The young doctors' strike for higher pay continues as the number of casualties across the Punjab rise due to the refusal of the doctors to even treat emergency patients. Estimates of the death toll as a consequence of such deplorable action vary from between 22 to 60 across the Punjab. The onus for these deaths rests squarely on the young doctors who have taken the Hippocratic Oath so named after Hippocrates who lived in the 5th century BC.
However a widely used modern version of the traditional oath was written by Dr Louis Lasagna, former Principal of the Sackler School of Graduate Biomedical Sciences and Academic Dean of the School of Medicine at Tufts University in 1964. "I swear to fulfil, to the best of my ability and judgement, this covenant... I will apply, for the benefit of the sick, all measures [that] are required... I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm."
And while many may understand the demand for higher pay by the young doctors who, like the rest of Pakistan, have been subjected to high rates of inflation led by an unprecedented rise in utility charges over a three-year period, yet to allow preventable deaths is, in the minds of the public, synonymous with murder. In this context, one would hope that better sense prevails and the young doctors begin to treat terminally ill patients as well as those requiring emergency treatment.
The young doctors in their own defence argue that the cost of living has increased manifold for everyone with all other professionals raising their fees commensurately, be they lawyers or accountants; they also point to the 50 percent raise given to bureaucrats in the budget for the current fiscal year. Yet, they lament, for the doctors to demand a raise is seen in the context of 'special obligations' which is grossly unfair. True, but then the other professionals do not take the Hippocratic Oath.
The provincial government has been maligned by doctors as well as by the opposition for the way it has tackled the doctors' strike: firing doctors who do not report on duty and refusing to increase salaries citing lack of financial resources as the basic rationale.
Prior to dismissing such action as heavy handed it is pertinent to recall the actions taken by Margaret Thatcher as well as Ronald Reagan in their desire to break the power of the state sector unions that, up-till then, had the capacity to hold the country's Executive hostage to threats of strike action: they refused to give into union demands and in some instances gave the order to commence the process of replacement of striking union members.
Reagan went so far as to dismiss all the air traffic controllers who had gone on strike and directed that their replacement process be initiated. The two leaders were successful which led not only to ensuring that union demands began to be tempered with what was negotiable between management and the workers but also ensured that wage push inflation did not negatively impact on the rest of the economy. In this context, the provincial governments' action makes some economic sense.
However what is inexplicable from the perspective of the young doctors is the fact that while the Centre has agreed to raise the salaries of bureaucrats by a hefty 50 percent as aforementioned, which would cost the taxpayer in excess of 30 billion rupees and so have the provinces, yet the doctors, public sector employees, were not included in this category.
In addition the federal government has been supporting a policy of reinstating sacked employees in state-owned entities (SOEs) and giving them arrears for the period since the day they were fired, a policy that has placed an unbearable financial burden on these units. The fact that these employees were sacked for a legitimate economic reason is ignored: rightsizing SOEs to preempt the need for bailout packages.
The government is also using SOEs as recruitment centres that partly account for continued large annual bailout packages from the taxpayers' money. This reveals the obvious: there is a need for the centre and the provincial governments to be on the same page with respect to policy on public sector employees' salaries otherwise an untenable situation from the perspective of the public would emerge.