Healthcare, social security systems needed

 With all its tragedies, unprecedented complexities and uncertainties, the coronavirus pandemic should focus minds on the inadequacies in our healthcare and social security systems that need rectification at the earliest. Consider.

The Pakistan Tehreek-Insaaf (PTI) government led by Imran Khan has been seen wringing its hands in despair at the thought that the logic of meeting the unprecedented challenge posed by the pandemic, i.e., a total lockdown, would condemn millions of the poor to starvation. Laudable as the concern is, the hesitation to act firmly and instead allow an incremental loosening of the partial lockdown, including allowing certain industries, such as construction and textiles, to reopen, runs the risk of falling between two stools. On the one hand, the government’s plan to revive these industries to offer continued employment and meet certain needs (exports in the case of textiles) faces considerable complexity. The anomalies that are likely to arise are already being spelt out by knowledgeable commentators on economic affairs. On the other hand, the picture emerging of threats to employment and the payment of salaries despite the revival of such industries makes for sorry reading.

The government’s directives to industry and commerce to retain employees and pay their salaries during the lockdown have largely been practiced in the breach. This should not come as a surprise when we reflect on the inadequacies of the factory inspections system, meant to ensure industries do not violate workers’ rights. There are only 542 factory inspectors throughout Pakistan, who are expected to look after 350,000-400,000 factories in the country. Even if the factory inspection regime were followed to the letter (which is conspicuous by its absence), this implies an average of about 740 factories per inspector. The annual inspections enjoined by our laws could at best be carried out every 740 years if a particular factory has been inspected today. However, these annual inspections have lapsed and are virtually non-existent since 1981.

This gaping hole in our regulation of labour laws and rights allows industrialists to operate under a contract labour system introduced during General Ziaul Haq’s rule that largely obviates any and all labour rights, including collective bargaining. A recent study shows that 80 percent of factories are unregistered. Of the total labour force, 75-85 percent is ‘informal’ (e.g. no letters of appointment). Despite the government’s well-meaning effort to keep the wheels of the economy moving, many textile factories are shut and their workers have either been fired or only partially paid. The industry bigwigs expect relief from public funds from the government to continue functioning, going to the extent of asking the government to pick up the tab for unpaid salaries during the lockdown.

The facts and figures regarding our working class make for troubling reading. Of the total working class, only four percent are unionised, while 93 percent toil long hours below the minimum wage without even the basic necessities such as toilets and clean drinking water. For women workers in the garments industry, conditions are even worse, including no childcare or maternity leave. Daily wagers in the industrial sector constitute 90 percent of the labour force, hired through labour contractors who fire workers on the spot if they ask for even their legitimate rights.

The industrialist community does not wish to share the costs and burdens of working people in this time of corona. As is its wont, it prefers to pass the buck onto the government to shoulder these responsibilities. Corporate social responsibility may have emerged as a buzzword in recent times, but in Pakistan at least, an essentially rentier capitalist class unabashedly puts its profits before people and their welfare.

As for healthcare, the less said the better. The public healthcare system has been glaringly exposed during this crisis. Its normal functioning was an area of concern before; its inadequacies in the face of the current pandemic can only evoke alarm. By some happenstance, the numbers of infected and deaths due to the coronavirus in Pakistan were reported as fairly low for weeks after the pandemic struck (below two percent). However, in recent days the count of fatalities is creeping up to two percent and the trend shows an incremental increase. This of course is based on the official figures, which may well be understated since our testing and detection regimes are woefully inadequate, bad enough in the large cities, virtually non-existent in the rest of the rural and small town hinterland.

Every forecast is pointing to a severe economic downturn if not recession globally. Pakistan too is headed in that direction. Yet reports speak of a rise in defence expenditure of about four percent to Rs 1.2 trillion, while development expenditure will fall by 34 percent to Rs 953 billion. If one fact is needed to point towards the skewed priorities we have been pursuing throughout our history, this is it. At this momentous moment in history, our ruling elite (dominated by the military) thinks it can carry on in business-as-usual fashion. Their inability to comprehend the risks of a people reduced to supplicants for state or private charity (an affront to any self-respecting human being) getting so angry and frustrated with an unfeeling system that only operates in the interests of the wealthy and powerful that they could conceivably revolt against its iniquities only is matched by the indifference towards and oppression of the French people in the 18th century that led to the storming of the Bastille.

Before we reach such a pass, which in the obtaining circumstances of no organised force able to lead such a revolt in a positive direction could conceivably lead to anarchy and social breakdown, thinking minds should dwell on crafting a universal healthcare and social security architecture, paid for mainly by employers’ contributions fixed by law, that could tide working people through such catastrophic times as well as ensure their survival and well being in relatively better times. And while we are at it, add universal education, free or at affordable nominal fees, to unleash the untapped creative energies of the vast majority of our people. In other words, a welfare state, so beloved of social democrats.

The alternative, history teaches, if this is not done (inevitably at the cost of shaving defence expenditure to lean and mean proportions), could well turn out to be a bloody revolution.