Ayaan's death exposes poor healthcare oversight yet again

• Former BMA president Rashid-e-Mahbub suggests formation of a committee under the coordination of the Ministry of Health and Family Welfare to supervise the activities of the DGHS throughout the year
• DGHS, responsible for monitoring and regulating healthcare services in the country
• It typically takes action only after major accidents or allegations of negligence 
• DGHS officials cite staff shortages and a lack of magistracy power as challenges to proactive monitoring

Highlights

• The hospital operated without a valid license, raising concerns about healthcare oversight
• DGHS typically reacts to major incidents, not proactively monitors
• Staff shortages and legal limitations hamper the DGHS's ability to actively regulate hospitals
• Former BMA president suggests a committee to oversee DGHS activities and address illegal hospitals
• Over 700 healthcare institutions are in the registration process, while 20% haven't applied yet
• United Medical College Hospital may reapply for registration but will face additional action pending the investigation report 

The Directorate General of Health Services (DGHS) on Sunday ordered the closure of United Medical College Hospital in the capital's Badda following the tragic death of a young boy named Ayaan following a circumcision procedure.

The revelation that the hospital was operating without a valid license and had not even applied for one has raised serious concerns about the effectiveness of healthcare oversight in Bangladesh.

The DGHS, responsible for monitoring and regulating healthcare services in the country, typically takes action only in the aftermath of major accidents or allegations of medical negligence or malpractice.

DGHS officials cite staff shortages and a lack of magistracy power as challenges to proactive monitoring.

The circumstances surrounding Ayaan's death draw parallels with a similar incident last year at Central Hospital on Green Road in the capital, where Mahbuba Rahman Akhi and her newborn lost their lives due to medical negligence.

Following Akhi's tragic death on 9 June 2023, the DGHS shut down all operation activities at Central Hospital after an inspection.

Professor Dr Sangjukta Saha of the hospital's gynaecology department was barred from medical activities after it was discovered she had practised medicine for 13 years without renewing her license from the Bangladesh Medical and Dental Council (BMDC).

Despite a temporary closure, Central Hospital resumed operations after a few months.

In another case, on 11 August 2022, the DGHS closed down SPA Riverside Medical Center in Kamrangirchar, Dhaka, after a private television journalist was attacked by a mob while reporting on a fake doctor. The DGHS cited the centre's lack of registration, resulting in the closure of all activities.

Since 2022, the DGHS has been conducting raids and closing down hospitals when allegations of major accidents arise. However, there are allegations that some of these hospitals reopen and continue to violate rules, prompting concerns about the efficacy of such measures.

Former Bangladesh Medical Association (BMA) president Rashid-e-Mahbub has suggested the formation of a committee under the coordination of the Ministry of Health and Family Welfare to supervise the activities of the DGHS throughout the year.

This committee will specifically focus on overseeing the operations of illegally functioning hospitals, addressing the recurring issue of closures and reopenings.

The DGHS reports that there are currently 15,149 legal hospitals, diagnostic centres, and blood banks in the country. Approximately 700 healthcare institutions have applied for licenses, but around 20% of them have not completed the application process.

Dr Abu Hussain Md Moinul Ahsan, director (Hospitals and Clinics) at DGHS, said, "If we learn of hospitals without proper registration, we'll act swiftly. Despite a lack of staff, we'll make prompt decisions about hospitals in the registration process."

The DGHS director said that United Medical College Hospital can reapply for registration, with the DGHS investigation report expected to be available on Thursday. Action will be taken if any complications arise in light of the report.

Regarding potential negligence by doctors, he clarified that the DGHS does not handle the punishment of doctors. Instead, the BMDC determines the extent of punishment. The report will be sent to the BMDC, which will then take appropriate action against the doctors involved.

Following Ayaan's father's complaint on 10 January, DGHS officials inspected the medical college hospital and discovered that the institution had been operating without registration. The DGHS promptly ordered the hospital closed on Sunday.

However, the hospital authorities claim to have submitted a registration application under the name of the main institution, United Healthcare Services Limited, which is currently under process.

Ariful Hoque, public relations manager of United Hospital, confirmed the closure of United Medical College Hospital in compliance with DGHS directives. He assured that corrective action would be taken, acknowledging the mistake in the application process and vowing to rectify it.

He added that United Medical College in Badda and United Hospital in Gulshan remain open and operational. All patients from United Medical College Hospital were released on Sunday.