“In medicine, we hold up ‘autonomy’ as a professional lodestar, a principle that stands in direct opposition to discipline.” — Atul Gawande in The Checklist Manifesto — How to get Things Right

WE had a few rickety tables and chairs dumped in a room in the Ministry of Health. In an internal meeting about office space, we wanted to get rid of this old and useless furniture. A fairly senior officer came up with a brilliant idea: send this furniture to the Basic Health Units and Rural Health Centres. Generally, people were fine with this suggestion. I’ll spare you the details about the scene I made on hearing this suggestion.

Ministry officers were fine with this suggestion because this is generally how primary healthcare is perceived — poor healthcare for poor people. The word ‘quality’ is nonexistent in our PHC lexicon. This is why I have stopped using PHC altogether; it is qPHC, now and forever.

I would request that all of us use qPHC. Adding a ‘q’ will always be a reminder of quality in PHC services and it would guide us in our relevant decisions about setting up facilities, organising trainings, managing procurements and supplies, upkeep of activities, monitoring, and above all, budgetary allocations. Improving quality also means being prepared to invest more money.

Without considering their quality, health services can be ineffective at best and counterproductive or outright lethal at worst. This is true for all health services. A cardinal principle in healthcare is, first, do no harm.

The........

© Dawn