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ISLAMABAD: A deadly fire at the Pakistan Institute of Medical Sciences (PIMS) on August 26 resulted in the deaths of at least 14 newborns, raising serious questions about safety standards, hospital management and the use of public funds. The tragedy has brought renewed attention to the financial resources provided to the country’s major public hospitals. Federal government records show that approximately Rs22 billion was allocated to PIMS over the past three years. Despite these substantial allocations, the hospital continues to face staff shortages, maintenance concerns and problems with essential equipment Official budget figures show that PIMS received an allocation of Rs6.84 billion during the previous financial year. However, the hospital spent approximately Rs7.51 billion, exceeding its approved budget by around Rs670 million.The institution also received an additional Rs660 million in supplementary funds during the year.For the current financial year, the government’s allocation for PIMS has been increased to approximately Rs7.63 billion. Questions have also been raised over funds allocated for repair and maintenance. The federal government had previously provided Rs500 million under this category, while only Rs230 million has been earmarked for the current year. These figures have prompted concerns over whether available resources are being effectively utilised and whether sufficient priority is being given to basic safety, maintenance and patient care. Despite receiving billions of rupees in government funding, PIMS is reportedly operating with a significant shortage of staff. Hospital data indicates that 949 sanctioned positions remain vacant. These include 385 doctors, 363 nurses and 201 paramedical staff. Such shortages can place additional pressure on existing employees and affect the hospital’s ability to provide timely care. Understaffed wards can also make emergency response more difficult, particularly in critical departments where patients require continuous monitoring. The PIMS fire has therefore intensified questions about whether staffing gaps and inadequate resources played any role in the tragedy. Determining the exact causes, however, will require a transparent and independent investigation. The concerns surrounding PIMS are part of a broader debate over safety and accountability in Pakistan’s public hospitals. A review of reported incidents between 2016 and 2026 has highlighted several cases involving alleged negligence and failures in healthcare facilities across the country. In June 2025, 20 children, including 15 newborns, reportedly died at DHQ Hospital Pakpattan, with oxygen shortage cited as a possible factor. In October 2020, seven patients died at Khyber Teaching Hospital Peshawar following an oxygen supply failure. In November 2024, a three-year-old child reportedly fell into an open manhole inside Children’s Hospital Lahore. Other reported incidents across different cities have involved alleged treatment delays, incorrect injections, oxygen-related problems and unsafe hospital infrastructure. The PIMS tragedy has once again raised questions about whether increasing government allocations are producing meaningful improvements in public healthcare. The government has ordered an inquiry into the fire, which is expected to determine the circumstances surrounding the deaths and identify any negligence or safety failures. For the families who lost their newborns, however, no investigation can undo the loss. The central question now is whether the billions allocated to PIMS have been used effectively and whether hospital authorities maintained adequate staffing, equipment, fire-safety systems and infrastructure. If a major public hospital receiving billions in government funding cannot guarantee basic safety for vulnerable patients, accountability must extend beyond temporary suspensions or administrative changes. The tragedy has highlighted the urgent need for stronger oversight, transparent financial management, adequate staffing and enforceable safety standards across Pakistan’s public healthcare system.