The Health Sector Reform Commission on Monday recommended reforming the constitution to recognise primary healthcare as a fundamental right of the citizens, urging the interim government to ensure free primary healthcare first through an ordinance and then turning the ordinance into a law.
MAJOR RECOMMENDATIONS
路 Unique health ID for every citizen 路 Ward pry health centres with referral 路 Zero VAT on drugs for cancer, diabetes, HBP聽 路 15pc of national budget for health聽 路 24-hour access to pharmacies 路 Separate wage board for health practitioners 路 鈥楳edical police鈥� for health centre troubles
The key recommendations by the reform commission included a unique health identity card for every citizen, ward-level primary health centres, a functional referral system, a zero value-added tax on the medicines for certain non-communicable diseases, the allocation of 15 per cent of the national budget for the health sector, a 24-hour access to pharmacies, a separate wage board for health practitioners, autonomy for the medical education institutions, and a 鈥榤edical police鈥� to prevent violence in health centres.聽
On the day, the reform commission, led by National Professor AK Azad Khan, submitted its report to the interim government chief adviser Professor Muhammad Yunus at the CA鈥檚 official residence Jamuna in the capital Dhaka.
Addressing the report handover ceremony, Professor Yunus said, 鈥楢 major issue is the shortage of physicians. And even when they are available, they are often not deployed where they are needed the most. These challenges must be solved permanently.鈥�
Highly praising the reform commission report, Professor Yunus instructed officials to implement the short-term solutions.聽
Following the event, Professor Azad briefed journalists on the HSRC report at the Foreign Service Academy. He said the commission has urged the state to constitutionally guarantee primary healthcare as defined by the World Health Organization.
鈥楧espite limited funds, we believe free primary healthcare is possible through a better coordination and resource management, he said.
Formed on November 18, the Health Sector Reform Commission submitted its report four days after its extended deadline of April 30.
At the press briefing, HSRC member Syed Md Akram Hossain presented the key proposals contained in the final report.
Under the theme 鈥楬ealth in All Policies鈥�, the commission recommended issuing smart health cards for all people with a unique identification number for every citizen.
A functional referral system was proposed to enable patients 鈥� regardless of location 鈥� to access services at local health centres or tertiary hospitals using their health ID card.
The commission proposed establishing tertiary hospitals in all divisional headquarters, inviting public-private partnerships and foreign investment for the development of these facilities.
It also recommended a zero VAT on the medicines for cancer, diabetes, high blood pressure, and listed antibiotics, along with free聽 access to essential medicines at primary health centres.
Other major recommendations include allocating 5 per cent of the GDP 鈥� or 15 per cent of the national budget 鈥� to health, dedicating 1 per cent to health research, ensuring uniform budget planning across development, revenue and operational costs, establishing anti-corruption cells at each health directorate with independent investigative powers and whistleblower protections, and upholding political neutrality.
To contain political activism in the health services, enforcing the Government Servants鈥� (Conduct) Rules, 1979, was recommended.
The commission also called for the deployment of trained 鈥榤edical police鈥� to prevent violence at health centres.
No health professional can be arrested for alleged negligence without clearance from relevant councils like the Bangladesh Medical and Dental Council, Bangladesh Nursing and Midwifery Council, Bangladesh Pharmacy Council, and Allied Health Professional Council, the commission recommended.
To limit the influence of the pharmaceutical companies on physicians, the commission proposed banning gifts and medicine samples for doctors, recommended the commission, adding that marketing should only be permitted via email or postal information.
The commission recommended a separate wage board for healthcare workers, including intern doctors, post-doctoral students, private hospital physicians, and nurses.
For medical education reform, the commission proposed making the relevant institutions autonomous. If the recommendation is adopted, faculty and health professionals of the institutions would hold non-transferable, full-time positions.
鈥楾he medical practitioners with academic posts will not be allowed to treat patients outside their institutions. To compensate, we have recommended improved salaries and sharing institutional income,鈥� said Professor Azad.
The commission also advocated for competency-based, community-oriented medical education, the closure of substandard institutions, and strict monitoring in line with World Federation for Medical Education standards.
To broaden women鈥檚 healthcare beyond maternity services, the HSRC proposed the creation of a National Women鈥檚 Health Institute, linking them to grassroots health centres.
Additional recommendations include establishing an independent and permanent Bangladesh Health Commission, forming a separate public service commission for the health sector, and consolidating departments 鈥� such as family planning, health economics, nursing, tobacco control, and medical equipment maintenance 鈥� under the Directorate General of Health Services.
Besides Professor Azad and Professor Akram, the other members, including Professor Muhammad Zakir Hossain, Professor Liaquat Ali, Professor Sayeba Akther, MM Reza, Professor Muzaherul Huq, Azharul Islam, Professor Syed Atiqul Haque, Ahmed Ahsanur Rahman, and Omair Afif, were present at the press briefing.
