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The Financial Express

Business as usual in health sector spending


Business as usual in health sector spending

Since the deadly virus started taking its toll on life and living in the country in March last year, deficiencies of all sorts in the health sector were exposed. Many blamed the government for allocating funds far below the requirement for the sector.

The lack of preparedness on the part of relevant authorities in handling any major health emergency came to the fore. No country was ready for a widespread outbreak of a virus-induced disease like Covid-19. Even many developed and resourceful countries at the initial stage faced a serious problem in handling this highly contagious disease. So, it was not unusual for a country like Bangladesh to encounter serious problems.

As the first wave of the pandemic gradually peaked and then subsided in 2020, men in authority spoke about plans and programmes to create capacity at all levels to face health emergencies. Multilateral donor agencies disbursed a substantial volume of the fund and promised to make available more to help expand the physical infrastructures and improve relevant other facilities in the country.

The government unveiled a well-knit plan to equip the government hospitals at the district headquarters to handle Covid-patients. The facilities included the installation of ICU beds and a centralised oxygen supply system. It also allocated funds for upazila health complexes to improve service facilities necessary for Covid patients.

That things have not moved according to the government plans is very much clear from the situation now prevailing in many districts, particularly the ones closest to the border with India.

Failing to get treatment in district hospitals, Covid patients in their hundreds are now crowding the government medical college hospitals in Rajshahi, Khulna and Rangpur. Because of their limited capacity, these hospitals have been forced to accommodate patients on the floor. Critical patients are not getting ICU beds and there is a short supply of high-flow oxygen.

As the second wave of the viral infection is raging in at least 36 districts, a piece of news published in a leading vernacular daily in its June 19 issue must have shocked many. The news story unveils the fact that many upazila health complexes did not even spend a penny from an urgent allocation of Tk 300,000, made available to them in April last year, to improve services and buy the equipment necessary to treat Covid patients. Some health complexes spent a part of it. The unspent funds are now going back to the government exchequer. Interestingly, the upazila health complexes have received a similar allocation in the budget for the outgoing financial year (FY). Officials of some health complexes reportedly did not spend money to avoid unnecessary hassles.

The district hospitals would not have faced so much of a rush had the UZ health complexes equipped themselves minimally to handle Covid patients.

The progress in installing ICU beds and centralised oxygen facilities in district hospitals, reportedly, also has been slow.

When in an emergency, money allocated for improving essential facilities goes unspent, what is the use of making higher allocation for the health sector?

The allocation for the health sector in the budget in Bangladesh has been one of the lowest in the region. People are made to spend over 60 per cent of their health-related expenses out of their pocket.

One cannot but feel disappointed if the ministry of health and the entities under its control cannot spend even an insufficient allocation or to make things worse allow irregularities involving it.

As far as inefficiency in using resources is concerned, the health ministry remains at the top of the list. Even the planning minister on some occasions has expressed his frustration over the low utilisation of funds by the health sector organisations.

The top notches at the ministry concerned, however, are very sensitive to criticisms. Their reaction to a recent report published by Transparency International, Bangladesh (TIB) bears testimony to that fact. The incident involving the daily Prothom Alo reporter Rozina Islam could be yet another example of such sensitivity.

Irregularities involving the procurement of medical equipment, drugs and medicines and other goods for hospitals and other health facilities have been rampant. What has come out in the press from time to time, many tend to believe, is only the tip of the iceberg.

The question is: What is the outcome of public or media scrutiny of the activities of the health ministry or units under its control? Has there been any noticeable improvement in their operations?

The answer is a big 'no'. There are reasons to believe that the relevant entities are not in a mood to take such scrutiny into cognizance. It is not fair to blame the health ministry singularly. What has been done so far in the name of so-called lockdown or restrictions is no less frustrating. The burden on the health ministry would have been less had the actions on the administrative front to contain the spread of the disease been implemented seriously. 

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