Health workers in Pakistan, led by the Red Workers Front, have organised to challenge the government’s plan to privatize the country’s major hospitals. Workers from various unions and groups have forged a Grand Health Alliance (GHA) to campaign against this policy which will further worsen the healthcare crisis in Pakistan.
On November 20, along with Punjab teachers unions, health workers participated in a protest against the privatisation drive in Lahore. Protests have been registered across Pakistan, particularly in the provinces of Punjab and Pakhtunkhwa.
“Nearly 80% of the 220 million population has no access to basic health provisions,” said Adam Pal of the Red Workers Front. Pakistan ranks among the lowest in the Human Development Index, and more than half of its population lives on less than USD 1 per day. In view of this, the government’s decision will further restrict access to healthcare and affect employment generation in the sector. “Instead of building public hospitals and spending more on health services, the government has planned to close the health department altogether and hand it over to the private sector,” Pal said while speaking to Peoples Dispatch.
According to the Red Workers Front, almost all governments after the 1980s are responsible for the deteriorating healthcare system in the country which has made it more difficult for the masses to access health services. The budget allotted to the health sector was the highest when Zulfiqar Ali Bhutto was leading the country in 1973. In 1968 and 1969 as well, the ruling elites were forced to concede a certain amount of their wealth for the working class, which increased the available budget for social investment and 40% of the budget was allocated for health and education.
However, the situation has radically transformed, and now, many experts have concluded that the healthcare system in the country is going through chronic under investment, with a total budget expenditure of PKR 13 billion.
Privatisation of Healthcare
Several workers’ unions have claimed that Pakistan’s meager public healthcare facilities have been in shambles for years due to the lack of government funding. The International Monetary Fund (IMF) loan program has further complicated the options available to the government, which is trying to privatise even the dismal services that are designed to serve the poorer social-economic classes that are unable to bear the high costs of private hospitals.
“One of the motives behind the privatisation drive (led by the IMF and the government of PM Imran Khan), is to reduce state expenditure for achieving so-called fiscal consolidation. That means that the government should be able to pay back its debt and interest to international and domestic lenders, while crushing the average working masses. Secondly, its purpose is to open up a profitable avenue of investment for private capital. The government has proposed a draconian law called the MTI act, which it has imposed upon the Punjab Province through an undemocratic governor ordinance,” the Red Workers Front said in its statement.
The Front criticised the fact that loans from the IMF and other entities often go into debt servicing of previous loans or are used to buy expensive weapons from the military industrial complex of countries like the US and China. They added that the IMF also imposes its neoliberal agenda, including requirements for privatisation and fiscal consolidation, as preconditions for countries that seek its financial help during economic crises.
Unions have emphasised how the privatisation policy imposed by the IMF has had drastic effects on the overall health situation in Pakistan. With the mushrooming of elite private hospitals that primarily serve the interests of the rich, including government officials and the ruling class, the toiling masses have been completely ignored.
The tax scheme in Pakistan is also a central point of contention as the poor and working class are forced to pay a large amount in taxes. The country has one of the highest indirect to direct tax ratios in the world, around 70% of the total tax collection comes from indirect sources, as people pay high taxes on petrol, electricity, water and other basic commodities. On the other hand, compared with the rest of the world the Pakistani elite pay very little in direct taxes.
The Grand Health Alliance has demanded that health facilities should be made free for every citizen of Pakistan. They have also proposed nationalisation of all private hospitals, which would be run by democratically elected workers committees. They have called for the health budget to be increased to 25% of the total, and for the construction of new hospitals. Even the demand for nationalisation of pharmaceutical companies has been raised, as more than 60% of the health expenditure by patients is on medicine. Lastly, the GHA insisted that all elected representatives and government officials get their treatment in Pakistan’s government-run hospitals.
To achieve these demands, the GHA is uniting with other workers unions across the country, who are also fighting against privatisation. The struggle has led the health workers to move towards a general strike on these demands.
“As we are quite sure that if we stay united and move forward with these demands along with workers unions of other sectors we can win this fight against privatisation. Many unions have won their fights against privatisation in recent history, though some were also lost due to betrayals of the leadership and other similar issues,” the workers body said.