Issues for a new health policy
Wednesday, 25 November 2009
Fahima Akhter
The way the premier public sector hospital in the country is managed has raised concerns among all circles including the functionaries of the government. The situation is hardly any better for other health service-providing hospitals in the public sector. On its part, the government has announced that it would frame a new health policy fairly soon.
The state of affairs in the government hospitals certainly calls for a drastic improvement under a new policy framework. The matter deserves serious attention. Patient care is lacking. Corruption and inefficiency need to be removed.
The new health policy would have to address the issues of irregularities and utter negligence. Better utilisation of facilities has to be ensured. Nearly all upazilas have government's health complexes with good buildings. Maintenance and administrative personnel should be able to run them reasonably well.
But the government hospitals in the cities and upazilas are more known for absentee doctors. And there is no arrangement for reward- and-punishment for the related health personnel on the basis of their field-level performance. While those doctors and other related personnel who serve diligently and dutifully the rural and other patients outside the city should be rewarded in terms of promotions and overseas training and scholarship facilities, those who are reluctant to serve such patients must also not be considered for such purposes and should be subjected to some kind of "punishment". Carrot-and-stick policy is needed here. But such a policy does not exist now.
In most public hospitals and health complexes and centres, patients do not get the medicines that the government provides in many cases for free distribution. Touts remain busy in hospitals and health complexes to tell the poor patients that they can get better treatment in the private chambers of the doctors, but on payment.
Do the hospitals provide proper treatment to the poor at affordable costs, for which the government runs them spending a lot of public money? Irregularities, negligence and inefficiency, all pervasive in these hospitals and health complexes, defeat the very purpose for which the government runs them. Low quality food is served to patients in many cases.
The malpractices, an exhaustive list of which would be too big, frustrate the purpose of having the public health care system. A new health policy would serve no objective unless it addresses these issues on priority. It should seek to develop a system of built-in accountability to ensure that the doctors and their personnel remain dutiful without resorting to any irregularity. It should put in place a system of punishment for negligence and rewards for the dutiful.
The new policy should stress raising the health awareness of people so that they take preventive measures against major killers like tuberculosis, AIDS, diabetes and hepatic disorders. Raising nutritional awareness among people, free distribution of nutritious food and medicinal supplements to school children, housewives and workers should also be among the objectives.
The way the premier public sector hospital in the country is managed has raised concerns among all circles including the functionaries of the government. The situation is hardly any better for other health service-providing hospitals in the public sector. On its part, the government has announced that it would frame a new health policy fairly soon.
The state of affairs in the government hospitals certainly calls for a drastic improvement under a new policy framework. The matter deserves serious attention. Patient care is lacking. Corruption and inefficiency need to be removed.
The new health policy would have to address the issues of irregularities and utter negligence. Better utilisation of facilities has to be ensured. Nearly all upazilas have government's health complexes with good buildings. Maintenance and administrative personnel should be able to run them reasonably well.
But the government hospitals in the cities and upazilas are more known for absentee doctors. And there is no arrangement for reward- and-punishment for the related health personnel on the basis of their field-level performance. While those doctors and other related personnel who serve diligently and dutifully the rural and other patients outside the city should be rewarded in terms of promotions and overseas training and scholarship facilities, those who are reluctant to serve such patients must also not be considered for such purposes and should be subjected to some kind of "punishment". Carrot-and-stick policy is needed here. But such a policy does not exist now.
In most public hospitals and health complexes and centres, patients do not get the medicines that the government provides in many cases for free distribution. Touts remain busy in hospitals and health complexes to tell the poor patients that they can get better treatment in the private chambers of the doctors, but on payment.
Do the hospitals provide proper treatment to the poor at affordable costs, for which the government runs them spending a lot of public money? Irregularities, negligence and inefficiency, all pervasive in these hospitals and health complexes, defeat the very purpose for which the government runs them. Low quality food is served to patients in many cases.
The malpractices, an exhaustive list of which would be too big, frustrate the purpose of having the public health care system. A new health policy would serve no objective unless it addresses these issues on priority. It should seek to develop a system of built-in accountability to ensure that the doctors and their personnel remain dutiful without resorting to any irregularity. It should put in place a system of punishment for negligence and rewards for the dutiful.
The new policy should stress raising the health awareness of people so that they take preventive measures against major killers like tuberculosis, AIDS, diabetes and hepatic disorders. Raising nutritional awareness among people, free distribution of nutritious food and medicinal supplements to school children, housewives and workers should also be among the objectives.