New healthcare ordinance to include digital medical services

Highlights:

• Districts to have committee to address healthcare service complaints
• Videos, photos, voice records will be accepted as legal evidence
• Govt notifications to set fees for services in public and private hospitals
• Hospitals and clinics to prominently display a list of fees for services
• Prescriptions will clearly state the names of generic medicines in large letters
• Fines and jail terms for healthcare providers and patients 

The government is set to enact the Health Care and Safety Ordinance 2024, which will for the first time incorporate medical services through digital platforms. 

Under this new move, no medical services or consultations may be provided via digital platforms without proper registration. 

The draft specifies that fees for health registration, management, oversight, and monitoring on digital platforms will be established accordingly.

The health ministry on Saturday released the draft on its website, aiming to repeal the Medical Practice of Private Clinics and Laboratories (Regulation) Ordinance 1982.

However, experts said such legislation will work if comprehensive reforms are made in the health sector. Besides, laws governing business operations should not be the same as those protecting healthcare providers and patients, they added.

Dr Syed Abdul Hamid, a leading health economist and professor at the Institute of Health Economics (IHE), said there are positive aspects in the proposed law but pointed out that there are various ambiguities and a lack of specific details in it. 

"Some provisions will be challenging to implement. While we commend the intention behind this law, it is inherently flawed. As a result, we may not achieve positive outcomes from it in the future," he added.

MA Akmal Hossain Azad, senior secretary of Health Services Division, at a press conference on 11 September, said the law was in its final stage.

What is in the proposed ordinance

To address complaints regarding healthcare services, the draft suggests the formation of a "Healthcare Safety Committee" in each district. Affected individuals can file complaints with the committee for any violations of it. 

In case of any untoward incident, the proposal states that any video, still image, or recorded conversation related to an incident will be admissible as evidence in legal proceedings.

Also, the government will periodically issue gazette notifications to set the fees for services provided by public and private hospitals, as well as charges for medical examinations. 

Besides, a list of these fees must be displayed prominently in hospitals or clinics.

The ordinance mandates that prescriptions clearly state the names of generic medicines in large letters. 

It also proposes penalties for government-employed healthcare providers working in private hospitals during official hours, including fines up to Tk5 lakh for institutions and Tk3 lakh for individuals, along with possible imprisonment for three months.

Furthermore, the proposed law stipulates penalties for any threats, intimidation, obstruction of duties, or damage to healthcare properties, with fines up to Tk3 lakh or two years in prison, or both. 

If a healthcare provider accepts fees or charges from third parties against government regulations, they may face fines ranging from Tk3 lakh to Tk20 lakh or one year in prison, or both.

Oppositions against the draft

The law should be better organised following necessary reforms in the health sector, experts said at a review meeting held on Sunday. It was organised by the Alliance for Health Reform Bangladesh and the Bangladesh Health Reporters Forum.

Dr Syed Abdul Hamid at the event said the draft law is incomplete, as it merely compiles suggestions from various experts without thorough review.

"Bangladesh needs legislation that protects the interests of both healthcare providers and patients," he added. 

He further said the draft distinguishes between public and private hospitals, leading to confusion in the definition of hospitals, which is unacceptable.

Lawyer Shishir Monir pointed out that the draft proposal is riddled with gaps. The formulation of the law lacked adequate research and input from stakeholders.

"It primarily protects doctors while neglecting patients. Alongside safeguarding doctors, there is also a critical need to ensure patient safety," he added.

Dr Abdun Noor Tushar said the proposed law reflects the previous regime's oppressive nature. He condemned the lack of research behind its formulation, dismissing it as a "waste of valuable time".

Rashed Rabby, president of the Health Reporters Forum, said no one is being protected under this law. He criticised the inclusion of mobile court provisions as unjustifiable.

"The proposed law also indicates that no brokers will be allowed to operate in hospitals, while allowing for the registration of agents for foreign hospitals," he added.