Chief Minister Syed Murad Ali Shah has vowed to resist any attempt by the federal government to take over three major hospitals in Karachi and asked his legal team to file a review petition in the Supreme Court after authorities in Islamabad notified the takeover of the National Institute of Cardiovascular Diseases, the National Institute of Child Health and the Jinnah Postgraduate Medical Centre from the provincial government. Speaking on the issue earlier, Pakistan People Party chairman Bilawal Bhutto had urged the federal government to wait for the review petition to be decided. The reaction of the government of Sindh, which has funnelled a huge amount of scarce funds into these facilities and tried to make them the country’s premier healthcare institutions, has been predictable. Eight satellites centres of the NICVD have been set up over last three years in various districts of Sindh. More districts are on the waiting list. The emergency department at the JPMC and its CyberKnife project have already become functional and won praise, among others from Justice Saqib Nisar, the former chief justice of Pakistan. Whether these hospitals can continue to work as efficiently under the federal government as they were under the Sindh government or not remains to be seen. The Sindh government had taken over these hospitals after the passage of the 18th Amendment, which makes health a provincial subject. Then came a Supreme Court order telling the government of Sindh to hand over its flagship hospitals to the federal government. Bilawal Bhutto has called the decision a blow to provincial autonomy enshrined in the constitution. The chief minister has said the federal government’s notification has unnecessarily created uncertainty for the staff. It stands to reason that the federal government should have held preparatory meetings with the Sindh government to discuss the modalities of the transition. Better still, it might have waited for the outcome of the review petition. For its part, the PPP appears confident of a favourable decision. The disagreement also brings to the spotlight, the matter of healthcare in general. Public facilities in most Sindh towns hardly reflect a government resolve to make healthcare a priority. Dispensaries and taulaka hospitals are the places of first contact between patients and doctors. The reports of an HIV epidemic in Larkana have shocked the whole country. There has still been no decisive crackdown by the Sindh Health Care Commission on quacks who have been identified as a major contributing factor in the spread of HIV. *