Bangladesh News

The government is going to introduce uniform charges for pathological and imaging tests at public hospitals in a few weeks, officials said.

The hospitals have long been imposing freewheeling charges on patients for such tests in the absence of any regulation.

“Public hospitals fix the costs of diagnostic tests on their own and have been charging the patients accordingly over the years,” Dr Akhter Hossain Bhuiyan, director (hospitals and clinics) at the health directorate, told The Daily Star.

The standardised charges will be placed for approval at the next meeting of the National Implementation Committee for Administrative Reforms/Reorganisation (Nicar), he said adding that it will come into effect soon after.

“We’d submitted a draft to the health adviser a few days back. He recommended some changes in line with the Safe Blood Transfusion Act 2002,” another health-directorate official told this newspaper.

The directorate afterwards sent the tailored draft to the Nicar, he said.

Patients have to pay whatever charges the public hospitals fix at will. Different departments at the Dhaka Medical College Hospital (DMCH) raised the costs of diagnostic tests over the past few months, according to staffers working there.

The DMCH clinical pathology department and the pathology, biochemistry and histopathology departments at the Dhaka Medical College spiked the charges in July.

Before July, the DMCH clinical pathology department had a monthly income of Tk 70,000-80,000 from tests done there. Revenues totalled Tk 13.13 lakh in July and August after the spike, sources said.

The four departments however backed off in the first week of September after press reporters focused on the issue.

Other units at the DMCH have not budged.

The DMCH clinical pathology department now charges Tk 5.50 each for total count (TC), differential count (DC), erythrocyte sedimentation rate (ESR) and haemoglobin (Hb) test of blood and Tk 22 for the four combined.

The Mitford Hospital and National Institute of Cardiovascular Diseases (NICVD) charge Tk 11 each for TC and DC tests and Tk 44 for the two combined.

Charges at the National Institute of Mental Health (NIMH) are higher: Tk 20 each for TC, DC, Hb and ESR tests. The NIMH and Shaheed Suhrawardy Hospital charge Tk 50 for the four tests done all at a time.

Some staffers at the National Institute of Traumatology and Orthopaedic Rehabilitation told The Daily Star preferring anonymity that they did not charge for tests before copycatting the Mitford Hospital.

“We pointed to the Mitford Hospital after the in-charge of the clinical pathology department asked us what charges to introduce for diagnostic tests,” one staffer said.

Asked about the differences at different hospitals, NIMH Director Prof AHM Firoze claimed that his hospital acted according to the government norm.

Brig Gen M Shahidul Haque Mollick, director at the Mitford Hospital, said, “There’s no room for taking more than the government-fixed costs.”

Akhter Hossain, director at the health directorate, said, “We’ve looked into such utterances but did not find the letters under reference at the ministry. The charts shown at the hospitals are their own.”

Dr MA Jalil, deputy secretary at the health ministry, added that there is no government-fixed chart of charges for diagnostics tests at the moment.

“In 2006, the ministry pencilled in the charges for only a few tests but it never got the approval. Some hospitals then photocopied the draft and started charging patients accordingly,” he said.

At present, the government gets 50 percent of the proceeds from the tests done at public hospitals, doctors get 30 percent. Staffers get the rest.

The new draft recommended 25 percent of the proceeds for maintenance purposes and 25 percent to the government fund. The rest would go to the doctors and staffers.

“Some changes will be made to exclude the proceeds from the sale of admission forms and tickets,” said a health-ministry official.