The comptroller and auditor general has detected financial anomalies worth around Tk 239 crore in an audit of the Bangabandhu Sheikh Mujib Medical University in 2020–21.
The anomalies were detected in eight areas, including highest Tk 116 crore for not realisation of users’ fees, Tk 80 crore for not transferring fund to the authorised recipient, and Tk 37 lakh for not conducting the research work despite advance payments were made for 16 researches, in the country’s premier institution for postgraduate medical studies cum medical care.
The financial anomalies also include irregularities worth around Tk 27 crore in realising extra fees and purchasing reagents at higher than ceiling prices.
The health audit directorate of the comptroller and auditor general did the audit.
The actions recommended in audit reports are hardly implemented in time, remarked former comptroller and auditor general Mohammad Muslim Chowdhury.
Blaming the bureaucratic exercises for the delay, he said that audit reports in the United Kingdom must be made public within one month of their submission to the government.
The report on Bangabandhu Sheikh Mujib Medical University that was made public by the comptroller and auditor general in the past month was submitted to the country’s president four months ago with recommendations of departmental actions and realisation of funds.
The public health sector regularly attracts criticism for corruption in procurement, wastage of medical equipment, and bribes in appointments—all leading to poor service delivery while pushing up the out-of-pocket health expenditure.
The out-of-pocket expenditure in Bangladesh’s healthcare sector reached Tk 68.5 for every Tk 100 spent on health in 2020, up from Tk 67 five years earlier.
Escalating expenditures push more people into poverty as revealed in a study report by the Bangladesh Institute of Development Studies released on July 15 that said 61,30,000 people slipped into poverty in 2022due to high treatment cost.
The public auditors also found that the healthcare service of the medical university made a neat profit worth Tk 323 crore generated from users’ fees between 2007 and 2020.
Of the profit, Tk 203 crore was disbursed to the physicians and technicians as commission from profit.
But the amount should have been Tk 87 crore at the rate of 30 per commission on overall incomes after deduction of 10 per cent tax.
But the university authorities calculated the commission on profits instead of overall income that yielded the commission for its staff at a far greater amount, according to the audit report.
The university authorities in its response to this particular finding wrote to the auditor general that they were realising the extra commission money from the staff who sought retirement. The auditors found this response unacceptable and recommended for departmental actions.
Dhaka University health economics institute professor Syed Abdul Hamid blamed the situation on a lack of experience of physicians in running the hospital administration.
Inexperience compelled them to rely mostly on the clerks and other low-ranking staff that many times led them to face financial irregularities, he said.   Â
The government has constructed a Super Specialised Hospital under the Bangabandhu Sheikh Mujib Medical University to further enhance its capacity.
But the auditor general’s report said that the institution had lagged behind in research activities.
It found that 16 researchers took Tk 38 lak in advance to conduct research on different issues but failed to submit any reports in the next 20 months from August 2020, which is a violation of the Bangabandhu Sheikh Mujib Medical University Act 1998.
Health economist Syed Abdul Hamid, however, said that the research culture in the country was still in a nascent stage.
Such audit objections will further discourage research, he said, adding that research activities should not be tightly tied to the conditions of financial audits.
The research topics were mostly related to the pandemic caused by Corona virus, according to the audit report.
Maximum Tk 6 lakh was allocated for research titled ‘Convalescent plasma transfusion therapy in severe Covid-19 patients—a tolerability, efficacy and dose response phase II RCT’, and minimum Tk 60,000 was allocated for ‘Remote consultation with cell phone in reproductive endocrinology and infertility: pushing telemedicine into mainstream healthcare during coronavirus pandemic and lockdown’. Another Tk 60,000 was also allocated for a research titled ‘Evaluation of comprehensive training course to prepare health professionals for dealing with Covid-19.’  Â
