>Ad hocism
>I often think that Pakistan is an Emergency country. Look around and you will see why I suggest it so; we do everything at the last moment. It has become a part of our daily life, from paying our taxes to utility bills or meeting our obligations. What impact such last minute actions has on the execution of any thing is that we have not had ample time to think through or plan for the activity. Therefore the outcomes are more often unpredictable and poor in nature.
In the recent months we have condoled with the families of those that lost lives in the terrorist bombings but also for those that lost their loved ones due to the negligence or oversight of medical doctors. As the whole nation was in shock to see the adorable child lose her life it resulted in an outcry and hatred against such gross misjudgment. Once again our response was even at the policy makers level very immature, reactionary and short term. All the same, based on the principles of ad hocism. The result was very simple, close down everything i.e. health facility.
After the dust settled and those that were suspected to be responsible for the gross negligence were fined or put behind bars. All of a sudden out of the woods came a health bill specifically for the private sector health providers. The health bill starts with the premise that all that practice in the private healthcare market are under the microscope and since they charge user fees for delivering healthcare they will be held responsible for any morbidity or mortality. They would be considered for charges of murder and would be stripped of this and that. The health facility will be closed down and this would scare everyone and things would improve. In my view again this is a reactionary and ad hoc response that has not been thought through.
The health bill’s first focus is on the private side of the healthcare service. If we suppose that the bill’s intention is to improve and guarantee quality then it has to encompass all the providers that practice healthcare both public and private sectors. The bill cannot go about putting punitive and criminal damages on licensed practitioners only when the cities are swarming with quacks that practice openly.
Why is the quality of the healthcare service so poor or delivered in hiccups because the people who should be responsible for making the laws to govern the quality and authenticity of healthcare have been busy with their love for the pharmaceutical sector. Question is why the focus on the drug industry only, because it involves money and large money means benefits for many. The time that should have been spent in implementing policies for improving and regulating the healthcare has been lost.
So now the problem is being solved as always in an Emergency without thinking through of the linkages, impacts and broad ripple effects; without any focus on plausibility of the policies and how they can be implemented and accepted by the stake holders. Again with an arrogance of bureaucracy it is believed that the laws will be imposed and they will be accepted and succeed in making a difference.
As logic should prevail the correct approach would be:
-to raise the professional / technical body to enforce a system of continuous improvement of production of professionals such as doctors and technicians and nurses.
-A compulsory system of reevaluation of the healthcare providers / professionals should be introduced to ensure up gradations and encompassing the minimum safe knowledge levels for the general safety of the patients.
-A system to be followed by all (public and private) health facilities that ensures standards of infrastructure, practicing rights of doctors,morbidity audits, mortality audits, infection committee,Pharmaceutical Committee,third party quality audits.
-A special force that can close down practicing people who do not have officially acceptable documents and or licences to practice medicine.
-A technical body designed to accept complaints and law suits against healthcare providers
Its a pity that we will continue to make the mistake of ad hocism as we are an emergency nation. May we become a nation of elective approach that uses our brain faculties. Amen!
