Health sector scams: Who is at fault?

Health ministry and health directorate logos
Health ministry and health directorate logos

As one scandal unfolds after the other in the health sector, the health ministry and health directorate embroil in a mud-slinging blame game. Neither the ministry nor the directorate wants to take the blame for granting permission to dubious hospitals and fake institutes to carry out coronavirus sample testing. Meanwhile, the common people suffer due to these discrepancies. The Regent Hospital scam followed fast on the heels of the JKG scandal, revealing the incompetence and failure of the health ministry and the health directorate.

The health sector is submerged in disorder and irregularities. After the misdeeds of Regent Hospital came to the limelight, questions were raised as to how it had been given the responsibility of such sensitive tests. Who is to blame?

Police on Sunday arrested the chairman of JKG Health Care, Sabrina Arif, who is also a physician at a government hospital, on charges of fraud. Prior to that, on 6 July, Regent Hospital was sealed off on charges of cheating people in the name of medical treatment. Police are searching for the hospital’s chairman Md Shahed alias Shahed Karim. Home minister Asaduzzaman said that there was no chance for him to escape from the country.

In the meantime, the Directorate General of Health Services (DGHS) on Sunday cancelled the permission granted to 5 institutions for coronavirus testing. These are Care Medical College Hospital, Shahabuddin Medical College Hospital, Stems Health Care, Thyrocare Diagnostic, and Chattogram’s Epic Health Care. Additional director general of DGHS Nasima Sultana said though these hospitals and diagnostic centres had been granted permission to carry out tests, they had failed to begin the task so far.

The health sector is submerged in disorder and irregularities. After the misdeeds of Regent Hospital, which had no licence, came to the limelight, questions were raised as to how it had been given the responsibility of such sensitive tests. Who is to blame?

On Saturday, DGHS came up with an explanation. It said that the MOU with Regent Hospital was signed at the directives of higher authorities in the health ministry. This explanation infuriated the health ministry and on Sunday a show-cause notice was issued against the director general of the health directorate. The ministry asked what he meant by ‘higher authorities’ of the ministry and also what factors were taken into consideration before signing the MOU.

Several officials of the health ministry have told Prothom Alo that the ministry has no control over the health directorate. They claim that though DGHS is placed under the health ministry, it is located at a distance, in Mohakhali of the capital city. The ministry officials do not watch over who the directorate is signing agreements with, from whom it is taking money and what work it is doing. So the directorate has to take responsibility for any irregularities there. They claim that the ministry did not give any directives regarding private hospitals to treat coronavirus patients.

Secretary of the health services division, Md Abdul Mannan, told Prothom Alo that a show cause notice had been served on the DGHS DG for blaming the ministry. The secretary said, “The minister said that the ministry knows nothing about the matter and received no letter in this regard.”

However, the DG DGHS Abul Kalam Azad, speaking to Prothom Alo, said, “The ministry has asked for an explanation and I shall certainly provide one. No one is above accountability. I certainly believe my director. I have not committed any fault. Another thing is, not everything is in writing. Many things are carried out on verbal directives. Even so, I have proof and I will produce that.”

Sources in DGHS have said that in a file note given by the directorate’s director (hospitals and clinics) Aminul Hasan to the DG, it is clearly stated who issued the orders. This note went to the additional director general (ADG). There are even photographs of who were present when the MOU was signed. It is not right that only the directorate signed the agreement and the ministry had nothing to do with it, he said.

The health directorate cannot do any major work without permission of the ministry. It is not possible. But there is still scope for them to work in coordination in the interests of the people.

Rashid-e-Mahbub, former president, BMA

Certain measures of the health ministry and the health directorate had created confusion and controversy in the past too. In a directive of DGHS on 25 March, it was said that if anyone appeared to have COVID-19 symptoms, a physician would treat him initially and if necessary would refer him to a second physician in personal protective equipment (PPE) and he would treat the patient wearing PPE. The order was later withdrawn following criticism.

On the same day, the health ministry issued an notice saying that anyone denied medical treatment should inform the army check-post or the office-in-charge (OC) of the police station. In response, the BCS health cadre association threatened to resign en masse. That order was withdrawn too. This brought to notice the lack of coordination in the ministry. The secretary of the ministry’s health services department at the time, Asadul Islam, had said that the order had been issued without his knowledge.

Former president of the Bangladesh Medical Association (BMA), Rashid-e-Mahbub, told Prothom Alo that there was a lack of coordination between the ministry and the directorate from the very beginning. He said their blame game left no room for team work and, as a result, the general patients suffered.

He said, “The health directorate cannot do any major work without permission of the ministry. It is not possible. But there is still scope for them to work in coordination in the interests of the people.”

* This report appeared in the print and online edition of Prothom Alo and has been rewritten in English by Ayesha Kabir