Strong local govts key to easing Pakistan’s health burden, health minister says

ISLAMABAD: Federal Health Minister Mustafa Kamal said on Tuesday that many of the public health and civic problems faced in Islamabad and the provinces can only be addressed through an effective local government system, as he also called for stronger primary healthcare to reduce the country’s disease burden.

Speaking at the inauguration of Phase-I upgradation of the Pakistan Institute of Medical Sciences (Pims) Cardiac Centre, the minister said the purpose of decentralisation was to ensure that public issues were resolved quickly at the Union Council level. He said a strong, efficient and empowered local government structure was essential for lasting progress in public health and for fair access to quality healthcare across Pakistan.

Mr Kamal said he was not opposed to the 18th Constitutional Amendment, but had reservations about what he described as its incomplete implementation. He said that although resources had been transferred from the federal government to the provinces, there was still no effective system to pass those funds onward from the provinces to districts and local governments.

According to the minister, around Rs8.848 trillion was transferred to the four provinces during the last fiscal year, but a strong local government mechanism to ensure effective use of those resources at the grassroots level was still missing. He said direct transfer of resources to neighbourhoods and local governments would improve basic services including safe drinking water, sanitation, sewerage and other civic facilities, which in turn would significantly lower the burden of disease.

Focus on prevention and primary care

The minister said Pakistan’s health challenges could not be solved only by constructing hospitals, and stressed that disease prevention through a functioning local government system was the more durable answer. He added that weaknesses in local governance had also made it harder to build public awareness and trust around polio and other immunisation campaigns.

Mr Kamal said locally elected councillors, as residents of the communities they represent, are directly answerable to the public and are therefore better placed to win public confidence. He said this makes it easier to carry out health programmes at the community level and improve trust in vaccination efforts. He also said the current administrative arrangement depends on only a few hundred bureaucrats to run the governance structure, while a robust local government system would widen the reach of public service delivery by involving millions of people at the grassroots level.

Pims patient load highlighted

At Pims, the minister also inaugurated the Patient Facilitation Assistant Service in the Emergency Department, a step aimed at improving patient guidance and service delivery. He said Pims is the largest referral hospital for patients from Islamabad as well as Azad Jammu and Kashmir, Gilgit-Baltistan, a large part of Khyber Pakhtunkhwa and other remote parts of the country.

Referring to the scale of pressure on the hospital, Mr Kamal said: “Pims receives approximately 7,000 to 9,000 patients every day, and when attendants and family members are included, between 30,000 and 40,000 people benefit from the hospital daily. This is equivalent to the size of a major public gathering every single day, reflecting both the immense trust people place in Pims and the extraordinary burden on the institution.”

He said the heavy patient load at public teaching and tertiary care hospitals across Pakistan was largely the result of the poor functioning of the primary healthcare system.