Pakistan Faces Private Hospital Shutdown as Doctors Escalate FBR Fight

ISLAMABAD: Private hospitals and clinics across Pakistan will lock their doors on Wednesday, September 30. A Pakistan Medical Association (PMA) strike turns a seven-month tax quarrel with the Federal Board of Revenue (FBR) into a direct test of the government's nerve.

The PMA says its leadership reached full consensus after meetings in every province. It has instructed all medical establishments to close completely for the day, and it says private healthcare providers across the country will join the protest. PMA Punjab has already written to its district presidents, directing them to rally clinics, hospitals and civil society behind the closure.

"Healthcare providers serve the nation by treating patients; they do not sell commercial commodities," said PMA Secretary General Dr Abdul Ghafoor Shoro.

PMA nationwide strike

The fight centres on two FBR moves. The first treats medical services as retail sales. The second orders private hospitals to plug their billing into the tax authority's Point-of-Sale (POS) network.

Under the POS regime, every taxable service must pass through an integrated outlet that issues a real-time electronic invoice. The provider must also keep its records for six years.

Doctors also object to Section 175C of the Income Tax Ordinance. That provision lets the FBR post Inland Revenue officers inside business premises to monitor services as they happen. PMA Punjab describes the enforcement under it as aggressive and humiliating.

Also Read: Govt Approves Prices for 52 Life-Saving Drugs, Boosting Patient Access

Dr Shoro argues that private hospitals already pay income tax. He says heavy fines and raids now make them increasingly difficult to run. He also says the private sector meets more than 70 per cent of Pakistan's healthcare needs. If the PMA's estimate holds, Wednesday's action could reach a substantial share of patients who rely on private healthcare.

'A Breach of Trust'

The dispute did not start this month. In February, the FBR issued a notification that named private hospitals, clinics, laboratories and diagnostic centres among more than a dozen sectors that must integrate with its system. Focus Pakistan reported at the time that the notification exempted private hospitals charging consultation fees below Rs500.

The PMA called the move a breach of trust. The association said the finance minister and the FBR chairman had earlier assured doctors that healthcare facilities would stay outside the POS net.

The tax authority reads the situation differently. The FBR has targeted high-earning but under-documented service businesses, clinics and hospitals among them. It links wider documentation to potential relief in income tax rates for salaried workers. Business Recorder reported last year that some private hospitals charge Rs100,000 to Rs200,000 a day for an inpatient room, more than many five-star hotels.

Patients Caught in the Middle

The PMA warns that patients could end up paying for any extra cost the new regime places on hospitals. It demands that the government and the FBR withdraw the POS requirement, scrap the fines and stop raiding hospitals.

PMA Punjab President Dr Kamran Saeed Sheikh has urged Prime Minister Shehbaz Sharif to intervene immediately and head off further difficulties for doctors, private healthcare institutions and patients.

Why the PMA Strike on September 30 Is Only the Start

The PMA says Wednesday's closure will not end its campaign. PMA Punjab plans to gather district leaders from across the province, along with representatives from other provinces, in Gujrat on October 11. The PMA has also raised the prospect of an indefinite suspension of healthcare services if its demands go unmet. The association's public statements so far do not say whether emergency and time-critical services, such as dialysis, chemotherapy and scheduled surgery, will continue during the closure.