- Doctors are scare. Under the present system, they naturally go to the patients who pay best.
- The poor get either no medical treatment or can careless attention from poorly-qualified practitioners.
- Observe the experiment of National Health Service in England?
- Conclusions at present a National Service for Pakistan would be very expensive.
Great as is the number of graduates leaving the medical vide sufficient doctors for the needs of Pakistan. Many a large village has no qualified doctor but puts up with the dispensations of hakim or other unqualified persons. The best doctors go into government service, preferring the security of a government post to the uncertainty of practice, among poor people. The highly-qualified doctors are found to be practicing as specialists in the big cities for high fees.
There are bright spots in this picture. Many a government servant does a great amount of honorary work. There are some doctors who do good work among the poor, well-knowing that they are not likely to be paid for their work. But in general the public are not well served, and good medical attention has become a luxury of the rich.
Though the position was much better in Britain, a recent government introduced a compulsory system of State medical services for all, rich or poor. A man is registered and is placed on the list of a certain medical practitioner. He has a card on which he has to put a stamp every week, costing about the equivalent of three rupees.
For this, he can have the services of the doctor for himself and his family without further payment. The medicines, too, will be at the expense of the State. The result has been that there are not nearly enough doctors to all who throng their consulting rooms. People who have to pay, whether availing themselves of the system or not, seem to think that they may as well go and consult the doctor, since it costs no more. The Dyer worked doctors have only time for a very hurried examination of the scores waiting in their surgeries. The cost, in spite of the hundred and fifty rupees per year paid by every insured person for stamps, has been hundreds of millions of pounds more than anticipated. Everybody is dissatisfied and grumbling, the doctors are overworked and discontented, and the expenses of the country have been greatly increased at a time when the State is already in financial difficulties. It has been an ill-timed and badly planned experiment, for which the country is paying dearly.
It is obvious that the poor man in Pakistan and could not pay nearly so much in contributions for his stamp, and a similar scheme for Pakistan would have even more unfortunate results. There is simply not enough money in the country to launch such a system. Moreover, it is, after all, a policy of repair, and it is better to prevent than to cure. If money is available, it would be better spent in supplying food to poor people and to school children, to giving milk to nursing mothers to improving housing. This would yield better dividends in national health than a policy of waiting till people are ill and then supplying them with medicine. In the meantime, it is better to move slowly and improve the existing services supplied by government officers, practitioners and missionaries; than to launch into a hasty and ill-considered socialistic experiment.