Dr. Zafrullah Chowdhury :
Part-III
Wide range of diagnostic test and medical services at minimal expense
These are free consultancy in the clinic regarding paediatrics, gynecology and geriatrics twice a week; the charge of Random Blood sugar test for diabetes is only 10 taka. In case of relieving pain the charge of each physiotherapy service is on 25 taka, stool and urine test will be gotten at the expense of 25 taka. The charges of blood grouping and blood cross matching are also 25 taka, general tests on blood like ESR, Platelet, Malaria, and dengue are also available at the expense of 50 taka each, specialized consultancy is available in charge of 100 taka. Tests such as ECG, Troponin and Rheumatoid factor for the identification of Cardiac disease and Menstrual Regulation will cost only 100 taka each. Diagnostic tests at the expense of 200 taka each are: ultrasonography, ecocardiology, liver function tests, tests on kidney failure, Serum Electrolytes, lipid profile and Microbiology, 250 taka will be charged for each test regarding Histopathology, X-ray test in charge of 400 (Four Hundred) taka, Covid-19 (RT-PCR) test in carge of only 700 (Seven hundred) taka, the expense of all other diagnostic test will be 50% less than Government destined charge, nutritious food like ‘Minavit’ complex syrup and all other medicines can be purchased with 20% discount than regular price, delivery and pregnancy services at the expense of 500 taka, facility of getting admission fee free seat at ICU and treatment and diagnostic test services with 50% discount at Covid-Ward, treatment of kidney-failure disease like Hemodialysis at the expense of 500 (Five Hundred) taka except Artiovenous Fistula which will cost extra 4000 (Four Thousand) taka, cataract surgery with new lens at the expense of 1000 (One Thousand) taka other than Feco operation which will cost 3000 (Three Thousand) taka, all kind of emergency surgeries including broken bone fixing at the expense of 5000 (Five Thousand) taka, for the treatment of large broken bone and joint fixing, the patients are required to bear implant expense, the expense of Neuro surgery, Cardiac Surgery etc is 50,000(Fifty Thousand) taka whereas Kidney transplantation will cost 100000 (One lakh) taka, if the Patients do not pay 200 (Two Hundred) taka as monthly premium of Special Gonoshasthya Insurance regularly, they will be deprived of the above mentioned facilities. In that case Government destined regular charge will be applicable which is four times higher than the available charge from the Special Gonoshasthya Insurance.
Required manpower for special healthcare/insurance are 4 trained doctors, 1 dentist, 1 physiotherapist, 14 healthcare givers/workers, pharmacist/pathology technician, accountant, public relation workers, guards, two drivers. A microbus for the purpose of transportation, medicine and pathological tests is also needed.
Required initiatives for making GONO healthcare a success are ten thousands working class families from low income segment have to be brought into this project. Promotional activities and cooperation from the government will be in demand, cooperation from the concerned authority will be required for constructing clinics for children, expecting mothers and senior citizens with the help of grants from the government. Water, electricity and toilet facilities have to be there in the clinics. Pharmacy, basic pathological tests and treatment facilities for the burnt and hurt have to be there in the clinics. Public donations are essential for the clinics.
In coming 5 years those clinics will be turn into the practice centers for the young general practitioners (GP). Government has to come forward. For expected results, if situation demands patients will be referred to central hospitals where more treatment facilities are available. Public donations have to be made available for creating a modern healthcare system in the capital city.
Middle and well to do class will have to spend an additional fee for receiving all health facilities from the clinics. To promote social health insurance across the country we will need trained workforce, security in the local health centers, renovation of the deep tube-well and uninterrupted electricity.
Secondly, it has to be made sure that doctors, dentists, physiotherapists, technicians and nurses will remain present at their respective work places in the Union, Upazila and district level public healthcare centers. Their recruitment has to be done locally not otherwise. No doctor will be given a chance for higher study unless the doctor serves in community level healthcare center for two years. After serving for two years those general doctors will be promoted as specialist while passing the following courses i.e. Pathology, X-ray, Ultrasonography, Anesthesia, Internal medicine, Cardiology, Nephrology, Orthopedics, General Surgery, Gynecology ENT, Dermatology and etc.
The promoted doctors will receive an additional allowance of 50,000 TK. Moreover they will receive 25,000 TK allowance along with the accommodation facilities for lecturing the medical and paramedical students in community level.
It must be ensured that these doctors can get the education in M.S., M.D., M. Phil., FCPS, etcetera in the subsequent 7 years. They will be considered as specialist if they earn these degrees through diploma training examinations and they will receive a minimum amount of taka one lakh as specialist allowance; if they are provided with the benefits of the positions of senior lecturer, assistant professor, associate professor, etcetera, the doctors in upazilas will be encouraged in providing service to the mass with dedication.
An investment of taka ten crore will be necessary for the security barricade, deep tube well and the assurance of electricity of the Union Health and Family Development Centre including the habitation of minimum 10 families, dormitory and laboratory for the students, external unit, x-ray, department of ultrasonography, internal unit of 30 beds and extension of operation theatre and modern machinery. Consequently, the Union Health and Family Development Centre will turn into the local modern health care centres like those of England. As a result, the doctors will feel pleasure serving in this stage. There is no problem with medicine in Bangladesh. The opportunity of 3-4 hours of private practice in the institution can be considered for the senior specialists. If 20,000 students do not get admission in the medical colleges, it will not be possible to initiate social health-insurance. For this, a number of 5 lakh doctors will be needed in the whole country.
It must be remembered that social health-insurance is a demand of the era and a mandatory part of modern health-management.
(Dr. Zafrullah Chowdhury is founder and Trustee of Ganoswasthya Kendra).
— Concluded.
