AS THE government discusses the reform strategy for the health sector, it should take into account findings of the Bureau of Statistics survey on public health services that reflect people鈥檚 demands and expectations. The survey report published on March 20 says that more than 90 per cent of the people have urged the government to contain extremely high prices of health services, including medicine, physician鈥檚 visit costs and diagnostic charges. People have asked for fixed retail prices for all health services, medicines and medical accessories. The demands are more than justified when there is barely any stability in the drug market. The Directorate General of Drug Administration sets prices of 117 essential medicines while prices of all other drugs are determined based on proposals of manufacturers. A recent market analysis shows that prices of drugs greatly vary. The Bangladesh Association of Pharmaceutical Industries tries to justify the price difference, saying that the quality of drugs is different for different companies, yet substandard drugs flood the market, risking public health. The health reform should implement a price ceiling mechanism for drugs and also put in place an effective quality control mechanism for pharmaceutical industries.
The health services reform survey also reports a dependence on the private sector and talks about an effective decentralisation of health infrastructure. In Barishal, Chattogram and Dhaka, people are mostly dependent on private health facilities. Mismanagement, corruption and inadequate number of beds and physicians often compel people to seek health care from private facilities. There is approximately one hospital bed for every 990 patients.聽This translates to聽0.96 beds per 1,000 people, which is significantly lower than the World Health Organisation鈥檚 recommendation. In district hospitals, many emergency facilities, especially dealing with non-communicable diseases, are absent. The treatment of the chronic diseases requires more resources than what is available with upazila health complexes. In the absence of such services, those who can afford seek services from private hospitals and people in poverty are left with no option but to suffer. At the moment, to establish private hospitals, clinics or diagnostic centres, it is not mandatory to obtain a licence. The price chart for medical services has not been recently revised. It is evident that the government has created a situation in which the private sector has more control over health services and the regulatory mechanism has failed the patients.
It is promising that the interim government has set up a commission to suggest reforms for the health sector. The commission, considering the findings of the survey, should prioritise a price ceiling and quality control mechanism for pharmaceutical industries as a reform agenda.
