The healthcare sector in Bangladesh is expanding rapidly, with increasing patient pressure, higher budget allocations and ongoing infrastructural modernisation. Yet this progress is scarcely reflected in the administrative structure of our hospitals. In most healthcare facilities across the country, doctors are still burdened with administrative duties. Although medicine and administration are two completely different professions, responsibilities ranging from patient care to financial management, human resources, procurement, and service supervision continue to be placed on the shoulders of physicians. This not only disrupts medical services but also impedes the overall development of hospitals. In this context, introducing a separate administrative cadre in every hospital has become an urgent necessity.
A doctor's primary responsibility is to diagnose diseases, deliver treatment and respond to emergencies. They are not trained to manage administrative tasks such as budgeting, tender processes, accounting, HR management, supply chain oversight and legal documentation. When doctors are compelled to shoulder these duties, their time and attention become divided, which directly affects patient care.
Meanwhile, the influence of brokers in upazila and district hospitals has grown alarmingly. These groups engage in unethical activities related to admissions, tests, medicine collection and diverting patients to private clinics. Hospital authorities often fail to take effective action due to legal or administrative limitations, making them overly dependent on executive magistrates. If hospitals had their own administrative cadre, they could control such malpractice through regular monitoring, enforcement, grievance resolution and strict discipline-thus reducing the need for frequent external intervention.
Administrative weaknesses also lead to problems such as medicine shortages, long-damaged equipment, poor state of cleanliness, absentee staff, wastage and irregularities in procurement. These issues persist largely due to the lack of skilled professionals capable of making quick and appropriate administrative decisions. Competent administrative officers could address these challenges far more efficiently.
In developed health systems, hospitals are managed by professional administrative teams, allowing doctors to focus solely on medical services. Countries such as England, Japan and Singapore employ dedicated health administration cadres, ensuring transparency, accountability and efficient service delivery.
In Bangladesh, establishing an administrative cadre in every hospital would result in disciplined budgeting, efficient supply management, proper infrastructure maintenance and improved service quality. It would reduce corruption, misuse of resources and inefficiency while making patient services faster, smoother and more humane.
Raisul Islam Rifat
Nakla-Sherpur
