Private-sector medical and diagnostic facilities in Bangladesh run with no proper guideline. In the absence of monitoring, they compromise medical ethics for profiteering motive. Medical negligence in these facilities have become more common. In the latest such incident, two-year-old Raifa Khan died because of medical negligence at Max Hospital in Chittagong. Private-sector hospitals and diagnostic centres are also known for arbitrarily charging high fees for services. Deviating from the government approved chart for medical services, private hospitals and clinics usually charge between Tk 15,000 and Tk 30,000 for a minor surgery like appendectomy or delivery while reputed hospitals charge about Tk 125,000 for a minor operation and about Tk 5,00,000 for a major operation like bypass heart surgery. In this context, the Human Rights Lawyers and Securing Environment Society of Bangladesh filed a writ petition with the High Court seeking its intervention to bring private-sector medical and diagnostic facilities under the monitoring purview of the government. In what follows, the High Court ruling to have private hospitals, clinics and diagnostic centres to display price charts of medical services in public view within 15 days is a welcome move.
For nearly two decades, successive governments have allowed private-sector medical facilities to run at their will. The government even amended the Medical Practice and Private Clinics and Laboratories (Regulation) Ordinance 1982 to ensure their profiteering interest. It is now not mandatory to obtain a licence for the establishment of a private hospital, clinic or a diagnostic centre. The price chart for medical services has not been revised since 1982. Besides, the public health administrators are yet to upgrade medical facilities, such as opening intensive care unit, in public hospitals in divisional and district headquarters. On every occasion, when the government takes action against errant private hospitals, the community of doctors foils the effort with a strike compromising their medical ethics and risking patients’ lives. On July 8, owners of private hospitals and clinics in Chittagong began an indefinite strike after a mobile court jailed owners of several private hospitals and fined hospitals on finding medicines and instrument with expired dates in their operation theatres. In this situation, the High Court directive for the government to constitute an experts committee within 60 days to frame the rules for regulating private medical establishments such as hospitals, clinics and diagnostic centres, promises a radical change in the health sector, if implemented judiciously.
It is evident that the government has created a situation in which the private sector has more control over health services and the existing regulatory mechanism has failed the patients. The out-of-pocket public health expenditure in Bangladesh is higher than any other South Asian countries. At least 477 patients died allegedly because of medical negligence in eight years till 2016 while the Bangladesh Medical and Dental Council punished only three doctors with suspension of registration on such charges in the past 38 years. For the government to prove its commitment to public health, it must implement the High Court directive judiciously.
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