Regulation of private health care in Pakistan

The private health sector in Pakistan has been expanding rapidly, largely unregulated and partly at the expense of the public sector. While there have been previous attempts at formulating policies for the regulation of this sector, these have not always been based on ground realities, with the result that they never reached the stage of implementation. The objectives of the thesis were: 1) to describe and evaluate the existing regulatory framework governing health care provision in general and private health care provision in particular both at federal & provincial levels; 2) to explore the views and perceptions of key stakeholders regarding existing regulations and the reasons for their effectiveness/non-effectiveness; 3) to identify whether and how regulatory mechanisms can be made to work effectively; and 4) to explore the views of stakeholders regarding the potential for alternative mechanisms for ensuring the quality of formal private medical services, including the role of information dissemination to service users/the public. The methods adopted to achieve the stated objective were mapping of the existing legislations and a stakeholder analysis. The results showed that the existing legislations on regulation of health care provision were scanty, weak and inadequate and required radical re-structuring. The stakeholder analysis demonstrated the conflicting interests of the state and the private providers, the role of the powerful medical community and the views of the service users, who were shown to be the ultimate victims. Avenues for alternative regulatory mechanisms, including one based on information dissemination were explored and their feasibility discussed. It is hoped that the information gained from this study, by reflecting the views of the various actors in this process, will contribute towards the formulation of a policy for regulation of private health care provision in Pakistan, which is realistic, feasible and sustainable.