Health to get a big shot in the arms

The health sector will get a boost in the next budget with an allocation of Tk33,000 crore and work is going on with long-term plans as well to remove weaknesses in the sector to deliver quality healthcare services to all citizens.

Joint Secretary to the Ministry of Finance, Shirajun Noor Chowdhury told The Business Standard the  ongoing coronavirus pandemic has exposed the weaknesses in the health sector, adding the government, therefore, is going to announce a three-year plan and a 10-year master plan to address these problems.

The health sector had been allocated Tk25,733 crore in the current budget which is going to rise by Tk7,000 crore in the coming budget. 

In the budget for the fiscal year 2020-2021, there will be a three-year-plan to staff the health facilities with necessary doctors, nurses and technicians, develop infrastructure, and adequate healthcare machineries and equipment will be ensured.

The government also plans on arranging series of trainings for healthcare professionals hiring expert physicians and skilled technicians from Singapore, South Korea and Vietnam, and ensuring collaboration with healthcare institutions of these countries.

Besides, there will be an announcement of a 10-year-plan for the development of the sector. Under this long-term plan, the government will take up various measures to improve the health sector like it did to improve the power sector a decade ago.

The long-term plan will be finalised after holding discussions with ministries concerned and other stakeholders following the budget announcement.        

The government will emphasise health diplomacy and encourage foreign investment in the health sector. Centres for disease control will be set up in Bangladesh as well like those in other countries, and the government also plans to use artificial intelligence for the development of health services. 

However, increasing the budget alone is not sufficient, according to bureaucrats. Weak management of the budget is also hurting the sector, according to them.

Finance ministry officials say the health ministry does not have the capacity to spend even the current allocation efficiently.     

The health ministry have been returning Tk1,000 crore on average from their allocation every year over the past 10 years, they added. 

Pointing to the prevailing irregularities and corruption in the health sector, a high-ranking official at the ministry says those problems can be overcome with proper political decisions by the government. 

There are instructions from the highest authority in the government for the development of the health sector.

Currently, the allocation for the health sector is less than one percent of the Gross Domestic Product (GDP). Experts have called for increasing the allocation to 3-5 percent of the GDP. 

Commenting on this issue, an official involved in the budget preparation says, "Our revenue earnings account for around 10 percent of the GDP. Therefore, it is not possible to allocate a huge sum for the health sector from the government's own fund.

"The government will encourage PPP and foreign investment and policy will be formulated to encourage foreign investment in establishing hospitals and providing health services."

Of the Tk33,000 crore allocation to the health sector for the next fiscal, Tk13,000 crore will be allocated under the annual development programme.                         

Additional Secretary (development sub-division) to the health ministry Saidur Rahman told The Business Standard allocation for the sector needs to be raised in phases after ensuring that the funds can be used efficiently.

Buildings and machineries are left unutilised due to understaffing, he pointed out, adding, "We are identifying the hospitals where projects have been completed but not staffed. We will recruit employees for those institutions.  

Meanwhile, former adviser of the World Health Organization's Southeast Asia region Prof Muzaherul Huq stressed the need to implement a good number of programmes to rein in the Covid-19 outbreak.

According to him, works on infrastructure development in the health sector need to be stopped for one year and the entire focus should be on standardising the health management system.

The government needs to provide the upazila health complexes with adequate manpower and equipment to make those functional, he continues, prompt supply of oxygen, oxygen masks, canola, ICU bed, ventilator, liquid oxygen tanks, and pipes must be ensured at every upazila health complex to control Covid-19.

He also calls for training the doctors and nurses who are deployed at the isolation units of those health complexes.

Prof Muzaherul says there must be two ICU ambulances at every district sadar hospital so that those can carry patients from the upazilas. The doctors and nurses at those ambulances have to be trained in basic critical care.

Institutional quarantine must be ensured at every upazila, he says, adding the budget should include measures to this end.