Profit-oriented private healthcare services are being operated in the country without maintaining proper rules and regulations, a TIB study has revealed.
According to the study, unavailability of time-befitting laws, poor enforcement of the existing ones, lack of government monitoring, undue political influence in management, and high profit-making attitude of the private sector hospital owners are responsible for the situation.
The study carried out by the Transparency International Bangladesh (TIB) recommended forming an independent commission to establish a better control over the private hospitals and diagnostics centres across the country.
The Dhaka chapter of the Berlin-based anti-graft watchdog launched report of the study - 'Private healthcare service: challenges to good governance and way forward' - at a press conference in the capital on Wednesday.
TIB Executive Director Dr Iftekharuzzaman and its Chairperson Advocate Sultana Kamal attended the conference, among others. Its Programme Manager Taslima Akter and Deputy Programme Manager Md Julkarnayeen presented the study findings before newsmen.
The research was conducted from January to December last year in 116 private healthcare facilities across the country, including 26 in the capital. Of those, 66 were hospitals and 50 were diagnostic centres.
Some 706 representatives from the stakeholders, including private clinics, patients, attendants and government monitoring officials, provided information for the study.
According to the study, the number of private healthcare facilities rose to 15,698 units in 2017 from only 33 units in 1982 amid the growing need of people.
Due to inadequacy in public healthcare establishments, the private ones are making rapid growth, as more than 63.3 per cent people receive treatment from the private sector.
The study further said the existing laws and rules to govern the private health facilities, including the Medical Practice and Private Clinics and Laboratories (Regulation) Ordinance 1982, are not duly updated.
More than a decade has passed to finalise the private healthcare service law due to the stakeholders' lack of response and absence of political will, it noted.
Due to poor law enforcement, the private clinics often charge the patients arbitrarily. The irregularities in private medical centres located in zila and upazila levels are much higher than those operating in the city areas.
The TIB study observed that many hospitals start operations without registration, while the owners pay Tk 5,000 to TK 3,50,000 as bribe to get these registered.
Besides, they pay Tk 500 to Tk 50,000 to renew their licenses often without meeting all the required conditions. The amount varies depending on the location of the facility and the owners' social or political influence.
According to the study, the patients cannot lodge complaints with the authorities concerned if they are given wrong treatment or deceived by the hospital staffs.
Most of the hospitals and diagnostic centres lack the required number of physicians, nurses, medical assistants and instruments.
"There are no full-time physicians in 52 hospitals, out of the 66 surveyed ones, while only 13 have full-time nurses."
According to the government Health Bulletin 2016, the country's private hospitals require 47,056 nurses according to their number of beds. But there is a shortage of 20,281 nurses.
The medical facilities often subject their patients to unnecessary treatment, the study revealed.
Coming under pressure from the hospital owners, the doctors concerned conduct caesarean delivery unnecessarily and even much earlier of expected date of delivery.
"The rate of caesarean delivery is around 80 per cent in the private sector hospitals, 38 per cent in the state-owned hospitals, and 28 per cent in the NGO-run ones," the study added.
Speaking on the occasion, Mr Iftekharuzzaman said the private healthcare services are flourishing because of their high profiteering.
"People are often being cheated in the name of getting healthcare services, mainly due to the government's lack of necessary control and monitoring."
He suggested forming an independent and impartial healthcare commission to take control over the sector in the light of experiences of other countries.
The TIB study also recommended amending necessary laws, the government watchdog's capacity building, online registration process, and taking stern actions against the irregularities to ensure service standards at the private medical centres.
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