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The Financial Express

Anarchy rules the roost in healthcare system


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With the outbreak of Covid-19 throughout the country, the nation's healthcare services have come to the limelight again. The citizens are still being deprived of minimum standard services from most of the health centres despite mushroom growth of private clinics and diagnostic centres.

Due largely to lax monitoring and regulation by the authorities concerned, such hospitals and clinics are being run without any proper guidelines which are posing a grave threat to public health.

Private hospitals have created options for the people to seek health services from various facilities other than the government ones only. But these hospitals are allegedly exploiting the patients taking advantage of lack of their knowledge and helplessness. The laws too are not effective and there are problems with compliance level as well.

What is surprising is that more than 40 per cent of private hospitals, clinics, blood banks and diagnostic centres are not registered with the relevant government agency. The hospital and clinic wing under the DG Health does not have the capacity to regularly monitor mushroom growth of the clinics, hospitals, blood banks, and diagnostic centres.

Apart from the government-owned hospitals, the situation in private clinics and diagnostic centres outside Dhaka is even worse. They do not have proper equipment, manpower, doctors, nurses, emergency, ambulances and authorised blood bank needed for a full-fledged clinic.

The quality of services of the healthcare workforce in providing services in these clinics and diagnostic centres is simply awful. The number of qualified doctors, nurses and other professionals is too inadequate to cope with the demand for qualified physicians, which is growing. Private medical institutions are also being set up at random. But there is a dearth of qualified teachers to produce qualified doctors. There are allegations that a section of dishonest public hospital staff influences patients to get admitted into private clinics citing better treatment. Private clinics offer a slice of their income to these 'touts'. Medicare services in public hospitals beggar description. It is hard to get proper services there. Specialist physicians are mostly busy with their private practices.

Overall, it's a hell of an anarchy that rules the roost in the country's healthcare system. Affluent people have little faith in local healthcare services. Going abroad for treatment is a regular phenomenon here. A substantial amount of foreign currency is going into drains for the purpose.

Unfortunately, specialist physicians in Bangladesh are very few in number. Quite naturally, patients seldom get their proper services. A specialist physician, after his/her duty at the public hospital, visits at least 50 patients a day at his/her own private clinic. How can s/he make justice in offering fair treatment to the patients?

In fact, poor doctor-patient communication poses as a hindrance to reaching correct diagnosis. Many doctors in Bangladesh are reluctant to improve such communication which is one of the key elements of treatment. Whereas Bangladeshi physicians have proved their worth in treating diseases abroad, they give little importance to good relation to heal patients at home.

It has been found that the poor and disadvantaged households with only little assets are likely to struggle to meet even small extra-budgetary expenses. Thus, improving the ability of the health system to reach the poor and disadvantaged population is essential to mitigate the income-erosion effect of ill-health and poverty alleviation in Bangladesh.

The country's healthcare system needs a drastic reform to better suit to the requirements of the common people. Private practice by public hospital physicians must be banned. It is not understood on what ground they are being allowed to do private practice when the number of doctors has significantly increased. This is a highly unethical practice.

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