Guest guest Posted January 26, 2010 Report Share Posted January 26, 2010 A MALADY THAT ALSO IS MORE OR LESS PREVALENT INTO OUR SYSTEM. Thank you very much. Nikhil Dr. Surender N. Gupta, MBBS; PGDHHM;PGDMCH;PGCHFWM; FAIMS;FIMS;MA (Phil);MAE (Epidemiology) Faculty, Regional Health and Family Welfare Training Centre, CHHEB, Kangra-Himachal Pradesh, India. Pin-176001. 01892-265472 (Fax); 01892-263472 (Office)Mobile: 094181-28634. E-mail IDs: drsurendernikhil drnikhilsurender --- On Sun, 1/17/10, EVENTS UPDATES <events_updates wrote: EVENTS UPDATES <events_updates{EU} Regulating doctors- Pakistanevents_updates Date: Sunday, January 17, 2010, 11:28 AM --- On Sat, 1/16/10, Faisal Siddiqui, MD. <faisalanissiddiqui@ > wrote: By Dr Tariq Hassan A large part of the medical sector, including the private sector in Pakistan remains either under-regulated or completely unregulated. The deluge of reports in the media regarding the deaths — allegedly caused by medical negligence — of three-year-old Imanae Malik, Huma Wasim Akram and politician Faiz Muhammad Khan have created a furore and has led to a collective demand for the accountability of the concerned doctors. In a knee-jerk reaction, several doctors were suspended; some were later restored by the courts as the administration had failed to follow the due process. Whether those who may have been responsible will actually be punished remains to be seen, primarily because cases of medical negligence or malpractice are difficult to prove. In any event, suspending medical practitioners is only a short-term remedy. Neither the victims of medical negligence nor their families are compensated by accountability measures that do not include the payment of punitive damages. Furthermore, the public is not likely to benefit from the large number of suspensions if this remedy is applied across the board and not just in high-profile cases. What is needed more than adequate and effective medical accountability is holistic regulation and better enforcement of professional standards. Presently, the status of regulation of the medical profession in Pakistan is inchoate. A large part of the medical sector, including the private sector, remains either under-regulated or completely unregulated. As part of its health policy, the government has undertaken steps to rectify the situation. A key area of reform included in the government’s 2001 Agenda for Health Sector Reform was: “To introduce required regulation in the private medical sector with a view to ensuring proper standards of equipment and services in hospitals, clinics and laboratories as well as private medical colleges and tibb/homoeopathic teaching institutions.†But to date, little seems to have been done in this regard. This situation has been viewed with concern by the Supreme Court in its judgment in Pakistan Medical and Dental Council v Ziauddin Medical University (PLD 2007 Supreme Court 323). Justice Tassaduq Jillani, noting the mushroom growth of medical and dental institutions in the private sector over the last few decades, emphasised: “The need for regulatory mechanism in the realm of general education and in the domain of professional courses has never been greater.†He suggested that there is a dire need to enforce the provisions of the existing laws. However, what may be needed even more than the enforcement of existing laws is the rationalisation and expanded application of these laws and the promulgation of new laws in areas not covered by existing legislations. Various health practitioners are regulated by different medical council laws, the most notable of these being the Pakistan Medical and Dental Council Ordinance, 1962 (MDC Act). All these medical council laws are similar in nature but different in content and scope. Presently, only the Pakistan Veterinary Medical Council Act, 1996 deals specifically with the private sector. No person other than a registered veterinary practitioner is permitted to hold any veterinary position in the private or public sector under this act which prohibits the use of unregistered veterinary qualifications by unregistered practitioners. The Pharmacy Act, 1967 also completely prohibits the practice of pharmacy without registration. In comparison, there is only partial prohibition for unregistered practitioners in other medical council laws. For example, the prohibition of employment of unregistered nurses applies only to hospitals, asylums, infirmaries and dispensaries which are maintained or aided by the federal or provincial government or a local authority. Similarly, the privileges extended to registered medical and dental practitioners under the act, and the registered unani, ayurvedic and homoeopathic practitioners under the Unani, Ayurvedic and Homoeopathic Practitioners Act, 1965 also apply only in relation to hospitals, asylums, infirmaries and dispensaries maintained, supported or aided by the federal or provincial government or a local authority. There is no prohibition on the employment of unregistered medical and dental practitioners, and unani, ayurvedic and homoeopathic practitioners in the private sector. All the medical council laws have different and somewhat outdated and irrational governance systems. They deal mainly with the mere registration of medical practitioners and not licensing. Furthermore, they do not have any provisions for re-certification and revalidation or detailed procedures for carrying out disciplinary action. The medical council laws are neither holistic in scope nor uniform in application. Although all of them deal with the establishment of professional standards, the provisions for the maintenance of these standards are scant. Furthermore, only two of them deal specifically with the establishment and maintenance of educational standards. The system of monitoring and evaluation of these standards is either weak or non-existent. The remedial provisions for non-compliance of these standards appear to be ineffective. Because of all these shortcomings, what is required is regulatory reform of the entire medical system. The focus of the reform process should be on good governance and economic and efficient regulation aimed at enhancing compliance. Given the government’s inability to cope with the growing demand for provision of universal and qualitative healthcare, the development of a private healthcare system may be conducive for the public. There is, however, a need for commensurate development of an adequate regulatory framework for the private healthcare sector. That there is scant implementation and enforcement of the limited number of applicable laws is cause for concern. The current regulatory deficiency can be met instantly by extending the application of existing medical council laws to private-sector healthcare practitioners. It would also be expedient for the government to make improvements in the institutional and regulatory framework of these laws. In cases where certain public healthcare practitioners such as paramedics and physiotherapists are not covered by existing laws, the promulgation of new laws would be necessary. Alternatively, the complex patchwork of the proposed legislative amendments could be avoided by the government by promulgating a new healthcare legislation that covers the full ambit of medical regulation. Accountability is the last segment in the regulatory process. Periodic suspension of doctors is neither a sufficient remedy nor an effective deterrent against future medical abuse. Prevention of medical negligence and medical malpractice requires uniform regulation of all medical practitioners. The writer is former chairman of the SECP and a lawyer.law.hassan (AT) gmail (DOT) com Glitter Graphics TO ADVERTISE FOR CONFERENCE, WORKSHOP, LECTURES, CME ALERTS: Contact Karachi Events Updates Office: Email: events.updates6@ gmail.com Cell: 0331-255-2542 FOR UPDATES OF UPCOMING EVENTS VISIT: http://eventsupdate s.blogspot. com/ Quote Link to comment Share on other sites More sharing options...
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