The Punjab Assembly on Wednesday passed the Punjab Medical Teaching Institutions (Reforms) Bill 2019 amidst scenes of stark disunity. The opposition vociferously opposed the bill - which puts state-run health facilities under the supervision of private-sector dominated boards of governors – while the government coalition in the Punjab Assembly rejected all amendments and forced the bill through with their numerical strength.

The bill, known simply as “MTI”, was contentious even before it reached the floor of the Punjab Assembly; it is a replication of the mechanism introduced by the Pakistan Tehreek-e-Insaaf (PTI) in Khyber Pakhtunkhwa (KP) back in 2015. Under the banner of Khyber-Pakhtunkhwa Doctor Council, Pakistan Islamic Medical Association (PIMA) of JI, Peoples Doctors Forum (PDF) of PPP, Malgary Doctoran (MD) of ANP and Young Doctors (YD) majority the activists of Islami Jamat Talaba have activity participating in anti-MTI protests in KP, while the bill has been challenged in the courts as well.

It is clear there is discontent among medical circles against the bill, but the PTI’s justification for why the discontent exists seems reasonable. Doctors used to eschew postings in rural regions to practice in the more lucrative cities, which left a dearth of god doctors in these regions. The MTI proposes the change that by forcing doctors to practice in rural areas and also monetarily incentivizes them to do so. The second major change, takes power away from the Health Ministry by decentralizing decision-making away from the bureaucracy and towards independently formed board of governors.

The changes are sure to upset the current ecosystem but the PTI must preserve. As it stands, with Police and Local Government reform in limbo, healthcare remains the only field where PTI has been consistently reforming the existing system. The change in the performance of public sector hospitals in Punjab will no be a major barometer of the government’s success - assuming the reform bears fruit as intended.