Article on TURMOIL IN HEALTH CARE A lot has been written and projected in the electronic media about the abysmal failure of health care system. At present young doctors are on the receiving end, being abused and vilified for declining their services to the patients. Mostly it has been a one sided narrative which is being highlighted ad nauseam I am not writing in defense of any particular side but merely stating a few facts after being in this profession for over forty years in different capacities. Past few years have seen Doctors, Nurses and almost all paramedical staff on road in protest marches. What are the basic reasons behind this turmoil? Foremost is a lack of prioritization of two major aspects of Human Resource development and wellbeing of masses at large i.e. Health and Education. We, as Pakistani, must feel ashamed when a pittance is allocated for these very important millennium goals. Punjab’s provincial Government health allocation is about five percent of the budget despite its burgeoning population beyond its control. In fact more is spent on securing the “vote bank” than on welfare of masses. On top of exacerbating the situation is migration of doctors en masse to foreign lands in search of their livelihood, respect, dignity and safety of their families. Now I turn to the present acrimonious Saga of Punjab Government’s Health care machinery and the doctors, specially the Young doctors as they are addressed. Before we demonize the latter lets look at their side of the story. On an average, an aspiring student has to obtain high marks in premedical studies and then appear in another examination prior to qualify for admission to a medical college. After five or six years of rigorous education he is awarded a medical degree (M.B; B.S) and appointed as a house officer for compulsory one year of service. He is subsequently required to take yet another examination prior to application to be eligible for a training position as an M.O (Medical officer) and if he is lucky enough to be selected for such a position, he becomes a victim of long grueling hours of duty, providing care to a large number of patients at times in a very hostile environment without much supervision of senior faculty and meager remuneration. He needs another four years of training for specialization. Many, especially female doctors, for various reasons drop out during this long drawn out process. His quest is not yet over; he needs to clear examinations conducted by Pakistan College of Physicians and Surgeons. He is now looking for a permanent appointment in medical field. Quite a few of them find their way to various countries. Those who join the domestic rat race they become frequent visitors to the department of health, but that is another story. The other side: Do the young doctors know that two to three millions of rupees are invested in every doctor for his education and training. Does he realize that to abandon his patients will add to the suffering of already ailing population? He must also know that in majority of countries the money spent on education binds him to return the “loan” and serve otherwise in remote and medically deprived area for a certain period of time to get a waiver of repayment. Now let’s talk turkey. All of the above does not give any government functionary a cause to thrash abuse and arrest the young doctors. They are not demanding, perks, privileges and plots but at the same time do not deserve pennies. Government needs to come to terms with young doctors legitimate demands. Most important is to provide them a service structure in which they can grow and be adequately reimbursed instead of ad hominem by “know it all” team. They need appropriate and secure environment to perform their duty. If the provincial health ministry remains in a state of denial, we all will be losers as people, politicians, patients, and doctors and in fact the entire health system will end up in a mare’s nest. Dr. Owais Farooqui, Chairman FOCUS PAKISTAN Senior consultant, obstetrics & Gynecology [email protected]