THE procurement and maintenance of medical and diagnostic equipment for public hospitals have for long been plagued by misgovernance, often at the expense of patients. The minister for health told the parliament on June 25 that 485 X-ray machines in 310 public hospitals and 395 ultrasound machines in 252 public facilities are out of service, limiting access to essential diagnostic care for thousands of patients. He added that procurement of major medical equipment, including MRI and CT scanner and dialysis and ICU machines, had remained suspended for long. The minister’s statement only confirms what has been reported in the media. A high-dependency unit at the Children’s Hospital and Institute in Dhaka remains non-operational because fund constraints have prevented the procurement of necessary equipment. A boat ambulance launched in Lakshmipur in 2022 to facilitate the swift transport of patients has never been put into service because no driver was recruited. Transparency and accountability in public procurement assume even greater significance in the health sector, where deficiencies can directly compromise patient safety and the quality of care.
The failure to ensure routine maintenance and timely repairs of medical equipment in public hospitals adds to people’;s out-of-pocket health expenditure, which is already the highest in South Asia, while private healthcare facilities make hefty profits by cashing in on the situation. The only MRI machine at Chittagong Medical College Hospital had been out of order for a month before its repairs in April. According to a 2023 Directorate General of Health Services record, at least 3,500 pieces of essential medical equipment in public hospitals were dysfunctional and required maintenance or replacement. The unusually short operational life of medical equipment in public hospitals raises serious questions especially as private hospitals and clinics do not typically face similar problems. This suggests that the lack of maintenance stems not only from procedural flaws or lengthy bureaucratic processes but from deliberate negligence that unduly benefits private healthcare providers. The consequences extend beyond the health sector. Bangladesh loses an estimated $5 billion every year as patients travel abroad for medical treatment, driven largely by a lack of trust in the national health care.
The government should, therefore, take immediate steps to procure and repair medical and diagnostic equipment to make affected district and upazila health facilities fully functional. At the same time, it should revisit the procurement and maintenance policies for the health sector to ensure that bureaucratic delays in procurement do not deprive patients of essential healthcare services. It should also investigate all allegations of corruption in the procurement and maintenance of medical equipment to prevent the embezzlement of funds allocated for life-saving health care.
