Weak oversight leaves Savar's private healthcare sector vulnerable: Experts

Highlights

• Savar has 130+ private health facilities; 18 are unlicensed or awaiting approval
• Regular and surprise inspections planned, with immediate shutdowns for failing facilities
• Little improvement since a 2018 crackdown; some clinics reportedly reopen under new names
• Experts want more staff, updated laws, and licensed brokers

Weak regulatory oversight, manpower shortages and a lack of accountability have left Savar's private healthcare sector vulnerable to mismanagement, speakers said at a civic dialogue on Friday (3 July).

The discussion, titled "Mismanagement in the Private Health Sector: Existing Crisis and the Way Forward", was organised by Hello Savar, a local digital civic platform.

Savar Upazila Health and Family Planning Officer Dr Mohammad Fozlay Bari said more than 130 private healthcare facilities, including hospitals, clinics and diagnostic centres, operate in the area. Of these, 117 have obtained approvals or have recently received them, while 18 are operating without approval or are awaiting approval after having submitted their applications.

He said service quality remains questionable in many smaller facilities despite some large hospitals providing regular services. The upazila health office lacks a dedicated wing and sufficient manpower to monitor so many facilities while also overseeing the upazila health complex, field-level health activities and private clinic inspections.

Dr Bari said authorities have decided to conduct regular and surprise inspections and take action against facilities operating without licences or failing to renew them. Inspections will assess doctors' attendance, nursing staff, pathology reports, reagent quality, hygiene, patient admission practices and dengue preparedness.

"Facilities with poor service quality, no doctors or nurses, poor hygiene or expired reagents will be shut down immediately," he said.

Mahfuzur Rahman Nipu, senior correspondent at Jamuna Television, said conditions have changed little since a major crackdown in 2018. He alleged that many clinics reopen after being fined or sealed, sometimes by changing names, while others begin operations after merely submitting applications.

He also raised concerns over unregistered anaesthesia providers, pathology reports issued without qualified personnel, unnecessary tests and forced admissions, though he noted that many hospitals and physicians provide sincere services.

Health management expert Professor Dr Muhammad Abdus Sabur said private healthcare has expanded because public facilities cannot meet demand. However, he said the government lacks the capacity to both provide healthcare and regulate private providers effectively.

"One UHFPO cannot regulate more than 130 clinics. The work now being done by one person requires at least four officials," he said.

Prof Sabur called for separate manpower at the upazila level for hospital management, preventive healthcare, coordination and private-sector regulation. If there is an inability to increase staffing levels immediately, he proposed the option of employing external agencies to conduct inspections of facilities and to provide reports for governmental action.

He also called for updating the Medical Practice and Private Clinics and Laboratories (Regulation) Ordinance, 1982, saying legal reforms must be matched by adequate manpower for enforcement. Digitalisation alone would not improve oversight without trained personnel to process applications, verify information and make timely decisions.

Abdus Sabur also said hospital brokers thrive because patients often lack information about treatment options and doctors. Instead of relying solely on police action, he suggested bringing such intermediaries under a regulatory framework with licensing and fixed fees. 

Urging private clinic owners to adopt self-regulation, he said poor-performing facilities damage the reputation of the entire sector. He added that ensuring quality healthcare in Savar would reduce the need for patients to travel to Dhaka for treatment.