In May 2012 another committee was notified to resolve the issue within three months but it also never happened like the previous exercises, he said.
“We were left with no other option except to go on strike. This time we did not call off strike on promises and planned a sit-in protest outside CM Secretariat on November 7, 2012. On knowing that this time YDA will not end strike, Committee headed by Senator Ishaq Dar held decisive negotiations with YDA”, he explained.
To a question that if YDA was satisfied with government steps to implement service structure, Dr Mudasir said the community was unaware about the style of working at Civil Secretariat. “I hope that the government keeps its promise and does not force doctors to start protest again in 2013.
Delaying tactics on the part of the government not only caused the people to suffer but also damaged the reputation of doctors as common man could not afford to go to costly private clinics.
Following in the footsteps of doctors now the paramedical staff are also using the tactics of agitation to convey their demands and even force the government to negotiate and accept.

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