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The preparation for launching a pilot project on specialist doctors’ chambers in selected government hospitals across the country is still on the discussion table, although the health authorities have only 14 days in hand to meet the deadline. The health authorities have expressed their firm desire to launch the pilot project on time, but the list of the selected hospitals and the selection policy are yet to be confirmed even two weeks before the deadline.
Welcoming the initiative, experts said that to make it successful, a lot has to be built centering the system to ensure a sustainable environment for the betterment of the patients, especially for the poor.
It won’t be realistic if they want to turn the page in a second rather they will need to have a definite policy for administrative and financial management in this regard, they opined.
On January 22, Health and Family Welfare Minister Zahid Maleque informed the media that they were going to allow specialist doctors in the country’s government hospitals for private practice inside their respective institutions from March 1.
At the briefing, he mentioned that the project would initially be started in five medical college hospitals and district and upazila hospitals in 20 districts.
Dr Sheikh Daud Adnan, director in-charge (hospitals and clinics unit) of DGHS, told the Business Post that they did not receive any guideline for selecting the hospitals.
Eminent neurologist Prof Dr Quazi Deen Mohammed, one of the members of the committee formed to determine the policy to initiate the pilot project, said that specialist doctors’ chambers in government hospitals must be opened on March 1.
Asked about the selection of hospitals or the formulation of guidelines, he said that these are on the discussion table till now but all issues must be settled within this month.
Prof Dr Deen Mohammed said that some proposals are on the table about physicians’ routine--if it is a rotation basis or duty in the hospitals once in a week, about the fees and so on.
Md Saidur Rahman, the chief of the committee and also additional secretary (administration) of the ministry’s health service division, could not be reached over cellphone for his comments in this regard.
BSMMU, BIRDEM already adopted the strategy
Former Vice-Chancellor (VC) of Bangabandhu Sheikh Mujib Medical University (BSMMU) Prof Dr Pran Gopal Datta introduced institutional practices during his tenure (2009 to 2015) that benefited the patients much.
BSMMU sources said that when it was introduced, most of the physicians of the medical university opposed it, but firm stance of the VC made it happen.
The fee is fixed at Tk200 for each visit and 66% of fees are for the physicians.
Later, Birdem also introduced it.
However, BSMMU started a specialised consultation centre on December 22 last year.
BSMMU is approaching in three ways depending on time and categories of patients. For the poor people, the ticket is only Tk30, said BSMMU VC Prof Dr Md Sharfuddin Ahmed.
In the morning (three-hour time), the patients have to pay Tk800 for professor, Tk500 for associate professor and Tk300 for assistant professor, he added. Again if anyone wants to visit the physicians in the afternoon, they have to pay Tk1,000 for professor, Tk700 for associate professor and Tk500 for assistant professor.
A lot has to be done before starting the project
Former Bangladesh Medical Association president Dr Rashid-e-Mahbub, also public health expert and chairman of the Bangladesh Health Rights Movement, welcomed the initiative but expressed doubt over finding a realistic approach for it.
When the health authorities lack manpower, the main challenge is to make it sustainable, he added.
Meanwhile, BSMMU has submitted a draft policy to the ministry in this regard where they said that to ensure sustainability for the project to ensure required manpower, opening of labs, and a policy to determine the inclusion and spend of the earned money by any institution have to be determined, said a member of the committee.
Prof Dr Sharfuddin, also president of the committee, said that the government can use the model they are following right now.
“But financial management would be the major problem. Collecting revenue, its depository section, expenditure module, required experts in every selected entity -- all are connected with the process.”
“It would be best if the medical college is made autonomous,” he opined.
When asked, the professor spoke against stopping private practices to allow private practice in the government hospitals terming it as unrealistic.
Rather he emphasised on having six specialists in the hospitals so that they can give one of his days solely for the hospital.
DGHS hospitals unit director in-charge Dr Adnan said that if the project is implemented, machinery they have given to the hospitals would use more. Poor people will get more services.
“We have taken our primary preparations so that we can start the piloting within a shortest possible time,”
he added.
