Regulating private health facilities

The Transparency International, Bangladesh (TIB) has stated the obvious about private health facilities in its study report that was published last week. Most people are familiar with many findings of the report. The TIB has just given an elaborated description of the weaknesses of the private health service-providing entities, while also suggesting a few steps to improve the situation. It is no secret that the private health service-providers have been indulging in various types of irregularities with least resistance from the relevant authorities. The dominance of the private health services, coupled with the government's apathy towards regulating their activities, has made a section of owners of such facilities and the medical staff there staunchly defiant.

 A good number of private health establishments, according to the findings of the TIB study, bypass relevant laws and rules to cheat their service seekers.  Allegations of negligence and misconduct on the part of medical staff also surface on occasions. (The public health facilities are habitually prone to causing sufferings to the patients who belong to poor and low income families.) The middle-class and affluent section of people usually opt for private health facilities and some of them are pretty expensive. But the expensive services that are provided by private hospitals, clinics and diagnostic centres, do not necessarily guarantee their quality. Barring a few, most private health service-providers very often demonstrate weaknesses of varied nature.

The growth of private sector health facilities in the country has been phenomenal during the last three and a half decades because of the inadequacy of government hospitals, clinics and relevant other establishments. The number of private health establishments increased from a paltry 33 in 1982 to nearly 16000 in 2017. The expansion has filled up the vacuum, no doubt. But the government's failure to ensure enough effective regulatory mechanism has created a sort of anarchy in the sector with the private health establishments charging fees arbitrarily and subjecting their service-seekers to hassles. In fact, there is no limit to profiteering by the private sector health operators, including hospitals and diagnostic centres.

The scope of making high profit without any form of resistance has attracted a large number of operators to the sector and some of them are in the business without having their registration from the relevant authorities. They manage their existence allegedly by greasing the palms of officials concerned. However, the high profit earning does not necessarily match with the services they render to people. The situation is worse in districts and sub districts (upazilas).

Lack of both physical capacity and political will of the authorities to regulate the health sector is responsible for the current deplorable state of service delivered by the private health facilities. Much of the effects of shortcoming in physical capacity could be overcome had the government been adequately alert to the need for regulating the operations of the private operators in the health sector.

That the government is indifferent to the need for regulating the sector is evident from the poor enforcement of the existing laws and the lack of enthusiasm to enact new ones, befitting the changed situation in the sector. There has to be a change in this sector's current state of affairs. The government must ensure that the private health establishments charge their patients fairly through delivery of quality services. By doing that it would only partially compensate for its own inability to extend quality health services to a broader section of the population.