MISMANAGEMENT and corruption in the public health system proved fatal again as a cardiac patient died while being stuck inside a malfunctioning lift at the Shaheed Tajuddin Ahmad Medical College Hospital in Gazipur on May 13. The attendants of the deceased said that their relative, a 50-year old female cardiac patient, died allegedly by suffocation after being stuck in a lift as the hospital authorities failed to respond to an emergency situation within their premises. Not only have the authorities failed to respond, but the attendants allege that the hospital staff hurled verbal abuse at them when they sought help and repeatedly pleaded to rescue them from the situation. After about 40 minutes, it was the fire service department that responded to their call through the national emergency centre. The district administration has initiated a probe and asked the additional district magistrate concerned to submit a report at the earliest. This is, however, not the first incident of reckless management at the hospital. On May 4, another patient died after accidentally falling through the gap between the floor and walls on the 11th floor of the hospital building. Recurring incidents of tragic deaths of patients at public hospitals owing to mismanagement demonstrate that the health service providers lack regard for the ethics of care.
Reported mismanagement and corruption in the health sector are cases of regulatory oversight. Patients and their attendants have long talked about the declining quality of services and the harassment at public health facilities while seeking care and treatment, but the system continues to remain unfriendly towards the patients. Patients from across the country reported the disturbing presence of unscrupulous ambulance service providers, compelling patients鈥� families to hire them at an unreasonable cost. Some patients alleged that the hospital authorities are at times intentionally negligent in repairing diagnostic equipment as they have direct or indirect monetary interest in private sector facilities and subsidised hospital services affect their business. Diagnostic facilities pay between 20 and 40 per cent commissions to doctors who refer patients for medical tests, many doctors even compel patients to go to substandard diagnostic centres and prescribe unnecessary tests for higher commission. Similarly, patients are often asked to pay for services or medicines that are supposed to be provided for free or at a subsidised rate. Meanwhile, there are barely any oversight mechanisms to monitor the quality of care at private sector health facilities.聽
It is clearly evident from the death of the cardiac patient who allegedly suffocated after being stuck in a lift that the lack of regulatory steps in the public health sector affected all aspects of patient care. The government must, under the circumstances, immediately revisit its public health services policy and enhance its oversight mechanism. The ministry of health, in consultation with stakeholders, must develop a guideline for the management of public hospitals, a guideline that would consider the ethics of care with the highest regard.
