AMBULANCE rackets on the prowl at major hospitals holding patients and their attendants have become a bane of the healthcare system that the government has so far mostly overlooked. Reports have it that syndicates composed of ambulance owners, hospital staff and political leaders dominate the ambulance business and compel patients and their attendants to pay inflated fares, often double or triple the regular fare. Ambulance operators running under 鈥榠nformal committees鈥� in public hospitals control the syndicates, maintaining a strict serial system of the vehicles and deciding who would carry patients, whether they are critically ill or dead. Patients carried from outlying areas to Dhaka cannot leave by the vehicle they hire as the syndicates force them to hire vehicles under their control for the return trip. The syndicates pay the ambulance owners a fraction of the amount and pocket the rest, part of which goes to local political leaders. In an instance on August 14, a newborn died after the ambulance carrying him had been blocked for an hour and a half by one syndicate in Shariatpur. The syndicate refused to allow any other ambulances other than the vehicles under its control.
The syndicates work cashing in on the shortage of ambulances. Data available with the Directorate General of Health Services show that only 118 ambulances are now in service in public hospitals across the country, with a request for 100 more still pending with the relevant authorities. But ambulance owners鈥� association leaders say that more than 6,000 privately owned ambulances are in service across the country. Ambulance owners say that they are forced to take hospital staff on board to get the documents from the hospital as some hospital staff in collusion with ambulance drivers running under the syndicates lay their hands on the documents immediately after the death of patients. They say that they also need to pay local political leaders to park their vehicles around and on hospital premises to avoid trouble. It appears that the problem of ambulances that has plagued health services has resulted from inadequacy left unattended by the health authorities. And, whilst such a strict monopoly perpetrated by unregistered, illegal groups continues to cause patients immense suffering, the government has ignored the issue, leaving an important component of health care in a mess. In the absence of any supervision, syndicates often modify any vehicles into ambulances without fitting in life-saving devices.
The government is reported to be working on a policy for the supervision of ambulance services, but the work is not yet in its final stages. The government should, therefore, immediately expand the fleet of ambulances for public hospitals and expedite the work and put in place effective oversight on ambulance services that are privately managed. The health managers should expand their regulatory framework to even oversee ambulance service patterns and set fares.