Health services: Absent doctors, a headache

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A doctor at a government hospital in Gopalganj has been absent from work since March 16, 2020.

Southern District Chest Disease Clinic authorities reported it to the Directorate General of Health Services (DGHS) six months later, when such an incident should have been reported within 60 days according to the department’s rules. .

The DGHS then stopped paying him and the civilian surgeon in Gopalganj sent another doctor to work in the facility. But the relevant officials at the management say they still do not know where the first doctor is.

After joining the civil service in August 2014, the doctor took a two-year study leave on March 1, 2017. Upon his return, he worked at the DGHS office in Mohakhali in the capital for eight months before to be transferred to Gopalganj in 2020.

“Doctors had been erratic at work from the start. When we asked him to be erratic, he just walked away. Patients went without services for months until we sent another doctor to the clinic,” said Niaz Mahmud, civil surgeon from Gopalganj. .

The doctor’s official contact number was found turned off.

According to DGHS officials, many doctors remain absent without leave and continue to be paid by the government. And thousands of patients are deprived of health care.

Samiul Islam, director (administration) at the DGHS, said that “absence without leave seriously hinders the functioning of the hospital”.

When doctors remain absent, the authorities in most cases take three to six months to replace them.

On many occasions, health facilities take months to report the absence.

There are about 25,000 doctors engaged in hospital services under the health directorate.

But there is no data on the exact number of these absent doctors. Samiul said the list of wandering doctors was an “ongoing process”.

According to data from a section of the DGHS, authorities stopped paying another doctor earlier this month, nearly a year and a half after he stopped going to work.

In order to better understand the issue, the DGHS on July 21 asked the heads of health facilities across the country to report doctors who are absent without permission.

As of September 11, the administration’s administrative wing has received the names of 161 doctors and initiated disciplinary action against 78 of them.

Of the 161, at least 116 are military doctors while the rest are senior doctors, including professors.

The surveillance wing has another list of at least 300 absentees.

Experts say the actual number of such doctors may be much larger. They also say that these doctors are not being penalized in a timely manner.

Currently, at least 250 absent doctors have not yet been sanctioned. Some cases have been pending since 2007.

MANAGEMENT FAILURE

When a doctor is absent for 30 consecutive days without leave, the head of the facility is required to report the matter to higher authorities, health officials said.

“In many cases, however, the establishment authorities do not report in time and we remain in the dark about the missing officer,” Samiul said.

A senior DGHS official said absent doctors get away with it by colluding with hospital authorities and administration officials.

MA Sabur, a health care expert, said: “This is a management failure. We have advanced technology available in the market through which the health management can see whether doctors are present or not.

In addition, a monitoring system is in place. But the system is not being used properly, he added.

Senior DGHS officials told this newspaper that doctors remain absent primarily due to the lack of opportunities for career development and timely promotions.

Doctors thus leave either to go abroad or to work in the private or development sector. They just don’t want to go through the long quitting process.

Government doctors who wish to resign before completing the two-year “entry period” must repay all their salaries. Those who resign after the entry period receive no gratuity or pension benefits, officials said.

Moreover, it takes between 6 and 12 months to properly leave the public service while the process should be done in two months, according to the rules.

Md Ehteshamul Huq Choudhury, secretary general of the Bangladesh Medical Association (BMA), blamed the health directorate and the health ministry for failing to take action against doctors.

“It is a weakness of the authorities… Everything is defined in the work regulations. But since the higher authorities have not acted over the years, this malpractice continues,” he said.

Contacted, Professor Ahmedul Kabir, Deputy Director General (Administration) at the DGHS, said: “Returning a doctor to the civil service is not easy. But we sort absentees without leave.

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