The Financial Express

Where licences mean nothing

Evaly and Fianancial Express Evaly and Fianancial Express
Where licences mean nothing

The coronavirus has wreaked havoc, as elsewhere in the world, on life and livelihood in Bangladesh. The deadly pathogen until November 28 last claimed more than 6,500 human lives and infected 0.46 million people. The economic cost was also substantial as millions were rendered jobless. 

The virus, however, has done one good thing---it has exposed the weaknesses of the country's health system. Most people were aware of the flaws. But the pandemic brought to the fore the issues of inadequate allocation for the health sector, administrative weaknesses and lack of preparedness to face any health emergency such as the ongoing one. The health authorities proved to be inept and insensitive even in the matters of executing many projects and programmes planned to deal with the Covid-19. 

When the pandemic was at its peak, the Regent Hospital Scam rocked the entire health sector. A surprise raid conducted by a mobile court, headed by a magistrate, unearthed that the Regent Hospital, which was authorised by the directorate general of health services (DGHS) to carry out Covid tests, had no valid licence. Investigations revealed that the hospital had distributed certificates to a large number of people without doing corona tests.

The incident had caught the health authorities off guard. They came under intense criticism from all quarters. Before that, the health officials had been under attack as allegation after allegation surfaced over procurement of face masks, personal protection equipment (PPE) etc. The Regent incident only added fuel to the fire.

As happened in most cases in this part of the world, the health ministry embarked on a damage-control mission and asked the DGHS to streamline the situation as far as hospital licences are concerned. The Ministry of Health also issued an order in July last asking the private hospitals and clinics to procure new licences or get the existing ones renewed by August 23 last. But allegations are there that many health facilities submitted applications online for new licences or renewal even after that deadline.

The number of private hospitals, clinics and diagnostic centres in the country is nearly 12,000. Out of that number, more than 9,000 have applied for new licences or renewal of the same.

It does appear that the health authorities are now willing to make the operations of private health facilities legal within the shortest possible time. But, it is pertinent to raise a question: Is the DGHS overlooking many urgent issues while trying to correct its past mistakes?

Before giving new licences or renewing the old ones, it is essential to make on-the-spot physical verification of manpower and logistics as mentioned in the application forms by the relevant private health facilities. And such verification needs to be sudden, beyond the knowledge of the owners of those facilities.

It is beyond doubt that the relevant government authorities have been indifferent to the need for checking the licences of thousands of private health facilities that have mushroomed over the years. The presence of so many private-sector health facilities without valid licences remains a testimony to that fact.

It is hard to believe that these facilities have been operating without reaching any underhand deals with the health officials concerned. There must have been an arrangement in place between the two parties.

Even availability of the valid licences is unlikely to change the situation on the ground. The private hospitals, clinics and diagnostic centres do usually charge fees much higher than the state-owned ones for the services they offer to patients.

Barring a few large hospitals, most private health facilities do not have enough experienced manpower, medical equipment and logistics. On-the-spot verifications, in all probability, would detect a gross mismatch between the claims made in licence application forms and what is available with these health facilities. 

It is alleged that financial irregularities in the government health offices are rampant and there have been no serious efforts to contain those. However, it is easier said than done. When corruption turns out to be systemic, containing corruption in isolation remains a difficult job. Yet there should be sufficient measures to curb irregularities.

There is no denying that the country's health sector has expanded to a great extent during the last four decades. The pace of expansion has picked up in recent years.

What remains essential here is the matching expansion of the supervisory and controlling capacity of the relevant government health institutions. It is important to make regular supervision and inspection of health facilities, both private and public, to help them operate efficiently.

Unfortunately, the capacity of the DGHS in areas of inspection and supervision has remained almost unchanged. While allocating more resources for the health sector, the government must expand its supervisory and controlling capacity. It is also essential to raise the supervisory capacity at the district level. 


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