Free pry healthcare, subsidised higher treatments prescribed

Free primary healthcare and subsidized higher treatments and establishing referral hospitals are among the must-haves prescribed by a reform commission for upgrading the medical sector in Bangladesh that counts huge costs of foreign treatments.

Also suggested are enhancing to 15 per cent the budget allocation for the healthcare sector and the formation of a permanent health commission as a watchdog.

The commission, which submitted its report to Chief Adviser of the interim government Prof Muhammad Yunus on Monday, proposed restructuring institutional structures and gradual increase in budget allocation and financing, touching all areas for improving medical services to ensure health rights for all through making all concerned accountable and transparent.

To ensure people's health right as a basic constitutional right, the panel of experts asks for making health laws through ordinance to incorporate into constitution.

Forming health cadre and hospital security police and setting up referral hospitals are also among major dos laid down in the report.

Direct drug-promoting visit to physicians by representatives of pharmaceutical companies is prohibited.

The commission says the independent commission on health would work from policy formulation to oversight on all concerned for "transparent, accountable and effective health services to rural and urban people irrespective of all groups, including women and children".

Bangladesh Health Service has also been proposed to be formed through an ordinance to ensure professionalism, and skilled and accountable services by reforming health cadre.

To achieve these targets, the commission also proposes enacting a series of new acts, including Bangladesh Health Commission Act, for the protection of patients, emergency preparedness, and the continuation of health services after revising all the existing acts.

The Health Reform Commission members disclosed the recommendations during a press conference at the Foreign Service Training Academy in the capital after handing over the report to the chief adviser.

Head of the Commission National Professor AK Azad Khan briefed the journalists, along with his team members, and said among the recommendations, the interim government can start activities of the Bangladesh Health Commission (BHC) through an ordinance as an immediate step.

Admitting execution of the recommendations would be challenging and take a long time, the team leader said a political consensus to continue the efforts to be taken as part of reforms during the interim government was received.

"Though health is said to be the right of all, the legal side is absent," Professor Azad said, adding that the commission has given the highest priority to primary healthcare, health education, research, institutional reform, pay scale of all concerned etc to ensure people's rights to good health.

Dr Abu Mohammad Zakir Hossain presented the key features of the report and said BHC, which will ensure transparent, accountable, and effective health services by supervising all services through its 17 divisions, will be accountable to the government and submit an annual report to parliament.

He said the report was prepared after consultation with different stakeholders and discussion with experts and professionals and recommendations are based on the consensus and study findings to assess the needs of the mass people.

Dr Zakir said the unification of different health-service agencies, decentralisation of health services, reformation in referral system, clinical, medical-college standardisation, raw materials for pharmaceutical sectors, price control of lifesaving medicines, digitalisation of entire health services, and digital platforms for complaint lodging have been covered in the report.

"Health of women and children, elderly people, police, students and journalists was tried to be addressed based on the demand of the surveyed people."

As the government will be liable to ensure health for all, Dr Zakir, professor in the Public Health and Health Informatics Department at Bangladesh Medical University, said improving medical services from private and public sectors has been proposed, giving importance to the fact that ensuring health is the responsibility of the state.

The acts proposed for enactment include Bangladesh Health Service Act, Primary Health Service Act, Health Protection Act, Medicine Price Fixing and Entry Act, Allied Health Service Act, Professional Council Act, and Bangladesh Medical Research Council Act.

Besides, the proposal to enact Health Service Provider and Patient Protection Act, Hospital and Diagnostics Accreditation Act, Bangladesh Safe Food, Drug, IVD and Medical Device Act was included in the report by amending Bangladesh Medical and Dental Council Act, Medical Education Accreditation Act, Nursing and Midwifery Council Act, Bangladesh Pharmacy Council Act, Tobacco Control Act, Poura and City Corporation Act etc.

As the country loses foreign currency of $4.0 billion to $ 5.0 billion, which is spent on treatment abroad, medical care, specifically for the ailments for which people go abroad, has been proposed to be improved in the country.

Besides, Bangladeshi expatriate physicians would be invited to provide services in the country to reduce dependency on going abroad for treatment.

The commission proposes establishing National Women Health Institute to ensure women's health, including women, children, adolescents, and people with special needs. The details, however, were not disclosed.

Another member of the team, Prof Dr Sayera Akther, said institute would be linked with other health services.

The interim government formed the Health Sector Reform Commission on November 18, 2024 with Prof AK Azad Khan, president of the Diabetic Association of Bangladesh, as the chief.

Other members of the commission are Prof Md Muhammad Zakir Hossain, Prof Dr Liaquat Ali, chairman of Pothikrit Foundation, Prof Dr Sayera Akther, a gynaecologist, Prof Dr Naila Zaman Khan, a neurologist at the Department of Paediatric Neuroscience, MM Reza, former secretary, Prof Dr Muzaherul Huq, former regional adviser (South-East Asia Region) at the World Health Organisation (WHO), Dr Azharul Islam, icddr,b, Prof Dr Syed Md Akram Hossain, Square Cancer Centre at Square Hospital, Prof Dr Syed Atiqul Haque, chief consultant of Green Life Centre for Rheumatic Care and Research, Dr Ahmed Ahsanur Rahman, scientist at icddr,b, and Omair Afif, a student of Dhaka Medical College.

The commission started working on December 3 and prepared the report holding 51 meetings, 32 advisory meetings, and consultation meetings in Chattogram, Rangamati, Khulna, Sylhet, Rajshahi, Rangpur, Barishal, Munshiganj, and Dhaka.

smunima@yahoo.com