PIMS Islamabad Young doctors threaten strike if demands not met in 48 hours
Islamabad (Thursday, August 04, 2011) – Young doctors of the Pakistan Institute of Medical Sciences (PIMS) have served a 48-hour ultimatum to the Capital Administration and Development Division (CADD) for resolution of the deepening crisis resulting from delay in notification of their salary raise and service structure.
“Should there be no headway on the issue within the next 48 hours, we will be forced to go on full-fledged strike leading to withdrawal of medical services from all critical areas including emergency, as well as intensive and coronary care,” the president of the Young Doctors Association (YDA) of Islamabad Dr. Sajid Abbasi said.
Continuing their strike on the 15th consecutive day here Wednesday, the protesting doctors staged a four-hour sit-in in front of the office of the PIMS executive director, raising slogans against the obstinacy of the hospital administration on the one hand, and the government, on the other. “We intend to block the main road in front of PIMS today (Thursday) and will eventually march up to the Parliament House to have our voices heard,” Dr. Sajid said.
The doctors want the government to fulfil its commitment by officially notifying the announcement that it had made on April 5 this year with respect to revision of their pay scales, implementation of the new Career Structure for Health Personnel, and regularisation of doctors working on contract. The package was to be implemented from July 1, 2011.
“There has been no progress on the issue so far. We have no idea when the notification will be issued. Now through the office of the ED, we have sent a formal application to CADD secretary, demanding an end to the crisis in the next 48 hours. If the hospital administration and CADD are happy maintaining their lackadaisical attitude, we too reserve the right to withdraw services from critical areas. Any casualties taking place during this time will solely be the responsibility of CADD and the hospital administration,” Dr. Sajid pointed out.
On the other hand, both CADD as well as the PIMS administration want doctors to understand that there are no short cuts available in matters with huge financial implications, and that laid-down procedures have to be followed when it is mandatory to obtain inputs from numerous divisions and departments.
“After approval by the prime minister, a committee chaired by Nargis Sethi and comprising additional secretaries of the Establishment and Finance Divisions and other co-opted members, was constituted to frame rules. This committee notified the service structure through an office memorandum (OM) within the stipulated 15-day timeframe. The actual implementation of the OM obviously has to be governed by certain rules, which were constituted by the Ministry of Health and had to pass through all relevant divisions before being finalised. These rules were vetted by the Establishment and Finance Divisions before being returned to the parent ministry. After that, they were sent to the Ministry of Law and are currently with the Federal Public Service Commission (FPSC), which is the competent authority for finalisation of rules pertaining to officers working in grades 17 and above. The FPSC will obviously take a few days,” a source told this scribe.
Aside from procedural delays, it is learnt that many senior doctors and non-medical staff who have been interacting with the decision-makers, are also playing a ‘behind-the-scenes’ role in perpetuation of the current deadlock. These senior doctors are concerned about de-linking of the new Health Pay Scale (HPS) from the Basic Pay Scale (BPS), as they would lose their civil servant status and be deprived of some of the rights that they enjoyed under the old service structure. “This is not true as the letter sent back from the Finance Division clearly states that the new system should include all perks and facilities,” another source informed, dispelling the impression.
While the tug of war between the decision-makers continues, cracks are also beginning to develop in the relationship between junior and senior doctors of PIMS. “We support the demands of the young doctors, but at the same time, they also need to understand that if they will spend one year protesting on the roads, when are they going to learn,” a senior doctor questioned. He blamed the hospital administration for taking the matter lightly, and the government for turning a deaf ear to the sufferings of patients who cannot afford catastrophic spending in private hospitals. “When doctors go on strike, the government should institute immediate action so that patient care is not compromised,” he added.
Another senior doctor criticised young doctors for planning a full-fledged strike. “This does not happen in any civilised country. How can we refuse treatment to a patient who comes in with a serious heart condition? We are under oath not to give preference to our personal interests over the interests of patients. We are not working at PIMS to make money; PIMS is a hospital for poor people. If VIPs can continue to be treated despite the strike, why should poor patients be neglected,” she questioned.
Another doctor advised his protesting colleagues to work for lesser hours per day, but to refrain from going on a full-fledged strike “because they are dealing with a shameless government, and an equally shameless hospital administration, which is unlikely to budge any time soon!”
When the young doctors’ attention was drawn to these sentiments, they said, “We are not happy about the strike, but what other pressure tactic do we have? We started off with boycotting the OPDs, then we took our protest outside the confines of the hospital, blocking roads and burning tyres; today, we staged a sit-in in front of the ED’s office and have now communicated our strategy for the future. But does anybody care? We have not heard a response in the last 15 days. Are we then to blamed for?” they asked.
Another protesting doctor talked about the immense pressure that the leadership of the young doctors has to endure when a strike extends beyond two days. “The YDA is itself in a quandary. You must understand that doctors are a soft target subjected to a lot of emotional blackmailing; even the media starts haunting us, but at the end of the day, we too have our families to feed and support,” she pointed out.
Criticising the administration, a senior doctor attributed the strike to gross mismanagement. “An administration that cannot manage a strike in 15 days is spineless. Have they been sleeping? It is the administration’s job to ensure that the hospital runs in a smooth manner. And if they are unable to perform this very basic function, there can be no justification for them to stay,” he said.
As many as 5,000 to 6,000 patients per day are examined and treated in the OPDs of PIMS and over 80 surgeries per day are performed. All cold cases have been discharged and no new cases have been entertained in the last 15 days. Patients who visit the hospital from far-flung areas are particularly disoriented because like the doctors, they too are totally clueless about when the government will spring into action. “We care two hoots about what the government does. All we want to know is when medical services shall stand restored,” commented a patient.