The healthcare system has been neglected in the budget for far too long.

By Haider Kaleem

The healthcare crisis has hit Pakistan hard, and part of the reason for this has been the negligible quota of the budget that the healthcare sector is given.

According to the federal budget in the last fiscal year (2019-20), the total budget was Rs7trillion out of which a total of Rs11.058 billion was to be spent on health affairs and services – which is lower by 20.4 percent from the previous budget estimates.

Punjab allocated Rs279bn for healthcare services in 2019-20. In the previous budget for Punjab, (2018-19) the health budget was around 284bn but the current government cut the health expenditures by Rs5bn.

In this regard, Voicepk.net spoke to experts on what the upcoming fiscal year’s budget of Pakistan should look like in order to deal with the healthcare crisis.

“Pakistan is currently spending less than 0.6 percent of the GDP hence we have to increase our budget in every aspect of healthcare,” said Dr. Shahid Ali, a senior doctor at Jinnah Hospital, Lahore. “But even if there is a 6 percent increase in the GDP for healthcare budget, this would still not be enough to deal with such a pandemic in the future.”

Community health expert, Kausar Saeed Khan, who played a key role in drafting the policy of the National Commission of Human Rights (NCHR) report on the need to recognize healthcare as a human right in Pakistan, stressed why more legislation on the right to healthcare in Pakistan is required now.

“I think people need to make these demands from the State,” he said. “Because plainly the State is content in providing us with the existing healthcare system. WHO defines health as physical, mental, and social well-being but in Pakistan, it is seen as services only,” he added.

Dr. Kaisar Bengali, a Pakistani economist, says the problem is not so simple.

No matter how much more money is invested, the current system can never give positive results of a good health service.

“No elected representative has lost an election because of the system not being based on performance,” he said. “So the local governments need to be reestablished and just like  NFC brings money to provinces, the provincial finance commissions, in turn, should also be distributing finances among districts. It should be linked to health and education indicators of the area. The local politicians will then have a political interest in performing. Otherwise, changing or making news institutions will not change much.”

Samia Altaf has been working in the public health sector for the past several decades.

Speaking to Voicepk.net she said that the problem is not just the budget, doctors or facilities, but bad planning and incompetent thinking. This is why the situation is what it is.

“The health services are corrupted because they are run without any kind of analysis of what kind of sustainable system must be built. There is a hospital on literally every corner now. At least 15,000 doctors graduate every year and looking at the number of districts, we have enough doctors and nurses. But the important question is how we utilize these systems.”

Altaf also pointed out how there is a mismatch in the demand and supply of health workers by giving an example of how many of them go out of the country to work under different MOUs.

Meanwhile, COVID-19 has emerged as a major challenge to many countries in the world. But it remains to be seen whether Pakistan will once again continue to spend large sums on defense budgets instead of health.

But the scenario seems to have a dismal future. Recently a large chunk – 67 percent – of the development funds of the merged districts in KP were snatched away and given to the security budget.