A Judicial and Political Murder

Being non-political himself, it did not matter to him which government he talked to. So, he took his project to the then Chief Minister of Punjab, Shahbaz Sharif who, after a few meetings, liked, approved and supported the idea. Dr. Akhtar feared if the Government of Punjab, through its bureaucracy, interfered in the matters of the hospital, his dream would then offend up like Jinnah Hospital in Lahore instead of the Massachusetts General Hospital. Both afraid and cognizant of that possibility, he had the CM approve complete financial, regulatory and functional independence for the project. This was accomplished through an act of the parliament.

From then on, he did not have to worry about securing large donations anymore and could spend more time in improving the quality markers, writing policies and introducing international standards. He could also hire foreign qualified physicians to return and start working with him to train Pakistani doctors and help reach the same level of competence. He just did not know how all this will be sabotaged soon by a populist opposition party and the judicial activism of a Chief Justice.

In the United States, every hospital has to undergo an accreditation process through a non-profit organization called The Joint Commission. It does not assess the medical necessity of care provided to the patients by physicians. It looks at the technical aspects of the hospitals and their staff. If the buildings meet international safety guidelines, if the hallways are wide enough to carry the patients, if there are enough functional elevators available, if there are enough operation theatres, if there are enough emergency exits, if fire extinguishers are present and working and so on. Dr. Akhtar worked with the International Joint Commission to put Pakistan Kidney and Liver Institute (PKLI) on the track of worldwide recognition from day one.

The question he still had to navigate through was how he could attract foreign qualified physicians to come back to Pakistan. Physicians living in the United States earned a decent income like he did when he worked there; their children grew up in a comfortable environment, went to good schools and followed careers of their choosing without having to worry about student loans most of the time. Being a part of that community, he knew their situation very well. Before PKLI, only Shifa Hospital, Shaukat Khanum and the Aga Khan University hired some physicians from abroad. And each one of them were provided competitive salaries - way above the government pay structure. He thought that with his independence guaranteed he could also offer a higher rate following this precedence. He did not know a hurricane was brewing up, waiting to lash out.

The decision to hire these physicians under the umbrella of the Punjab Government made the Pakistani doctors furious. They felt as if they were being treated as second-grade citizens in their own country and their own department was discriminating against their talent and hard-work. The former Chief Justice’s brother happened to be a government-employed physician who reportedly complained to his brother about the ‘injustice.’ Blinded by the difference in pay, Justice Saqib Nisar took up the case against Dr. Akhtar and hijacked the whole system. In every hearing, abuses were hurled at the staff, the administration and the PKLI which was still in its infancy. As a result, a mist of doubt engulfed the hospital and the institution which was supposed to have taken off got buried under the rubble of judicial misconduct.

Yet, that was not enough. It seemed the judicial hurricane had to be followed up by a devastating political storm which dealt the last blow. It was then the Opposition party of Pakistan and is now in the government. The justice for Pakistan Tehreek-e-Insaf meant that it saw corruption in every aspect of the previous government’s decisions, irrespective of the evidence. For example, one day, Dr. Akhtar called the current Health Minister of Punjab, Dr. Yasmeen Rashid, one of the Pakistani-trained physicians, to come and tour the facility. In response, she turned it down. She wanted to do a surprise raid in the middle of the night! With that mindset, the financial freedom was taken back and the management of the institution rolled over to the Government of Punjab. The days of independence were long gone.

Would it then be unfair to say that with the current government, the hope for PKLI to become Harvard has almost died down? If the answer is no, listen to the story of Dr Amir Yar Khan, a prominent physician who returned from the United States. He resigned from his job after the controversy. Yet, his name was put on the exit control list, an intimidation technique. There has been no allegation of corruption or wrong-doing against him but he is threatened and warned. Why? The previous administration provided him job security, an administration that the current government cannot think of having done anything right. After him many others will quit too, sooner or later. How many would venture to come again? None. The future of PKLI is being the next Jinnah Hospital of Lahore, not anything else.