Daily Times

There has been a flurry of heartbreaking stories of apparent medical negligence in the media recently. Whether it happens at a public or a private healthcare institution, stories of wrong injections, overdose of a medicine or an anesthetic, the list of such cases is endless. These are only the visible tip of the iceberg. There are numerous other cases where the patient is disabled for life or suffers from chronic diseases caused by a negligent health system. Such experiences leave behind traumatised families and raise many questions regarding the healthcare system.

Such incidents make people wonder. They get confused regarding how they should address their healthcare concerns. Should I continue to trust my doctor or stay away from everything medical? What self-care measures can I take instead of going through the hassle of seeing a doctor? Is there somebody looking into cases of blatant medical negligence that appears on our news channels almost every other day? Will there ever be a remedy available to the people being wronged? Will the perpeterators ever be taken to task?

Such rampant stories of negligence related to allopathic health system leave permanent scars at an individual level. A recent survey by Gallup Pakistan shows that even on a collective level, confidence in allopathic system of treatment is declining. According to the survey, patients’ preference for allopathic doctors has decreased by five percentage points over the last 18 years, whereas reliance on homeopathy has increased by three percentage points. The survey results might need validation with a more robust methodology and a larger sample size, it does make a point about the decreasing trust patients have in allopathic doctors.

From a consumer rights perspective, the changing consumer choices are an indicator of the patients’ dissatisfaction with the deal they are receiving at healthcare places. At the health systems level, the deterioration in services is an inevitable consequence of decades of neglect of the primary care system and lack of spending in preventive and public health programmes. The large crowds, daily, filling big city hospitals and stretching their resources to limits would never have been there in the first place if most of the patients had been entertained at earlier levels of care. Primary care infrastructure has degenerated beyond resurrection. The system is deteriorating with every passing day.

The high incidence of medical negligence is a result of wrong and misplaced investments and wrong priorities. There is evidence that a well-functioning primary care system is important to screen patients closer to their homes. Only those needing a higher level of care should be sent to the next level. The primary health care system as envisaged and introduced in the seminal Alma Ata Declaration of 1978 needs to be reimagined today with the dramatic changes emerging in the fields of communication and connectivity through smart phones and the Internet.

The changing consumer choices are an indicator of their dissatisfaction with the deal they are receiving at healthcare places

Investment to maintain a healthy state is the first and foremost responsibility of the state and its apparatus. Sadly, most of the spending until now has been focused on disease. We need to invest in maintaining health and bring emphasis back to providing health care closer to where people live rather than rush everybody to the biggest hospital in town.

Having said that, it needs to be underlined that any effort to resurrect the failing primary care has to keep in consideration that future of services sectors is fast moving towards technology operated new solutions. Information technology is today an essential part of any solution. It must be an essential part of the comeback of primary care and health promotion. As an example of use of technology, artificial intelligence has gained a lot of credence in this regard. According to a research, diagnosis (in the case of heart disease for instance) using AI is more accurate than by some doctors. A pioneer is an app called Babylon that has integrated with the NHS in UK. The app, downloaded by over 40,000 people, provides the patients relief by directing them to an option of self-treatment or consulting a doctor via video chat, saving the patient travelling time. This kind of technology comes with a core mission of integrating within the existing healthcare system instead of the commonly held view of replacing it.

In terms of access to child and maternal health services, Pakistan currently stands 57th among 60 countries in the Asia-Pacific region, ,just ahead of Afghanistan.

As a start, Pakistan has tapped this market, albeit on a limited scale. Pakistan has around 67 million 3G/4G subscribers, information technology solutions can lead to imoproved healthcare accessibility through social media and telemedicine.

Ayyaz Kiani is a senior public health pharmacist;

Zara Kayani is a research fellow at the Institute of Social and Policy Sciences. The writers can be reached at ayyaz_kiani@hotmail.com and zarakiani40@gmail.com