ISLAMABAD: The Pakistan Medical Association (PMA) has issued a stern warning to the Federal Board of Revenue (FBR) over a recent tax notification seeking to bring private clinics, hospitals and diagnostic facilities into the Point of Sale (POS) system, saying the move violates earlier government assurances and risks destabilising an already fragile primary healthcare sector.
In a statement issued after an emergency meeting of its central council, presided over by PMA Secretary General Dr Izhar Chaudhary, the association said a draft Statutory Regulatory Order dated February 18, 2026, proposing mandatory integration of medical service providers with the FBR’s electronic invoicing and POS system amounted to a “breach of trust” by the government.
The PMA said senior officials, including the finance minister and the FBR chairman, had earlier assured the medical community that healthcare facilities would remain exempt from POS requirements.
The association rejected what it called the “commercialisation” of healthcare under the proposed regime, arguing that doctors were being treated as traders and clinics as retail outlets. “Medical care is a service provided to vulnerable patients, not a commercial transaction in the same sense as retail trade,” a PMA office-bearer said, warning that compulsory real-time invoicing could disrupt care delivery, particularly in small clinics that form the backbone of primary healthcare in urban settlements and rural areas.
The warning comes days after the FBR issued a notification directing a wide range of service providers and businesses to digitally integrate their operations with the tax authority’s system through electronic invoicing hardware and software to improve documentation and widen the tax base.
The notified categories include restaurants, hotels, courier services, beauty salons, gyms, private schools and colleges, and a broad spectrum of medical service providers -- including clinics, diagnostic laboratories and private hospitals. Under the notification, no taxable supply or service is to be made except through integrated outlets, with real-time verifiable electronic invoices to be issued and records retained for six years.
The PMA leaders said the move disregarded the unique nature of healthcare delivery and the realities of small practices, many of which operate in low-resource settings. They warned that imposing strict documentation requirements on neighbourhood clinics could lead to closures or reduced access for low-income patients who rely heavily on private primary care due to weaknesses in the public health system.
The association also pointed to the ongoing outflow of medical professionals, noting that more than 3,000 doctors left Pakistan last year, and added that policy uncertainty and “hostile regulatory approaches” were contributing to the brain drain.
The PMA said it had previously cooperated with tax authorities to encourage voluntary compliance among doctors based on assurances that healthcare facilities would not be brought under the POS regime. “This sudden reversal undermines trust and threatens the doctor-patient relationship by introducing intrusive documentation at the point of care,” a senior PMA official said.
In its resolution, the PMA’s central council called on the FBR to immediately halt monitoring of medical practitioners under the new framework and to suspend the application of enforcement provisions against doctors.
It warned that if the FBR proceeded with implementation, the association would withdraw its focal persons coordinating with tax authorities and terminate collaborative efforts aimed at facilitating revenue documentation in the health sector.
The association also urged its provincial chapters to mobilise members and maintain unity, advising doctors to refrain from engaging with tax officials until further guidance. While stressing that the medical community supported fair taxation and transparency, the PMA leaders said any documentation drive should be applied consistently across service sectors and designed in consultation with professional bodies to avoid unintended harm to patient access and care delivery.
The FBR officials maintain that digital integration is essential to curb under-reporting of income and broaden the tax base across services. However, health sector representatives are calling for dialogue to revisit the scope and implementation of the policy, arguing that blanket application of POS requirements to healthcare risks deepening inequities in access to care rather than strengthening compliance.
