ACC and errant doctors  

What the Anti-corruption Commission (ACC) has found about the doctors skipping their duties at the public health facilities is nothing revealing about the latter except for those serving in hospitals located in Dhaka city.

The ACC's 'enforcement' teams while making surprise visits to a total of eight government health facilities at district and upazila headquarters found 63 per cent doctors absent from their respective workplaces. Their estimates do corroborate what is published in the media very often. In fact, the doctors' rate of abstention is found to be even higher---80 per cent--- in many cases.

But the rate of skipping duty at 40 per cent detected in, at least, a couple of government hospitals that the ACC teams visited in Dhaka does appear rather surprising. Doctors posted at upazila health complexes remain absent from their duty, in most cases, to stay in Dhaka as they find the living conditions in these semi-urban centres highly unattractive and uncomfortable.

But why should they skip their duty while being posted in Dhaka hospitals? It is most likely that they do part-time work in some private health facilities for pecuniary benefits.

The ACC teams, possibly, would have found far greater number of doctors, including senior ones, not attending their duties had they visited the major public hospitals in Dhaka.

In fact the problem is a chronic one. Even the heads of governments and ministers on many occasions in the past had air their dissatisfaction at the growing propensity among doctors, posted at rural health facilities, to skip their regular duty. But the situation has remained unchanged.

Thus, the ACC's concern about the sufferings of the people visiting the public health facilities deserves appreciation, but some people might wonder why should ACC make surprise visits to check doctors' attendance? What are the health ministry and relevant other agencies doing?

'Unauthorised absence from work' on the part of the public servants, possibly, is not an act of corruption and it is also not among the offences that are mentioned in the Penal Code of 1860, concerning the public servants. The ACC is empowered to deal with such offences under the Anti-corruption Commission Act of 2004.    

By abstaining from regular duty wilfully, the doctors concerned, in fact, are committing a crime that is no less serious in nature than graft-taking in any form. Patients coming from far and near places are deprived of necessary medical care. Due to non-availability of medical help people suffer. The victims of such neglect invariably are poor since they cannot afford treatment in private health facilities. All sorts of deficiencies notwithstanding, the poor and low-income people are left with no option but to go to upazila health facilities.

It remains a puzzle as to why the health ministry or the directorate of health services is not handling the issue of doctors' absence from their workplaces with due seriousness. It is unlikely that the Bangladesh Medical Association (BMA), the apex body of the medical professionals would oppose any tough disciplinary measures against errant physicians.

Fresh medical graduates are seen making frantic efforts to grab government jobs. They, in most cases, get their first appointment in upazila health complexes. Once appointed, these doctors start intense lobbying to get transferred, preferably to health facilities located in Dhaka or nearby places.

Many tend to believe that one of the reasons behind physicians behaving erratically is more political than anything else. They argue, if members of other cadre services can stay at upazila headquarters, then why should doctors behave differently?  Once the political parties stop patronising the organisations of professionals, the problem would largely be over. But, will they be so pragmatic and prudent?  

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