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diagnostic laboratories, and for-profit hospitals. There are also some large
tertiary hospitals in the private sector, concentrated mostly in the main urban
centres. There is a lack of duly empowered regulatory mechanisms to oversee
the dispensation of private healthcare. In Pakistan there are two types of
hospitals providing services to the patients; public and private. Where private
hospitals provide good quality service they are too expensive and unaffordable
for the majority of the people. Private hospitals also have a commercial approach
and work as business enterprises with profit maximization/revenue generation
as their primary objective. Public hospitals on the other hand are overcrowded
and suffer from inadequate facilities. There is also a high number of absentee
staff in government hospitals as doctors who are paid low salaries focus on
private practice. All this leads to misery and hardship for poor citizens as they
have to wait for hours in queues to see a doctor.
Regulation of medical education
The seminal challenge with respect to medical education is the verification
or authentication of the academic credentials of the practitioners and at times
even the ability of the private institutions both in Pakistan and abroad to impart
the desired medical education itself. A standard practice in rural areas is that
medical assistants after gaining sufficient experience set up clinics posing as
doctors. In more urban settings a challenge faced is with the verification and
acknowledgment of medical degrees received from foreign institutions, mostly
from China and Central Asian Republics. Perhaps, a clearer and more stringent
criteria needs to be devised. On the domestic front the regulation of “private”
medical colleges has also been on the rise. Theoretically speaking, they are
regulated by the University of Health Sciences (UHS), yet there remain
significant doubts regarding the monitoring. UHS is an internationally recognized
student centred research university with 80 colleges and institutes affiliated to
it and with around 35,000 undergraduate and 4,000 post-graduate students
registered. The competition to get into public medical colleges is cut throat
and only the very best are supposed to get admission. The standard or merit
required to gain admission to most of the private medical colleges is considerably
relaxed when compared to those of the public sector. Another undesirable
practice is that of “self-finance” scheme, which allows students who do not
meet the admission criteria to get in after paying a higher tuition fee. There
have been calls to revisit licence granting procedure to private medical colleges
and to raise the threshold.
Quacks
On the extreme end of this spectrum are the practitioners of “traditional
medicine” which include the homeopathic doctors and Hakeems, etc. In most
cases they prescribe medicines and even perform surgical procedures without
any formal training. The medicines prescribed are completely untested in any
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State of Human Rights in 2012