Health and Family Welfare Minister Samanta Lal Sen has vowed to crack down on illegal hospitals and clinics in Bangladesh, aiming to eradicate corruption in the healthcare sector.

"I have made it clear that there will be no tolerance for corruption. Unauthorized and unlicensed medical facilities cannot be allowed to operate. While it’s not possible to resolve this overnight, these illegal clinics and hospitals must be shut down. Measures will be taken against them," he stated on Tuesday (January 16).

The Medical and Private Clinics and Laboratories Ordinance, 1982, prohibits hospitals, clinics, or diagnostic centers from operating without the approval of the health directorate. However, recent shocking incidents shed light on the irregularities of unauthorized hospitals and a lack of compliance with existing regulations.

In one such incident, a five-year-old child passed away on December 31, 2023, following a circumcision procedure at United Medical College Hospital in the capital’s Badda. The health directorate later shut down the medical college for operating illegally.

This unfortunate case is not isolated, as unexpected casualties and mismanagement in private hospitals continue to make headlines, despite government efforts.

A comprehensive nationwide survey conducted by the health directorate last year uncovered 11,940 hospitals, clinics, and diagnostic centers operating illegally. Among them, 2,916 had not applied for a license, while others were operating without approval or with expired licenses.

In response, the health directorate conducted raids, closing around 2,500 unlicensed facilities and imposing fines on various clinics. However, the owners of unauthorized healthcare facilities often reopen these banned or closed hospitals without adhering to proper regulations.

Experts argue that this lenient attitude allows owners of illegal private healthcare facilities to jeopardize public health.

According to research by the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), approximately 14% of private hospitals in Bangladesh have never filed for registration due to challenges in the licensing process.

Private Healthcare: A Look at the Issues

Once celebrated for advanced technology and service capabilities, private hospitals and diagnostic centers in Bangladesh have deviated from their commitment to service, plunging into chaos, as revealed by a recent Transparency International Bangladesh (TIB) survey.

The survey exposes profit-driven practices in private hospitals, emphasizing a "commission-based marketing mechanism" where referrals are exchanged for commissions, benefitting physicians, facility owners, and middlemen at the expense of patients.

Unfortunately, these profit-driven motives have infiltrated public hospitals, despite being state-funded. The strained public sector, facing shortages in staff, resources, and bureaucratic obstacles, hinders easy access to medical services, resulting in corruption and mismanagement in the service delivery process.

Access to healthcare, a basic human right, is compromised as fees soar, costs remain unregulated, and treatment quality declines. Private healthcare, utilized by 63.3% of households across 15,698 facilities, has become pivotal, influencing not only dependent patients but also policymakers handling the nation's growing health demands.

While the private sector was introduced to alleviate pressure on public hospitals and foster innovation, recent scrutiny reveals a disregard for medical ethics in pursuit of profit. Striking a balance between profit-making and essential medical care is crucial, emphasizing the need for systemic improvements and ethical practices.

TIB Executive Director Dr. Iftekharuzzaman highlights the challenge, stating, "The booming private healthcare sector has helped more people have access to medical services, but those who are involved in the private healthcare services are trying to turn the facilities into business outlets," emphasizing the importance of maintaining basic standards.

 

Regulation and law enforcement alone cannot solve the issues at hand. A comprehensive solution is required, involving ethical practices, enhanced monitoring and regulation, and the removal of barriers to a people-centric health service.

Navigating Bangladesh's Healthcare Crisis: A Call for Ethical Practices

The healthcare sector in Bangladesh faces a crisis marked by excessive fees, unregulated costs, subpar treatment, and a shortage of trained professionals. The profit-driven health facilities, once celebrated for their capabilities, are now synonymous with skyrocketing fees and ethical concerns.

Enhanced regulation and law enforcement can alleviate some issues, but expecting regulation alone to solve everything is unrealistic. A balanced approach, combining stringent oversight with systemic improvements, is necessary for lasting change and improved healthcare services.

Ethical considerations play a crucial role in referrals, where a doctor's responsibility to guide patients to the right specialists, hospitals, and treatments is essential. While legalities might permit certain practices, ethical guidelines, such as the Hippocratic Oath, should guide decision-making.

Issues like the scarcity of skilled staff and high equipment import costs aren't solely the private sector's responsibility. Addressing these requires a comprehensive solution—promoting ethical practices, enhancing monitoring and regulation, and eliminating barriers to a people-centric health service.