Most of the privately run hospitals and diagnostic centres in Bangladesh are plagued by commission-based medical services and the profits are enjoyed by doctors and middlemen, among others, says the Transparency International Bangladesh (TIB).
To fend off such unethical practice and irregularities in the private healthcare sector, TIB on Wednesday recommended forming an independent commission.
The graft watchdog’s Executive Director Iftekharuzzaman came up with the recommendations based on the findings of the organization's latest survey on private healthcare, its challenges and ways of overcoming them at a press conference at TIB office in Dhaka’s Dhanmondi.
The survey was conducted last year on the operations of 116 privately run organizations – 66 hospitals and 50 diagnostic centres – around the country.
Disclosing the findings, Iftekharuzzaman said these hospitals and diagnostic centres were marred by unethical profiteering and prioritizing commission-based care as they were operating unsupervised.
To check the irregularities in private healthcare, the government should form an autonomous ‘Private Health Commission’, he said.
TIB in its study said those involved with various levels of commission include doctors of public and private hospitals, medical assistants, family planning workers, rural doctors, drug sellers of pharmacies, receptionists of private hospitals, rickshaw pullers and middlemen.
These people take 25% to 50% of commission from service recipients. Commission ranging from Tk500 to Tk5,000 is given for a caeserian section, for example.
TIB said the victims brought allegations against middlemen who send them to private clinics. These incidents happen mostly to those who come to the city from rural areas.
According to the report, the ordinance titled 'Medical practice and private clinics and laboratories (regulation)' was not upgraded since it was adopted in 1982. No rules and regulations of the ordinance have been formulated either. TIB attributed lack of coordination among stakeholders, conflict of interest and lack of political goodwill as the main reasons for the ordinance not passing as a law.
The findings also identified lack of transparency in registration and renewal of registration of private clinics. Allegations are that more tests are prescribed than required, sub-standard and expired reagents are routinely used, signatures of specialist doctors are put on prescriptions in advance and later the patients are assessed by technicians. There are also allegations against some diagnostic centres that they prepare reports without conducting tests. This practice is called bucket test.
TIB Deputy Program Manager Md Julkarnaine said in the bucket test case, samples are collected from patients. Later they are handed reports without conducting any test and the samples are thrown into buckets. That's why the test is dubbed as bucket test.
Based on their findings, TIB came up with 16 recommendations. Three of them are related to rules and regulations, 10 for authorities while the rest are related to services.
This article was first published on banglatribune.com