The health sector reform commission is set to recommend 鈥榚ffective鈥� referral and back-referral systems, connecting tertiary and grassroots health facilities.
According to the commission members, these systems would not only facilitate the full recovery of critical patients at minimised expenses but also lessen the burden on public and private hospitals in cities including Dhaka.
If the referral system functions effectively, insolvent patients from rural and remote villages could avail themselves of specialised medical care at tertiary hospitals, they said.
鈥業n our recommendation, there will be a referred-back system so that a patient, after receiving treatment at a tertiary hospital, can receive rehabilitation services at the health centre where he or she was initially admitted,鈥� said Professor M Muzaherul Huq, a member of the Health Sector Reform Commission.
He added that the patients would be issued a health card for sequential use.
On March 20, the Bangladesh Bureau of Statistics published a public opinion survey on Health Sector Reform 2025, revealing that 92.6 per cent of respondents supported the introduction of health cards for patients.
The BBS conducted the survey on 8,256 households across the country.
Explaining the planned referral and back-referral systems, another commission member, Syed Md Akram Hussain, said that patients鈥� out-of-pocket healthcare expenses would reduce significantly if the referral and the back-referral systems work effectively.
鈥榃e are planning to develop a network of general health practitioners or family care physicians who will be the initial responders to patients. Without their referral, no patient, except in an emergency, would be allowed to visit a specialist or a specialised hospital,鈥� Akram said.
Such a restriction, however, would prevent patients from making unnecessary hospital visits and incurring avoidable diagnostic and medical care expenses.
鈥楳oreover, the fee of a family care physician will certainly be less than that of a specialist,鈥� he added.
According to Akram, the commission would propose the availability of at least two MBBS doctors as family care physicians, or one family care physician per 15,000 people, at union-level health centres.
Such family health physicians would also be available at the ward level in urban areas.
鈥榃e are planning to transform all district-level general hospitals into tertiary hospitals,鈥� Akram said.
The BBS public opinion survey on health sector reform 2025 also revealed that 91.3 per cent of respondents wanted primary health care to be recognised as a constitutional right.
鈥楾he constitution does not legally bind the state to ensure citizens鈥� primary health care. It should,鈥� said Faizul Hakim, convener of the Janaswastha Sangram Parishad, a public health advocacy platform.
On January 15, the Constitution Reform Commission, in its full report, recommended that the right to health, which requires 鈥榮ignificant resources鈥� and 鈥榯ime to implement,鈥� should be implemented based on the 鈥榓vailability of resources,鈥� with a commitment to 鈥榩rogressive realisation.鈥�
The World Health Organisation defines primary healthcare as a system that enables health services to support a person鈥檚 health needs, from health promotion to disease prevention, treatment, rehabilitation, and palliative care throughout their lifespan.
However, the Health Sector Reform Commission will propose legally binding the government to ensure citizens鈥� primary health care.
鈥楢dditionally, the commission will recommend 鈥渂asic emergency care鈥� free of cost. The government will be bound to bear this cost even if a patient receives the service at a private hospital,鈥� Akram said.
The commission would also recommend the establishment of a separate service commission for health professionals, the formation of regional health services, the creation of a private hospital management board, the allocation of 10 per cent of private hospital beds for insolvent patients, and the prevention of pharmaceutical company owners from owning hospitals, among other measures.
On November 18, the interim government formed five reform commissions on health, media, local government, labour, and women鈥檚 affairs.
These five reform commissions were initially expected to submit their reports by mid-February. However, on March聽 27, all commissions were granted an extended deadline until April 30.
