PHC’s anti-quackery crusade: Ubiquitous healthcare facilities are the ultimate cure
In this article, Durdana Najam highlights the steps taken in the anti-quackery drive in Punjab since the establishment of Punjab Healthcare Commission in 2012 and the measures that government still needs to take in this regard.
The Punjab Healthcare Commission (PHC) started functioning in early 2012 with a mandate to enforce the Punjab Healthcare Commission Act-2010. The operations of the Commission are divided into four regulatory functions that together with other supporting activities enable the Commission achieve its fundamental goal of bringing quality in the healthcare establishments across Punjab. Before the establishment of the Commission, the health sector in Punjab was so loosely regulated that the medical fraternity, especially from the private sector, felt little obligation to follow. The environment provided a perfect setting to not only the expensive private sector to flourish, but also to quackery to fill the gap laid open by the irresponsible and at times non-existent and shoddy public health sector. On the accountability continuum, the health sector of Punjab was at the far end of survival. Because of the sensitivity of the issues, the Commission had realised at the onset that it would be a race against time.
For the PHC the most critical part was to win the trust of the stakeholders in the belief that the Commission did not have any ambition to pursue its regulatory responsibilities with any sense of persecution. This hurdle was successfully crossed, as the Commission from the development of Minimum Service Delivery Standard – Commission’s bedrock – to its implementation had taken each and every stakeholder on board. Trainings have been imparted to make the implementation process mutual and reciprocal while due care has been taken to provide the healthcare establishment ample time to adjust to the new regulatory environment. Still all this good work looked timid in the presence of a parallel medical industry run by quacks.
In June 2015, the PHC started crackdown on quacks, but the drive took real momentum in 2016 following the development of Regulation for Banning Quackery in all its forms and manifestations as provided in section 40 of the PHC Act-2010. In the meantime, the Commission took to conducting a census of the healthcare establishments in Punjab. This exercise had multiple benefits, major being the identification of quacks along with the unregistered and unlicensed doctors and healthcare establishments.
Since June 2015 the PHC has sealed 18,373 outlets of quackery with a total fine imposed to the tune of 313.55 million rupees.
Building upon this resource, the PHC expanded its legal and administrative infrastructure by developing a dedicated Anti-Quackery Cell. The icing on the cake proved the Supreme Court’s order in 2018 that made the PHC a lead agency in the fight against quackery. The district governments of Punjab were ordered by the honorable court to facilitate the Commission’s anti-quackery efforts. Since June 2015 the PHC has sealed 18,373 outlets of quackery with a total fine imposed to the tune of 313.55 million rupees.
The Commission considers all those doctors, nurses, hakeems and homeopaths not licensed by their concerned federal councils as quacks. Even those doctors or hospitals dispensing treatment that does not fall in their professional purview are considered practicing quackery. For instance, if a homoeopathic doctor or Hakeem is prescribing allopathic medicine or is caught, during inspections by the PHC team, possessing any medicine other than what is used conventionally in their respective treatment, it would be considered quackery.
Every month quackery outlets are sealed by the hundreds and unless the illegal practitioners or the healthcare establishment in question prove through legal documents their intention to quit quackery, the outlet is not unsealed.
The anti-quackery team at the PHC is continually cracking down on quacks across Punjab. The information about quacks is received through PHC helpline, written complaints and the data accumulated through the census. Every month quackery outlets are sealed by the hundreds and unless the illegal practitioners or the healthcare establishment in question prove through legal documents their intention to quit quackery, the outlet is not unsealed. Being a circular activity the anti-quackery team keep monitoring sealed outlets through regular and special inspections. Special inspection being unannounced have been instrumental in not only eradicating quackery but also in removing imperfections in the regular mode of treatments.
The sad commentary about quackery is that when it does not kill a person it ruins lives because of wrong diagnosis and maltreatment. Unfortunately, Punjab, rather entire Pakistan is infested with this malice. The onus of this sin lies on the government. One of the core responsibilities of any government is to provide primary health services to the people. When the government fails in the provision of equitable and secure health services in the public hospitals, people with meagre or no resources get attracted to any person who provides them with immediate but inexpensive relief from their malady. No matter how intense is PHC’s drive against quackery, for a long-term solution, the government has to provide healthcare services on the proverbial doorsteps of the people. Ubiquitous healthcare facilities are the ultimate cure for quackery.
Unfortunately, many doctors have also been involved in promoting quackery, some out of financial constraints, and others due to greed. The PHC and the Health Department Punjab can double down on quackery if society as a whole recognizes its role towards this menace. It is a long, but winnable haul – provided the government understands its responsibilities because the buck stops here.