Doctors have expressed strong concern about the recent Punjab Medical Teaching Institutions (Reforms) Ordinance 2019, which effectively puts state-run hospitals under their respective boards of governors (BoGs), consisting of members of the public. Instead of getting the law passed from the assembly, the government promulgated the development through an ordinance. Doctors, paramedics and other staff, whose performance would come under the devolved mechanism, have vowed to oppose the law, drafted on the pattern of Khyber Pakhtunkhwa’s MTI Act, tooth and nail. The public may suffer as doctors will use their deadly ‘hartal (strike)’ weapon to coerce the government into accepting their demands. The MTI Ordinance brings government hospitals under the control of fully empowered BoGs which will have “… powers for the appointment of admin officials on key slots and appointment of senior faculty members. The post of principal shall be converted into dean who shall be appointed by the BoG for a period of five years”. Besides BoGs, hospitals will have management committees, each consisting of a hospital director, medical director, nursing and finance directors and two members nominated by the BoG. The committee shall have powers to terminate any and all the employees of the institution in accordance with the rules and regulations framed under the ordinance. This is a contentious point. Doctors and other staff are averse to be assessed at the workplace. The ordinance abolishes their status as civil servants, throwing them off the ambit of the health department. This puts doctors and other staffers in a catch-22 situation. “The employees would be given a choice to continue to work for the institution in private capacity under the MTI Ordinance. In case, he/she wants to work as civil servant, his/her services will be sent to the disposal of the health department for further posting in any other state-run institution,” the ordinance says. The ordinance will initially be implemented in 23 hospitals attached to the five government medical universities – King Edward Medical University, Fatima Jinnah Medical University, Faisalabad Medical University, Nishtar Medical University and Rawalpindi Medical University. Doctors say the new arrangement will turn hospitals into money-making facilities. Well, yes and no. The new arrangements allow doctors to sit in hospitals as private consultants in the evenings. A doctor may not do justice to the patients visiting them in the morning, for that patient would be a source of money for them in the evening. It would affect service delivery in the mornings. The government’s plan to grant financial and management autonomy to public hospitals seems good as it will make bureaucratic red tape a thing of the past, but most of the time autonomy is turned into authoritarian rule by those at the helm. *