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Pakistan: SSP surgical services disrupted in Lower Dir as doctors resist new taxes, 180 daily surgeries shift to private care

Pakistan: SSP surgical services disrupted in Lower Dir as doctors resist new taxes, 180 daily surgeries shift to private care

Khyber Pakhtunkhwa [Pakistan] September 14 (ANI): Surgical services under the Sehat Sahulat Programme (SSP) have been severely disrupted across Malakand division, particularly in Lower Dir, following the introduction of new taxes in the region, with doctors reportedly refusing to perform several procedures under the health insurance scheme, according to a report by Dawn.
As cited by the Dawn report, figures gathered from private hospitals indicate that around 200 surgeries were previously conducted every day in Lower Dir under the SSP. However, since September 1, only around 20 surgeries per day have been carried out through the programme, while the remaining 180 procedures are reportedly being performed privately at considerable cost to patients.
Five private hospitals affiliated with the SSP in Timergara, the headquarters of Lower Dir, had been undertaking a significant number of surgical procedures under the programme. Hospital sources told Dawn that orthopaedic procedures and several other major surgeries had been affected after doctors stopped cooperating following the implementation of the new tax regime.
However, gynaecological services and dialysis treatment have continued under the SSP without disruption, according to the report.
Under the tax structure introduced in Malakand division, a 15 per cent withholding tax and a 14 per cent service tax are applicable, resulting in a combined tax burden of 29 per cent.
According to the SSP's payment structure, hospitals receive 60 per cent of the package amount, while doctors receive the remaining 40 per cent. Medical practitioners have argued that the newly imposed taxes have substantially reduced their earnings from procedures conducted under the programme.
Health officials told Dawn that the compensation provided for surgeries under the SSP was already insufficient and needed to be revised. They said the existing package rates were making it increasingly difficult for hospitals to cover operational expenses, purchase medicines and surgical equipment, and maintain healthcare standards.
Private hospital managements, meanwhile, said they had continued providing treatment despite increasing operating expenses, heavy taxation and relatively low SSP package rates. However, they maintained that the refusal by some doctors to undertake surgeries under the scheme was directly restricting healthcare access for low-income patients, as cited by Dawn.
Residents have also questioned why SSP-supported surgeries continue to be performed in other districts of Khyber Pakhtunkhwa while similar services have been disrupted in Malakand division, particularly in Timergara.
They argued that financial and administrative disagreements should not be allowed to deprive economically disadvantaged patients of the free medical treatment on which they depend.
Lower Dir, with a population of around 1.6 million, has a large number of residents relying on the health card scheme for surgical treatment. The ongoing disruption has reportedly forced many patients to either pay substantial amounts for treatment at private hospitals or turn to government-run healthcare facilities.
Hospital officials said the disruption had also placed additional pressure on the district headquarters hospital in Timergara, where patient numbers have increased in recent weeks.
Residents have urged the provincial government, the State Life Insurance Corporation and other stakeholders to resolve disputes related to taxation, hospital expenses and doctors' remuneration so that surgical services under the Sehat Sahulat Programme can be restored fully, according to the Dawn report. (ANI)

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