New taxation ‘disrupts’ surgical services under Sehat Sahulat Programme in Malakand

The provision of surgical services under the Sehat Sahulat Programme (SSP) in Malakand division, particularly in Lower Dir, has been significantly disrupted due to the imposition of taxes, according to reports. Previously, around 200 surgeries were conducted daily in Lower Dir under the SSP; however, since September 1, only approximately 20 surgeries are being carried out through the programme, while the remaining 180 are being performed privately at high patient costs.

Five private hospitals affiliated with the SSP in Timergara, the capital of Lower Dir, were providing numerous surgical procedures under the programme. However, doctors in these hospitals have reportedly refused to perform many procedures within the SSP, leading to a major setback in healthcare access for low-income patients. Orthopaedic and several other major surgeries have been most affected, with private hospitals stating that the new tax regime, comprising a 15% withholding tax and a 14% service tax, has significantly reduced their earnings from SSP procedures.

This has resulted in doctors being less willing to participate in the scheme. Health officials have acknowledged that compensation for surgeries under the SSP is already insufficient and require revision, further exacerbating the challenges faced by hospitals. Private hospital management argues that despite rising operational costs and heavy taxation, they have continued providing treatment.

However, they emphasize that the non-cooperation of some doctors directly impacts access to healthcare for low-income patients. The disruption has also increased pressure on the district headquarters hospital in Timergara, with a surge in patient inflows. Local residents have expressed concerns about the disparity in surgical services between Malakand division and other districts of Khyber Pakhtunkhwa, urging the provincial government, State Life Insurance Corporation, and other stakeholders to resolve taxation, hospital expenditure, and doctors' remuneration issues to restore full surgical services under the Sehat Sahulat Programme.