Open Discussion
Public Health service: Budget 2014 – 15 and health Management “Health care is much broader than treatment of diseases”
Shasthya Andolon Network (Health Movement Network) organized an open discussion meeting on “Public Health Service: Budget and health management" at the VIP Lounge, National Press Club Dhaka on 29 June, 2014. A total of 108 participants attended the discussion meeting. The participating organizations included Naripakkho, Bachte shekho Nari, Adibashi Forum, Narigrantha Prabartana, NIPSOM, Dhaka Community Hospital, Jatiyo Shasthya Odhikar Andolon, Chikitshak Songsad, Nirapad Development Foundation, WBB Trust, Public Health Movement, Gonoshasthaya Kendra, Health and Hope Hospital, Unnayandhara Trust, Women's Health Coalition, Center For Medical Education, Church of Bangladesh, Nirnoy, Shasthya Andolon Network members, Adhunik, United Peoples’ Trust, Beez Bistar Foundation, Consumer’s Association of Bangladesh and Bangladesh Lekhika Shangho. In addition journalists, Students and members of other professions attended the meeting.
Aminur Rasul, Member Secretary Unnayandhara Trust Chaired the meeting with Palash Baral, Director UBINIG moderating in the meeting.
Farida Akhter, Executive Director UBINIG and Joint Convener, Shasthya Andolon started the discussion on behalf of the Shasthya Andolon. The panel of Discussants included Dr. M Mushtuq Hossain, Principal Department of Medical Social Science, (IEDCR); Prof. Dr. Rashid-E-Mahboob, President, National Committee on, Jatyo Shasthya Odhikar Andolon, Dr. Zafrullah Chowdhury, Trustee, Gono Bishwabidyalay and Trust, Gonoshasthaya Kendra, Dr. Lelin Chowdhury, specialist on Preventive Medicines, Health and Hope Hospital, Advocate Syed Mahbubul Alam, Director, WBB Trust and Ibnul Syed Rana Chairman, Nirapod Development Foundation.
Farida Akhter: Very soon the budget 2014-15 will be passed in the National Parliament. Naturally a question comes up why we are discussing the budget now? Every year we give our response on the budget before placing in the parliament and after it is passed. Many other organizations gave their suggestions in their respective fields for consideration in the budget. But there is little reflection of their suggestions being heard in the budget, except those by the business community and the companies. Shasthya Andolon is disappointed to see that the allocation in the Health Sector in the proposed budget, although increased by total amount, it has reduced as proportionate allocation. The health sector budget has been reducing gradually over last few years. This time, even the Health Minister has expressed his unhappiness for inadequate allocation in the budget. During last few years, the allocation for Health Sector was 5.9% of the budget 2010-11, it was slightly increased in 2011-12 by 6.5%, but in 2012-13 it was again reduced to 4.8%, in 2013-14 it was 4.3% and for 2014-15 it has been proposed for 4.45%.
For 2014-15, a sum of BDT 11,146 crores has been allocated for health sector in the budget. It is an increment of 0.19% compared with last year’s budget allocation. Out of the total allocation of 11,146 crores, BDT 4349 crores are allocated for development expenditure and BDT 6797 crores for revenue budget.
Prof. Dr. Rashid-E-Mahbub: It was earlier proposed by the Finance Minister that there would not be any increment of allocation in Health budget this year. There is lack of commitment on the part of the government in health sector. There is mention about the Community Clinic but in reality those are not health centers at all. These are basically managed by untrained heath personnel as the common quacks in the rural areas are doing. They are given antibiotics to give to the patients without proper diagnosis. It is a matter of deep concern that antibiotics are supplied in the community clinics.
Maternal mortality rates have decreased due to good works of the NGOs. Similar priority should be given on other health issues. Sheer neglect of the state on Health and Family Welfare sector has been continued for long. We all know that gross national product of any country depends on good health and ability of the people. Any neglect in this sector will consequently impact upon public health, nutrition and population planning.
Syed Mahbubul Alam: There are many inconsistencies in the budget. I find little justification for the Railway Ministry for establishing hospitals. There are many diseases which can be prevented with appropriate preventive measures. Unfortunately there is no allocation for preventive sector. One of the main cause of diseases is the inappropriate food habit. There should have legal instrument in place and effective orders for implementation of those for controlling food adulteration and the use of chemicals in agriculture.
Dr. M. Mustaque Hossain: It is a good gesture that the tax earned from tobacco and mobile phone will be used in health sector. There is record of pilferage in health sector. Effective measures can improve public health service. Money making in the Health Sector taking the advantage of the market economy should also be stopped. The Ministry of Health and Family Welfare should take the lead for ensuring safe food for the people.
Ibnul Syed Rana: The health administration, BMDC, BMA and other professional bodies should take unified approach for improvement of the Health Sector. The inflow of patients from the rural areas to the cities could be decreased significantly if the Union Health Centers and Upazila health centres were made functioning properly. The private companies have been doing business and exploiting the people taking advantage of the inefficiency of the Government health service. This issue deserves urgent attention of the Government and other stake holders.
Dr. Lenin Chowdhury : There is nothing new in this budget. Every year we talk on budget. I think we talk on the same spirit. We speak more on budget allocation. But whatever allocation is there, it is not properly used. There is little effort for prevention of diseases. The only visible approach is treatment of the diseases. In that respect, we can not call it health budget, it is actually a budget for Treatment. The approach should be ensuring good physical and mental health of the people.
Dr. Zafrullah Chowdhury: We will not be benefitted even if the budget on Health sector is increased three times. The tax on 40 raw materials of medicine has been reduced 10-25 percent. Even then the companies did not reduce the price of medicines. There is no industry for making raw materials for medicine in Bangladesh. There in need of establishing such industries in the country with a view to reducing the price of medicine.
There is proposal for improving the fertility of infertile mothers. In this society, women are blamed for infertility. In fact, in 70% cases men are responsible for not having a baby for a couple. There is good treatment of men for improvement of fertility.
In the Open Discussion Samia Afrin, Project Manager, Women Health Project, Naripokkho; Sheikh Rakib Uddin, Journalist; Jahangir Hosain, Journalist, the Daily Mukta Khabor; Dr. Manjur Kadir Ahmed, Coordinator, Gonoshasthaya Kendra highlighted the key issues of health services. They mentioned that the poor and inefficient service delivery system needed urgent attention for improvement. They suggested for good governance, accountability of the health professionals to the public and the Government.
Aminur Rasul: The Health Sector in Bangladesh is in total disarray. The Government has neglected the health sector in this budget also. The past governments also neglected the health sector. The Government has been giving priority to infrastructure instead of providing good health for the people. The government has been supporting private business and in this budget also encouraged private sector. The death of patients for wrong treatment or neglect has been increasing. The poor people have to spend a significant amount of money for health care and day by day they are becoming poorer.