Healthcare system needs drastic reforms
Shahiduzzaman Khan | Sunday, 1 March 2009
ADVANCED healthcare facilities are now being offered in Bangladesh on a limited scale. State-of-the-art facilities have been established and world class services are being provided by some major healthcare groups. They have opened branches in Bangladesh and are offering advanced treatment through endoscopic and laparoscopic surgery, multi-disciplinary management, tele-medicine, better pediatric and neonatal services etc.
All these are good news for those who do not want to go abroad for treatment. Advanced healthcare facilities are now being offered only in few places of the capital and those are not enough to cater to the growing healthcare demand of the country.
According to reports, famous Square Group has set up Square Hospital with most modern medical machineries and equipment. The hospital hired a good number of expert professionals with attractive compensation packages. The hospital, situated at Panthapath, is equipped to treat most of the complicated diseases.
Japan-Bangladesh Friendship Hospital started its maiden journey in the city two years back. With two branches -- one at Gulshan and the other at Dhanmondi -- the hospital was set up with a goal to offer 'advanced healthcare within affordable costs.' The hospital authorities have brought the latest medical equipment, surgical apparatus and machines from abroad. With the generous assistance from the Japanese government, the hospital is now rendering services to the people.
Apollo Hospital, Dhaka, started its operation in Bangladesh not so long ago. STS Group established this hospital in joint collaboration with a famous Indian group. Apollo Hospital has branches in many Asian countries. In healthcare treatment and management, the hospital maintains a certain standard. They have hired an adequate number of full-time specialist physicians and skilled nurses.
With Malaysian joint venture collaboration, the United Hospital was set up in Gulshan area recently. The complex is attractive and medical support services are good. The Ahsania Cancer Hospital is on its way for its grand opening. There was a long-felt demand of such a hospital in the country. LabAid has set up a modern hospital for heart-related diseases. Islami Bank Bangladesh has also established a number of hospitals in the country. Dipham Hospital has been set up at Dhanmondi with the aim of treating diabetes-related diseases.
Even these are not enough for a country that has a population of 140 million. Good enough that the people's awareness about the need for advanced treatment is growing. But the rural areas in Bangladesh 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. Nurses hardly take care of the patients. An anarchic condition prevails in these public hospitals and medical centres.
How are the city-based public hospitals doing? The government is spending a huge sum of money for running these hospitals and medical institutions. Yet they do not serve the real purpose. Gross irregularities, mismanagement and corruption have gripped these hospitals and institutions. The authorities do not seem to bother about improving medicare facilities in these public hospitals.
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. Is it really a sensible decision? When the number of doctors is grossly meagre as compared to swelling number of patients, how can this be viewed as a wise decision? Specialist physicians find little time to attend the patients at their own hospitals and medical institutions as they remain horribly busy with their practices in private hospitals and clinics. A physician is associated with more than one private hospitals and clinics. Sometimes, many clinics run advertisements in the media naming some of the country's famous physicians as their associates. And for using their names only, the physicians get hefty amounts of fees from the private hospitals and clinics. Good earnings from referrals to certain clinics for pathological and other examinations need no mention.
Due to such fabulous 'business' being carried on by a section of specialist doctors and physicians, there is hardly any scope for improvement in the present state-run medicare system. Mushroom growth of clinics and medical centres is no guarantee for getting better treatment. As the doctors get ample opportunities of making money from various sources, they do not show their interest in full-time assignments in any globally-renowned hospital based in Bangladesh. For that reason, foreign physicians are being hired by these hospitals. In a country where the number of surplus manpower is enormous, it is difficult to a find good full-time local doctors for a specialised hospital.
What really happens to the public hospitals and institutions is known to everybody. Almost every week, large quantities of medicine and medical equipment supplies are sent to the country's each and every hospital. Excepting some low-prices drugs, most of such supplies vanish from the stores almost instantly. Where they go-nobody knows. Vested coteries have surfaced in each and every hospital that includes personnel from high-ups to the bottom level. If most of the employees are members of the syndicate, how can the medicines reach the doorsteps of the common men?
Intriguing it may sound though, this is a hard reality with all public sector hospitals and medical institutions. Services are grossly meagre, nearly absent. The people have little faith in their treatment. There are a good number of doctors and nurses at the public hospitals. But the problem is: none seems to take proper care of the patients. They are busy with outside jobs in private hospitals and clinics. As the government failed to slap ban on private practice by the public sector physicians, the door is wide open to those who want to engage themselves in private business. Most of the physicians are associated with the country's sprawling nursing homes and hospital business; they are making money at the cost of the people's sufferings.
The World Bank has advised the government recently for contracting out the medical services to the non-government organisations (NGOs), private institutions of fame etc. Such contracting-out should be based on win-win situation. The private sector organisations must be chosen from among the lists of transparent and accountable firms and organisations. At the initial stage, the government may go for contracting out union and upazila level medical services which is all-important for ensuring bare minimum services to the needy ones at grassroots level. Then it may consider bigger public sector organisations in cities and towns to open up.
In this context, the government may even go one step ahead. It may consider transferring the management and operation of the large health sector entities to famous overseas medical services groups and firms. The large entities might include Suhrawardy Hospital, Hospital for the Handicapped and Disabled, National Heart Diseases Institute Hospital, Eye Hospital etc. In the wake of chronic mismanagement, negligence and widespread corruption in these organisations, it is necessary that there should be an effective mechanism to streamline the activities of such ailing organisations. For example, Singapore-based famous National Healthcare Group can be given responsibility of managing National Heart Diseases Institute Hospital. Similarly, some Thai healthcare groups may be given identical responsibility of running Suhrawardy Hospital, Hospital for the Handicapped and Disabled etc. The country will certainly benefit from such a move.
Country's medicare 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. When other professionals are barred from doing private jobs, why should the privilege be enjoyed only by the physicians? They may be given separate pay scale to compensate some of their 'losses'. The government should initiate a pragmatic policy that brings the teeming millions under an integrated healthcare system. It should ensure that its 'health-for-all' policy is implemented in its entirety.
..................................................................
szkhan@thefinancialexpress-bd.com
All these are good news for those who do not want to go abroad for treatment. Advanced healthcare facilities are now being offered only in few places of the capital and those are not enough to cater to the growing healthcare demand of the country.
According to reports, famous Square Group has set up Square Hospital with most modern medical machineries and equipment. The hospital hired a good number of expert professionals with attractive compensation packages. The hospital, situated at Panthapath, is equipped to treat most of the complicated diseases.
Japan-Bangladesh Friendship Hospital started its maiden journey in the city two years back. With two branches -- one at Gulshan and the other at Dhanmondi -- the hospital was set up with a goal to offer 'advanced healthcare within affordable costs.' The hospital authorities have brought the latest medical equipment, surgical apparatus and machines from abroad. With the generous assistance from the Japanese government, the hospital is now rendering services to the people.
Apollo Hospital, Dhaka, started its operation in Bangladesh not so long ago. STS Group established this hospital in joint collaboration with a famous Indian group. Apollo Hospital has branches in many Asian countries. In healthcare treatment and management, the hospital maintains a certain standard. They have hired an adequate number of full-time specialist physicians and skilled nurses.
With Malaysian joint venture collaboration, the United Hospital was set up in Gulshan area recently. The complex is attractive and medical support services are good. The Ahsania Cancer Hospital is on its way for its grand opening. There was a long-felt demand of such a hospital in the country. LabAid has set up a modern hospital for heart-related diseases. Islami Bank Bangladesh has also established a number of hospitals in the country. Dipham Hospital has been set up at Dhanmondi with the aim of treating diabetes-related diseases.
Even these are not enough for a country that has a population of 140 million. Good enough that the people's awareness about the need for advanced treatment is growing. But the rural areas in Bangladesh 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. Nurses hardly take care of the patients. An anarchic condition prevails in these public hospitals and medical centres.
How are the city-based public hospitals doing? The government is spending a huge sum of money for running these hospitals and medical institutions. Yet they do not serve the real purpose. Gross irregularities, mismanagement and corruption have gripped these hospitals and institutions. The authorities do not seem to bother about improving medicare facilities in these public hospitals.
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. Is it really a sensible decision? When the number of doctors is grossly meagre as compared to swelling number of patients, how can this be viewed as a wise decision? Specialist physicians find little time to attend the patients at their own hospitals and medical institutions as they remain horribly busy with their practices in private hospitals and clinics. A physician is associated with more than one private hospitals and clinics. Sometimes, many clinics run advertisements in the media naming some of the country's famous physicians as their associates. And for using their names only, the physicians get hefty amounts of fees from the private hospitals and clinics. Good earnings from referrals to certain clinics for pathological and other examinations need no mention.
Due to such fabulous 'business' being carried on by a section of specialist doctors and physicians, there is hardly any scope for improvement in the present state-run medicare system. Mushroom growth of clinics and medical centres is no guarantee for getting better treatment. As the doctors get ample opportunities of making money from various sources, they do not show their interest in full-time assignments in any globally-renowned hospital based in Bangladesh. For that reason, foreign physicians are being hired by these hospitals. In a country where the number of surplus manpower is enormous, it is difficult to a find good full-time local doctors for a specialised hospital.
What really happens to the public hospitals and institutions is known to everybody. Almost every week, large quantities of medicine and medical equipment supplies are sent to the country's each and every hospital. Excepting some low-prices drugs, most of such supplies vanish from the stores almost instantly. Where they go-nobody knows. Vested coteries have surfaced in each and every hospital that includes personnel from high-ups to the bottom level. If most of the employees are members of the syndicate, how can the medicines reach the doorsteps of the common men?
Intriguing it may sound though, this is a hard reality with all public sector hospitals and medical institutions. Services are grossly meagre, nearly absent. The people have little faith in their treatment. There are a good number of doctors and nurses at the public hospitals. But the problem is: none seems to take proper care of the patients. They are busy with outside jobs in private hospitals and clinics. As the government failed to slap ban on private practice by the public sector physicians, the door is wide open to those who want to engage themselves in private business. Most of the physicians are associated with the country's sprawling nursing homes and hospital business; they are making money at the cost of the people's sufferings.
The World Bank has advised the government recently for contracting out the medical services to the non-government organisations (NGOs), private institutions of fame etc. Such contracting-out should be based on win-win situation. The private sector organisations must be chosen from among the lists of transparent and accountable firms and organisations. At the initial stage, the government may go for contracting out union and upazila level medical services which is all-important for ensuring bare minimum services to the needy ones at grassroots level. Then it may consider bigger public sector organisations in cities and towns to open up.
In this context, the government may even go one step ahead. It may consider transferring the management and operation of the large health sector entities to famous overseas medical services groups and firms. The large entities might include Suhrawardy Hospital, Hospital for the Handicapped and Disabled, National Heart Diseases Institute Hospital, Eye Hospital etc. In the wake of chronic mismanagement, negligence and widespread corruption in these organisations, it is necessary that there should be an effective mechanism to streamline the activities of such ailing organisations. For example, Singapore-based famous National Healthcare Group can be given responsibility of managing National Heart Diseases Institute Hospital. Similarly, some Thai healthcare groups may be given identical responsibility of running Suhrawardy Hospital, Hospital for the Handicapped and Disabled etc. The country will certainly benefit from such a move.
Country's medicare 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. When other professionals are barred from doing private jobs, why should the privilege be enjoyed only by the physicians? They may be given separate pay scale to compensate some of their 'losses'. The government should initiate a pragmatic policy that brings the teeming millions under an integrated healthcare system. It should ensure that its 'health-for-all' policy is implemented in its entirety.
..................................................................
szkhan@thefinancialexpress-bd.com