The decade 1970s in Bangladesh experienced creeping inflation in its later part. For this the public healthcare sector was becoming costly day by day.The 1986 industrial policy of the Government adopted liberalized business approach to develop private sector and the decade 1990s experienced the establishment of hundreds of hospitals and clinics developed in private in line of open market economy policy.
Besides, the increase of the disposable income of the people of Bangladesh along with their increasing purchasing capacity caused to expand the medical service sector in private. In the 1980s, clinics started to flourish on private sectors. However, it is only in the decade 1990s when quality medical service started flourishing with some large scale entrepreneurshipsas a strategic business unit (S.B.U.).
It can be relevantly mentioned that usually a country's economic development is more or less a gradual progress where first agricultural sector is developed, then comes industrial sector and finally service sector flourishes.
This is what happens to the developed countries. Unlike developed nations, the service sector started to develop in Bangladesh in such a moment when Industrial sector has not become saturated at all. That is why like other service sector, private healthcare sectors started to develop also very haphazardly.
The lower category private clinics of Bangladesh especially in Dhaka might be grouped under the selling concept. Their target is just to earn profit by somehow operating a clinic. To promote their clinics, they usually set their clinics either near government hospitals or close to the mainroad sothat they can get patients even without ensuring quality and services properly by focusing their product. The hospitals attractive signboard having information of hundreds of doctors is a lucrative sales strategy for many.
On the other hand, International or semi-international standard Hospitals like, Apollo Hospital, United Hospital, Square Hospital, Lab Aid that believe in social marketing concept try to ensure superior customer service (though in premium price)so that they can get profit through customer satisfaction.
Since they focus on customer needs, so they offer several healthcare service in package to get the upper-middleclass along with the upper class people. They follow integrated marketing approach by a satisfactory combination of skilled doctors and nursesso that patients belong to upper and upper middle class can be diverted from their habit of going abroad for treatment.
In third category fall NGO-based private clinics that follow production concept. Most NGO clinics like SabujChata has a wide range of distribution center of service .They fix comparatively lower price for the purpose of mass marketing. NGO type Clinics like Marie Stoppes, Ma o Sishutry make their service as much available and affordable as possible. So their target market is the mass people of the country instead of rich or upper class.
The cost of stay at hospital per day in most of the hospitals must be calculated based on salary and allowance of staff, Equipment and Furniture, Bedding, Transportation, Maintenance of building and diet charge.
But that does not mean any entrepreneur will fix pricing of his hospitallike five star hotel where accommodation far supersedes treatment cost which happens for many of our reputed private hospitals in Dhaka. Many patients, sarcastically speaking, become more worried of hospital bills than his or her health condition.
There are also complains against many reputedprivate hospitals who continue life support even after death of the patients in Bangladesh to charge more bill.
Private hospitals in Bangladesh have started a competition to import costly diagnostic machines and expose it in advertisement to increase customers without increasing basic service quality. Though formally we take pride in local surgical development, still our doctors suggest the upper class people to go outside Bangladesh for major surgical operation like brain's neurosurgery, because we have locally high-infection probability.
Our post-operative is not still upto the standard. Most private hospitals and clinics have introduced consultancy center inside their clinics or hospital with specialist doctors as part of their marketing or promotional strategy. Still most hospitals in private sector are dominated by the doctors of government hospitals in Bangladesh. However, the situation is changing with recognized hospitals that prefer full time regular doctors, not part time at all.
However, the cost of dental surgery is comparatively low in Bangladesh. The authority of one private dental clinic of Dhaka said that as teeth cannot cause fatal disease, people are hardly careful about teeth for which dental clinics are comparatively less profitable. In most cases, the target market of dental care is the rich and upper-middle class.
Lower class people take dental treatment usually when they have no way but to go to doctor.Without the increase of more and more disposable income, people cannot be motivated to befully aware of their dental health in Bangladesh.
The increase of private medical college is also working as a feed back to increase the number of private hospitals in Bangladesh.
However, the study is very expensive in private medical colleges but it is easier to get certificate from private medical than public medical. So, the students of government hospitalsbeing more talent have been still dominating the job market of healthcare industry. Unfortunately, private medical college business has become more profitable than private hospital business like a cash cow concept of marketing in many cases.
Actually, our private health care sector has been trying to be same with foreign hospitals in terms of medical technology.But the market is still inefficient market in the sense that our private hospitals have not received people's full confidence yet for which even many middle class people prefer to go to either Singapore or Thailand in search of better treatment.
In developed countries, the concept of health insurance gives a huge financial back up to common people for medical treatment in hospitals. Since we are yet to develop such insurance concept, suddenly imposed cost of treatment by our private hospitals seem inhuman or unethical to us.
Most of the women related to child delivery case think in Bangladesh that it is not the operation charge but the private clinic and hospitals accommodation charge (cabin fee) which is too high for the middle class people to maintain.
The writer is the First Assistant Vice President, Shahjalal Islami Bank Ltd.
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