OVER A COFFEE : When doctors turn into Mr Hyde — Dr Haider Shah
Could any office bearer of Young Doctors Association share with us how many licences of their members they helped in cancellation where the members fell short of their expected standards?
After witnessing some ugly scenes, it comes as a relief to note that finally, some sanity has prevailed among doctors and normalcy is returning to hospitals in the Punjab. The situation reminded me of the London riots when some groups of opportunist youth went on a shoplifting spree. A few theory-led commentators started digging social causes for the unrest, but more pragmatic analysts termed that a failure of the police to deal with thugs swiftly and firmly. When a house is on fire, the first concern is to extinguish the fire; what caused the fire can be investigated later on. Similarly, when public order is damaged, the state has to act resolutely to re-establish its writ. On previous occasions, the Punjab government had shown restraint and excessive accommodation while responding to the agitation and nuisance created by doctors, which emboldened them to the extent that health and lives of ordinary citizens became their least priority.
We are accustomed to the news of extremist radicals abducting foreigners or local dignitaries and then presenting their demands to government. Their demands often include release of their jailed colleagues and when these demands are not met, the unfortunate kidnapped ones are often killed in cold blood. If a comparison is made the conduct of young doctors’ association was not much different. They do not need to resort to kidnapping, as poor patients are already their captives, which they use for blackmailing purposes, and when demands are not met, like Taliban, they do not refrain from putting the lives of vulnerable patients at stake.
The problem of abusing the right of association, however, is not limited to doctors only. In the recent past, we have seen lawyers thrashing judges or coming to the support of a member of their community who had allegedly murdered a female servant. In civilised societies, the main function of professional bodies is to regulate the professions and to ensure that their members provide a high quality service. They act as regulators by initiating disciplinary action against a member who is charged of misconduct and by revoking licences of misbehaving members. Could any office bearer of Young Doctors Association share with us how many licences of their members they helped in cancellation where the members fell short of their expected standards?
During my student days, I can recall that a few student leaders of the Khyber medical college belonging to various political parties after graduation could not remain inert for long and established the Pakistan Doctors’ Association to satisfy their restless souls. Enjoying a celebrity status, the leaders of that body would not miss any opportunity of going on a strike on the slightest pretext. If a doctor had slipped on a banana skin, you would find hospitals shut the next day. A few years ago, I had a chance of observing the state of affairs in our hospitals as I stayed with my late mother during a surgery at a Peshawar hospital. From nurses to doctors, I noticed a culture of absence of empathy towards patients. When the situation was brought to the attention of the hospital’s executive director, he was candid in saying that he could not even transfer an ordinary paramedic, as the whole union would go on a strike.
In the UK, in November 2011, students organised a big protest march against imposition of tuition fee. During their protest in London, a group of students resorted to vandalism and violence. These acts of violence undermined the campaign, as all shades of public opinion were unanimous in condemnation even though people in general felt sympathetic to the demands of the student community. The young doctors in the Punjab unfortunately ignored this lesson. Perhaps, they were emboldened by the political expediency-led appeasement policy of the government in the past. The young doctors’ association was formed in 2008 when a few doctors were then proceeded against on professional misconduct and negligence charges. As the government withdrew the cases, indiscipline bred more indiscipline whose sinister implications can be seen today. Again, the Punjab government has released the arrested doctors, not allowing law to take its course. Does this mean that writ of the state is an issue in the case of Taliban or Baloch nationalists alone?
Poor pay structure is a public sector wide issue. The provinces can allocate greater budgetary expenditure to health and education if they get more from the federal divisible pool. This in turn needs a complete reappraisal of our spending priorities at the federal level. In the UK’s latest budget, £240 billion have been allocated to health and social protection, while £39 billion are for defence spending. Turning to our budget, we see that military expenditure and debt servicing together leave little for social welfare and developmental needs. If doctors are genuinely sincere in changing the lot of all employees, then they should demand rationalisation of our national budget. Doctors are important but they are not special breed. Teachers, lecturers, and sepoys, for example, are also performing important duties. Provincial governments do not pluck money from trees. Doctors have to be, therefore, realistic in their demands.
In the late 18th century, Robert Louis Stevenson wrote the Strange Case of Dr Jekyll and Mr Hyde, which made the problem of split personality between the charitable Dr Jekyll and the villainous Mr Hyde famous. Little did he know that in Pakistan erosion of professional ethics would cast almost the whole doctors’ community into the mould of the vicious Hyde. It is in the best interest of doctors’ community to reposition itself as Dr Jekyll on a permanent basis so that it can regain respect lost during an ill-conceived campaign.
The writer teaches public policy in the UK and is the founding member of the Rationalist Society of Pakistan. He can be reached at email@example.com