When the state abdicates its primary responsibility it invariably throws its citizens at the mercy of brute non-state operators. It’s true both for the political security sector as well as the private health sectors.
When the Frontier Constabulary and the Levies fail in delivering security and justice, Lashkare Islam and TTP stepped in. Similarly, the failure of public health sector creates the space for private hospitals which come across as money-minting machines. Often, patients with modest financial means – once admitted end up indebted because of the huge bills accruing of consultant’s fees, multiple tests and the lodging.
And once you walk in with a patient, the staff at these commercial health facilities pounces upon like starving vultures, making sure to fleece as much as possible. Every new patient means another money-minting object for doctors, para-medics and the administration – all of them seem to focus on how best to monetize their attention to patients.
Two personal experiences within last three years exposed us to the brutally commercial nature of two prime private hospitals in Islamabad. In the first instance, a surgeon implanted three stents into my father’s artery to save his life. Ironically, the surgeon came several hours later than the time he had indicated for the procedure. So he performed the procedure twice on my 87 year old father, first for two stents and then next day for the third stent. Three months later my father died of cardiac arrest. His treatment had cost more than a million rupees.
Some doctors I consulted later wondered as to why was a seriously sick 87 year old patient put to the angioplasty procedure at all and that two in two installments.
This prompted me to ask the owner of the hospital during a dinner as to whether he would recommend angioplasty for a person above 80.
“No I won’t advise because such a person is already on borrowed time,” came the incredibly shocking reply from the famed surgeon. Why?
Because he had himself signed documents for our father’s surgery by another known surgeon. Oh really, did I? Came the response when I recalled the entire episode. He promised to get back to me which he never did.
For over a weak, the intensive care unit of that hospital looked like a parking lot for the patients of respective surgeons and consultant physicians. Doctors were not supposed to touch other doctor’s patients. And the doctor in-charge would have the moral integrity to seek a second opinion for the ailment of our mother. On a critical day, the consultant doctor didnt show up at all and I drove him myself from his clinic at 1030 p.m to the hospital where my mother was struggling with epileptic fits.
Next days were not different either except for a better response after we complained to the executive director of the apathy of doctors and the casual attitude of the staff at the ICU.
During our stay we witnessed another patient being ripped off for what was a simple case of hypertension; within 24 hours, this patient had to cough up almost 40,000 rupees – first for treatment at the emergency and then for a few hours at the ICU – all this because of a false alarm that a consulting doctor had raised when the patient walked in.
Here we are talking of two hospitals which claim to possess DAS ISO 9001-2008 Certification. It’s a hospital where we could spot flies and mosquitos even in the intensive care unit. The wheel of one of the stretcher carts they used to carry critical patients was fractured.
Of course these facilities are far better in appearance, equipment and cleanliness than the public sector hospitals, yet they charge patients as they please.
What is the remedy for the common man, particularly those with limited financial resources?
There is no check on doctors who draw salaries from the government but perform tests and surgeries at private hospitals.
Most of their earning is in cash – particularly at smaller clinics. Tax evasion in this sector, particularly by prominent surgeons and physicians, is brazenly common. Situation in smaller towns are even worse where patients are treated as herd of sheep.
At best private hospitals, individual pontificating medical specialists/surgeons are no different from the hotel and restaurant industry where massive tax evasion goes on and the regulators (ministry of finance) often share the spoils from hefty profits these institutions and individuals make off the helpless patients. No accountability. Nor any sense of responsibility, and hence the rip-off, with countless patients falling victim to the insatiable greed of private hospitals.
By Imtiaz Gul, Weekly Pulse Magazine, May 26, 2014