• Bids for robotic system tender for Liaquat University Hospital open today
• LUH chief Abbasi says hospital needs the system as automated surgeries have multiple benefits
• Decision reflects ‘misplaced priorities’ as hospitals need basic facilities first, say PMA, PIMA

KARACHI: Amid strong opposition from professional medical bodies, the provincial government has decided to go ahead with the controversial procurement of a robotic surgical system for the Liaquat University Hospital (LUH), Hyderabad, it has emerged.

Bids against a tender for procurement of the costly system for the LUH are being opened on Monday (today).

The LUH is among three tertiary care hospitals in Sindh for which the provincial government had last year approved billions of rupees for procurement of five robotic surgical systems. However, the procurement process was stopped by then caretaker health minister Dr Saad Khalid Niaz on the grounds that the funds were required for more pressing health needs.

His move stirred a major controversy within the government as caretaker chief minister retired Justice Maqbool Baqar wanted the health department to carry out the tender process. He was of the opinion that the caretaker set-up had no authority to stop past government’s decisions.

When the government of Pakistan Peoples Party took over after the Feb 8 elections, it went forward with the plan formulated in its previous term.

Speaking to Dawn, LUH medical superintendent Dr Aijaz Abbasi justified retendering for the system, describing it as “hospital’s need” and that the decision for the system’s purchase had been taken by the provincial cabinet.

“Robotic surgeries have multiple benefits. They reduce chances of infection, duration of operation and recovery time, among other things. We have a surgeon trained in robotic surgeries,” he explained, adding that he had joined the office as its medical superintendent two months ago.

When asked about the letter written by his predecessor to the health department last year, seeking its permission to use the funds released for the purchase of two robotic systems for “essential machinery and equipment”, he said the hospital had requested the government for several medical items one of which was this system.

To critics describing the purchase of an advanced system as “waste of resources in a situation where the masses are deprived of basic health services”, he said this problem existed across the country and not just Sindh.

Asked about the information alleging that the tender advertisement is tailored to suit a specific company, he said he wasn’t technical person and that he wasn’t aware of this matter.

It might be recalled that last year the LUH MS had sought permission from the health department for purchasing “essential medical equipment” from the Rs2.13 billion funds released for procurement of two robotic surgical systems.

Decision condemned

Like the previous year, several health professionals again have strongly opposed the government decision, underscoring the need for focusing first on the shortcomings of primary healthcare services before allocating resources for costly advanced technologies.

The tender, they said, reflected Sindh government’s misplaced priorities.

In a press statement, Dr Abdul Ghafoor Shoro of the Pakistan Medical Association (PMA) “strongly condemned” the Sindh government’s move to procure robotic surgical instruments.

“Spending the nation’s money on costly instruments, such as surgical robots, without first ensuring the availability of essential medical facilities and services at the grassroots level is a grave oversight that will only exacerbate the existing disparities in healthcare access and quality,” he said.

The funds allocated for the procurement of surgical robots, he argued, would be better utilised in improving the availability of basic healthcare services, upgrading medical equipment, and enhancing the training and retention of healthcare professionals, particularly in rural and underserved areas.

The association also criticised the recent tax proposed by the provincial government.

“The government has set the tax rate at three per cent on the services provided by private hospitals, clinics, and diagnostic centres, announcing that there is a scarcity of resources. However, on the other side, it has tendered for procurement of costly robotic surgical instruments,” he reasoned.

Dr Abdullah Muttaqi, who heads the Pakistan Islamic Medical Association, stated: “We cannot afford an expensive robotic system costing over a billion rupees in a situation where health facilities lack basic equipment such as syringes, blood test kits or even medicines.”

He added that the tetanus injection was still not available in the markets even after two months.

The cost of laparoscopic surgeries, he said, usually ranged between Rs50,000 and Rs100,000. But, the cost of the same operations increased four-fold when carried out through robotic systems.

Dr Muttaqi also pointed to the reported irregularities in past purchases of the robotic systems and said they were bought at a higher price than the market value.

Published in Dawn, June 24th, 2024