Surgical services under the Sehat Sahulat Program (SSP) have been significantly disrupted in Malakand Division, particularly in Lower Dir, following the imposition of new taxes.
Doctors have reportedly refused to perform several procedures under the health insurance scheme.
According to figures collected from private hospitals, around 200 surgeries were previously performed daily in Lower Dir under the SSP. However, since September 1, the number has dropped to around 20 per day, while the remaining procedures are being carried out privately at patients’ expense.
Five private hospitals affiliated with the SSP in Timergara, the district headquarters of Lower Dir, had been performing a large number of surgeries under the program. Hospital sources said orthopedic and several other major procedures have been particularly affected.
The new tax regime includes a 15% withholding tax and a 14% service tax, resulting in a combined tax burden of 29%.
Under the SSP payment structure, 60% of the package amount is paid to hospitals while 40% goes to doctors. Medical practitioners argue that the new taxes have significantly reduced their earnings from SSP procedures.
Health officials said the existing compensation rates for surgeries are already inadequate and need to be revised. They said the current package rates make it difficult for hospitals to cover operational expenses, medicines and surgical equipment.
Gynecological services and dialysis treatment, however, continue to be provided under the SSP.
Private hospital managements said they have continued providing treatment despite higher operating costs and taxes but acknowledged that some doctors’ refusal to perform surgeries is affecting access to healthcare for low-income patients.
The disruption has also increased pressure on the District Headquarters Hospital in Timergara as more patients seek treatment at government facilities.
With a population of around 1.6 million, Lower Dir has a large number of residents dependent on the Sehat Sahulat Program for medical treatment.
Residents have urged the provincial government, State Life Insurance Corporation and other stakeholders to resolve the taxation and remuneration issues and restore surgical services under the program.
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