The health minister’s written order discontinuing the distribution of “user fees” among the government hospital employees has given rise to new conflict.
Patients are treated for free in public hospitals but they need to pay user fees for diagnostic facilities.
According to existing arrangements, half of the money collected as fees is given to the exchequer, and the remainder is to be disbursed among para-clinical staff – lab technicians and employees who conduct the tests.
However, the doctors, officials and employees of other departments, not directly involved with running the tests, have been reportedly demanding a share of the fees. They say the existing arrangement is discriminatory.
Following a High Court order, the system of sharing user fees was suspended for two years, sources say. Over that period of time, the entire amount collected, which was about Tk2bn, went to the government exchequer.
On October 10, 2012, following a Civil Leave to Appeal Petition filed by health ministry officials, higher courts issued an interim order for the release of the amount collected as user fees over the last two years.
After the court order, the health ministry raised the money, which, sources said was more than Tk1bn.
In May this year, the Dhaka Tribune ran a story in which sources were quoted as saying the process of distributing the Tk1bn among the doctors and staff of public hospitals was nearly complete.
Sources said being a doctor himself, Health Minister AFM Ruhul Haque wanted the doctors to benefit from the user fee sharing process as well.
However, there are allegations that tens of millions of Takas have been hurriedly disbursed among only the para-clinical staff in a number of government hospitals, without the health minister knowing about it.
These hospitals include the National Institute of Traumatology and Orthopedic Rehabilitation, the National Institute of Cancer Research, and Shahid Suhrawardy Hospital in the capital; the Sylhet Osmani Medical College Hospital and a number of other district and upazila level healthcare centres around the country.
When the clinical staff of these hospitals complained about the matter, the health minister on July 14 issued a written order stopping the disbursement process.
Sources said Tk103.8m, Tk25.8m and Tk20m, meant to be disbursed among the staff of Dhaka Medical College Hospital (DMCH), the National Institute of Cardiovascular Diseases and Mitford Hospital respectively, were sent back to the banks.
DMCH Director Brig Gen Mostafizur Rahman admitted to this correspondent that he had halted the process of disbursing the money after receiving verbal orders from the health minister.
The situation has reportedly resulted in a standoff between the clinical and the para-clinical staff of many government hospitals. The two groups have threatened to go for elongated periods of strike if their demands were not met.
An employee of the para-clinical division of a government hospital told this correspondent that the clinical staff, who have never bothered about the user fee, started doing so because a lot of money was collected recently since the number of diagnostic tests had increased.
The employees also criticised the health minister for saying he did not know about the money being hurriedly disbursed among the para-clinical staff and demanded that the money be distributed among them in line with the existing arrangements.
Dr Noman Chowdhury from the Radiology and Imaging Department of the DMCH said the clinical staff of the government hospitals must wait until there were new regulations.
Investigations revealed that there is no definitive policy regarding the sharing of user fees. The user fee practice has been in place for 26 years, following a written order issued by the Ministry of Health in 1984, during the tenure of the Ershad government.
After coming to power in 2010, the current government increased the amount charged as user fees, and decided to formulate a regulation to share half of the amount collected with doctors and staff of the hospitals, which, however, has never been implemented.
