THIS is a shakeup Pakistan’s ailing public health sector can do without. Prime Minister Imran Khan announced on Friday that his government would shut down all district headquarters hospitals where government doctors are reluctant to serve and facilitate the private sector to provide healthcare through the Naya Pakistan National Health Card to people in far-flung areas of the country.

Mr Khan was speaking at Governor House, Lahore, on the occasion of a ceremony to launch the health card when he made the surprising declaration. Pointing out that DHQ hospitals were lying deserted because of a lack of doctors, he asked, “why should the government spend money if doctors were not going to the DHQ hospitals to serve the masses?”

The prime minister’s resentment over the wastage of precious resources is valid, but the remedy is misplaced and short-sighted. It would amount to an abdication of the government’s duty and make primary healthcare even less accessible to lower-income families, thereby defeating the very purpose of such a move.

The PTI government’s endeavours in the public health sector, specifically the Sehat Sahulat Programme, are commendable. It is clearly an aspect of the party’s manifesto that it has put some thought and planning into. The card was first launched in KP in 2016 during the PTI’s first provincial government and is being gradually rolled out in the rest of the country.

The latest expansion in the scheme, to mark which the event on Friday was held, makes the health card available to deserving families in the Lahore division from the beginning of this year, with the facility to be extended to all of Punjab by March 2022. Describing it as a major step towards the creation of a welfare state, the prime minister said the government would be spending Rs400bn to offer health insurance to 30m families in the province. According to Mr Khan, the private sector would be incentivised in various ways to come forward and set up hospitals even in areas far from urban centres.

However, to do away with DHQ hospitals or any other part of the government’s primary healthcare system, including Basic Health Units, Rural Health Centres and Tehsil Headquarters Hospitals, would likely create more problems for the underprivileged. For one, the health card covers mainly inpatient procedures.

Primary healthcare facilities cater to the outpatient requirements which form the bulk of healthcare needs; where will patients requiring outpatient care go, especially in rural areas? Secondly, there are thus far around 450 empanelled hospitals in the entire country, making access to them an expensive proposition for many people until and unless there is an empanelled hospital in each and every tehsil. Moreover, if health professionals are absent from duty in public-sector facilities, it is the failure of the government and one it should rectify instead of throwing out the baby with the bath water.

Published in Dawn, January 3rd, 2022

The editorial has been slightly amended for clarity.