3rd, 4th grade staff syndication poses challenge to healthcare in govt hospitals

 
Syndicates of some third and fourth class employees, who have worked for decades in the same government hospitals, have emerged as a major challenge to Bangladesh's healthcare system in public sector.

According to health sector experts, long-term postings have allowed some employees to build powerful local networks that influence hospital operations, patient services and referrals, raising concerns about accountability, transparency and the quality of healthcare provided to the public.

It was because of these syndicate-related problems that the government later stopped permanent recruitment for third and fourth class positions in hospitals and introduced outsourcing-based hiring. This made it easier to apply a hire-and-fire system and take action against underperforming or problematic employees.

Health and Family Welfare Minister Sardar Md. Sakhawat Hossain said to The Daily Observer that, the government has already taken several steps to break these syndicates.

Experts say that because many of these employees stay in the same area for a long time, some become involved in local political, social and economic net works.

As a result, there are allegations that some of them influence hospital administration and national health policymaking decision. 

Experts suggest that, in addition to increasing the salaries and benefits of third and fourth class employees, the law should be amended to prevent them from serving in the same hospital for an extended period of time.

Patients, relatives and some doctors claim that groups formed by certain third and fourth class employees have created a clique through collusion that affects both patients and healthcare workers.

According to the allegations, some employees have worked in the same hospital for many years and built strong networks.

These groups are said to have unofficial control over ambulance services, patient trolleys, bed allocation, diagnostic test schedules and other support services.

Abid Hossain a relative of a patient at Mitford Hospital in Dhaka said they faced delays in getting a trolley from the emergency department.

"Someone later hinted that things would move faster if we paid money. We had no choice but to pay," the relative said.
Several patients said that although government hospitals are supposed to provide free or low-cost services, they are often asked for extra money under different excuses.

One of the most serious complaints involves brokers who operate inside and around government hospitals.