The State, the Private Health Care Sector and Regulation in Bangladesh

Multifarious factors have contributed to the development of the private health care sector in Bangladesh. Its growth has been facilitated by the inclusion of private health care development in planning policies, by symbolic encouragement by government officials, by state patronage through medical education and training, by public sector physicians being allowed to practise privately, and by the provision of grants, subsidies and funds for investment. Opportunities for its expansion have also been created by a host of problems in the public health care system, including an inability to provide services, limited resources, poor perception and poor quality of services, a lack of personnel, absenteeism, corruption, and poor planning and management. But complains are also levelled against the private sector, as it lacks necessary infrastructure, equipment and personnel, with poor service conditions, poor quality and poor standards. The government enacted an Ordinance to regulate private health care, but evidence shows that regulatory practices are ineffective as a result of problems of legislative design, information and implementation, as well as internal and external contradictions within the regulatory system. Some policy guidelines are necessary to ensure positive outputs from the private health care sector.