Instead of improvement, country's overall healthcare services have further deteriorated. Although there is a mushroom growth of health-related infrastructure, proper treatment is absent almost everywhere.
Indiscriminate use of anti-biotic is having a negative impact on the health condition of patients. Anti-biotic is available in every nook and corner of the country without prescription. So the abuse in its use in widespread. Besides, a section of dishonest public hospital officials influence 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. Poor people have no alternative other than going to these hospitals. It is hard to get physicians' services there. Specialist physicians are mostly busy with their private practices. Even on-duty doctors leave hospital premises to visit patients in private clinics without any permission.
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 goes into drains for the purpose.
There has been widespread growth of private hospitals and clinics in the country. But standard treatment like in Singapore or Bangkok is absent there. Even India and Malaysia are offering state-of-the-art treatment facilities to the patients that are globally recognised.
Unfortunately, specialist physicians in Bangladesh are very few in number. Quite naturally, patients seldom get their services. A specialist physician, after his duty at the public hospitals, attend to at least 50 patients a day at private clinic/clinics. How can he make justice in offering fair treatment to the patients? A specialist usually gives only five minutes per patient which is obviously too little a time to determine his disease and diagnosis.
In fact, poor doctor-patient communication poses a hindrance to reaching proper diagnosis. Many doctors in Bangladesh are reluctant to improve such communication which is one of the key elements of treatment. However, Bangladeshi physicians have proved their worth in treating patients abroad, but, at home, they give little importance on establishing good doctor-patient relationship.
The existing healthcare system in the country is, unfortunately, ineffective in reaching the poor. It generates less benefit for the poor than the rich, and imposes repressive cost burdens on poor households. The inequitable nature of the health system limits the access of the poor to healthcare though they need it the most. Concern was raised recently about attaining the health-related Millennium Development Goals (MDGs) in countries like Bangladesh without improving the ability of health system to reach the poor effectively.
It has been found that the poor and disadvantaged households with only a few assets struggle to meet even small extra-budgetary expenses. Thus, improving the ability of the health system to reach the poor/disadvantaged population groups is essential to mitigate the income-erosion effect of ill-health and poverty alleviation in Bangladesh.
It is a good sign that the people's awareness about the need for advanced treatment is growing. But the rural areas are vastly neglected in terms of getting medicare facilities. The government has set up medical centres at union and hospitals at upazila level. Doctors and nurses remain largely absent in most of the upazila hospitals and life-saving drugs are hardly available. Doctors allegedly stay in big towns and cities without taking leave from their workplaces. Nurses hardly take care of patients. An anarchic condition prevails in these public hospitals and medical centres.
Doctors in the public hospitals and institutions are by far the most fortunate ones to be allowed to do private practice. When neighbouring countries like India, Pakistan and Sri Lanka have strictly prohibited private practice by the doctors of the state-run hospitals and clinics, the Bangladeshi doctors view it as a victory for them that they have been able to continue with the government permission of doing private practices.
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 highly unethical.
Although there is a provision to treat 10 per cent poor patients out of the total number of patients at free of cost, no private hospitals follow this rule. Some private hospitals have outdoor services that charge some fees from the patients. They have now doubled the amount of fees. Free services were earlier available at the Outdoor of the public hospitals, but now some fees, though nominal, are being charged, adding to the woes of the poor patients. There are no free services wings in these hospitals.
The fact remains that when patients go to their doctors, they do so with the faith that the latter will do their best to help and serve the former. Therefore, it is only natural that when a doctor wilfully breaches the patients' trust, through either negligence or malpractice, they should be held accountable and made to pay. Unfortunately, however, even though patients are constantly denied proper care, there have been no instance of doctors being held accountable due to the absence of well-defined laws and definitions of negligence. Such a lack of accountability, many believe, is at the root of the dismal scenario now prevailing in the health sector.
Health service in the private sector does need to be streamlined. This is, however, not possible unless a proper mechanism is put in place. On its part, the government needs to initiate a move to create a legal framework so as to ensure quality treatment. In fact, a holistic approach is required to provide full-scale free healthcare to the disadvantaged. Otherwise, the concept of 'Health for All' is unlikely to materialise any time soon.
The government should, in the meantime, introduce evaluation of doctors, nurses and pharmacists by organisations accredited to the Joint Commission International (JCI). Private hospitals also need to be encouraged to meet the standard of JCI.
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Ensuring quality treatment
Shahiduzzaman Khan | Published: September 20, 2015 00:00:00 | Updated: November 30, 2026 06:01:00
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