摘要：This paper attempts to explain why Hospital Autonomy (HA) Reforms in Pakistan could not succeed in achieving its stated objectives. Use of sense making technique is employed which consists of frame, cue and relationship. Frame of the reforms is developed using constructs like governance system of Pakistan, its connection to the past, legacy of bureaucracy, accountability traditions and the status of rule of law in Pakistan. The study shows that the current structure is strongly influenced by its colonial heritage, with most of the ingredients of the governance system persisting till today. The HA reforms, imposed by IFIs, were likely to challenge the unchallenged position of bureaucracy in the context of Pakistan. Though initially it dented the coveted position of bureaucracy, but later the bureaucracy was able to bounce back and reclaim the lost territory. These reforms hurt the public badly as user charges were increased and subsidies disappeared.
关键词：governance system of Pakistan; colonial impact; accountability; rule of law; Pakistan; power; Hospital autonomy reforms
