Public hospital staff, including doctors, are said to be trying to fill their pockets by getting their hands on a Tk1bn fund, collected as “user fees”, from the exchequer.
Sources said the system of sharing “user fees”with public hospital staff was suspended for two years following a High Court (HC) order.
Patients are treated for free in public hospitals but pay to use diagnostic facilities. According to arrangements for the sharing of the fees, half the amount is allocated to the exchequer, and the remainder is to be disbursed among hospital staff and doctors.
According to sources because of the HC order, the entire amount collected as “user fees” over the last two years, estimated to be around Tk2bn, went to the exchequer.Theysaid a process of distributing Tk1bnamong doctors and staff of public hospitals was nearly complete.
After coming to power in 2010, the current government increased the amount charged as “user fees”, and decided to share half the amount collected with doctors and staff of the hospitals.
Following the publication of several news reports on the issue, the president of Human Rights and Peace for Bangladesh Monjil Morshed filed a writ petition with the HC to secure a ban on the government’s decision.
The ban remained till last year when the HC issued a stay order on it following an appeal by the Secretary of Health (Civil Petition for Leave to Appeal 2616).
Investigations revealed there are no definitive policies outlinedwith regard to sharing of “user fees”. The practicecontinued for 26 years following a written order issued by the Ministry of Health in 1984, during the tenure of the Ershad government.
The Ministry of Finance however complained every year about discrepancies found in audits due to the practice, because there is no policy pertaining to it.
The finance ministry isreportedly planning to award an “economic code”to validate raising money from the government exchequer ’s fund for this purpose.
This raised health rights activists’ suspicionsthat there could be huge amounts illegally transacted for the issuance of the “economic code”.
There are also allegations about Dr Noman Chowdhury, associated with the ruling party backed doctors’ association Swadhinata Chikitsak Parishad (Swachip), has been using his influences to releaseTk1bn from the government.
Dr Chowdhury, an assistant professor of the Department of Radiology and Imaging at the Dhaka Medical College Hospital (DMCH), is alleged to have charged 3% commission toensure the funds’ release.
The Swachip leader, however, denied all allegations and said clinicians were spreading propaganda about him because generally they did not get a share of the “user fees”.
Dr Chowdhury said he was trying to get the fund released because it was the right of public hospital doctors and staff, and said he was ready to pay 10% commission to officials of the Office of the Comptroller and Auditor General of Bangladeshto get what is their right.
There are also allegations against the Auditor General’s office about not releasing any fund without commissions.
Dr Rashid-e-Mahbub, president of the Health Rights Movement National Committee, said the manner in which the money was received and spent was “totally inappropriate.”
He said most patients who go to public hospitals are poor and spend their hard-earned money for diagnostic tests. He also suggested that rather than sharing the money raised with doctors and staff, it should be spent onthe overall development of the public health sector so that it could benefit the common people.
Reportedly, onlyfew departments, namely radiology and imaging, radiotherapy, pathology, biochemistry, blood transfusion, are directly involved with diagnostic tests in public hospitals.
Sources saidwhile doctors and staff of these departments were delighted at the possibility of receiving their share of the fund, the departments not involved with tests, were very dissatisfied because they would not get any share of the money.
They said they too should get a share of the money raised because they also contribute towardsthe treatment of patients in public hospitals.
They claimed the current government formulated a draft policy soon after assuming power enabling all employees to get a share of the fund raised from user fees but it never saw the light ofday.
Although an exact estimate of theamount that is due on all user fees is difficult to make, somereputed hospitals reportedly owe large sums to the government.
Director (finance) of the Health Department Dr SayedurRahman said the department earns around Tk1.25bn every year from organisations it runs across the country. “But I can’t immediately say how much of that amount consists of user fees,” he said.
