Clear guidelines needed

Bangladesh’s healthcare system resembles a marketplace. Just as the market is riddled with irregularities, corruption, syndicates, and adulteration, so too is the health sector plagued by the same issues. To combat market corruption, mobile courts are already in place. Now, to tackle irregularities and corruption in the health sector, the country’s civil surgeons have requested the authority from the government to operate mobile courts. They have also proposed the deployment of Ansar personnel or a "health police" force to ensure security at hospitals and workplaces.

According to information received from the media on Tuesday (13 May), civil surgeons of the country have organised a two-day conference for the first time, modeled after the Deputy Commissioners' Conference. At this event, civil surgeons presented various demands and proposals to the government.

Their demands are as follows: Civil surgeons should be given limited authority to operate mobile courts in order to control illegal clinics and laboratories, fake doctors, broker networks, and counterfeit medicines. Additionally, due to a lack of security in hospitals across the country, healthcare workers are often exposed to threats. To ensure safety, Ansar personnel or a dedicated "health police" force could be deployed in hospitals. They further stated that there is a lack of discipline and accountability in the health sector. Without addressing this issue, no matter how many doctors, nurses, or other personnel are recruited, the desired outcomes will not be achieved. They emphasised the need for promotion of skilled officials and the implementation of both local and international training initiatives. They also called for an increase in the health sector budget.

Their demands are undoubtedly reasonable. However, it is also important to consider whether granting civil surgeons the authority to operate mobile courts might lead to new forms of disorder within the health sector. After all, to eliminate irregularities and corruption, goodwill is often more effective than mere authority. The civil surgeons have asked for limited powers—but how limited it is? On what legal basis will these powers be defined? Will the mobile courts operated by civil surgeons function under the existing Mobile Court Act of 2009 in Bangladesh, or will a new mobile court law be introduced specifically for civil surgeons?

Whether civil surgeons will actually be granted the authority to operate mobile courts remains to be seen. However, past experience suggests that mobile courts often serve more as a symbolic gesture to appease the public. When market chaos erupts and prices spiral out of control, mobile courts attempt to regain some order by fining a few dishonest traders. Yet the cycles of corruption and syndicates tend to persist year after year. We do not know if granting civil surgeons the authority to run mobile courts will lead to similar outcomes.

Moreover, it is uncertain whether granting such authority to civil surgeons will lead to conflicts with executive or district magistrates. According to the Bangladesh Health Care and Protection Act 2023, there are already legal provisions in place to prevent irregularities and corruption in the health sector. Yet we have repeatedly seen shortcomings in the proper enforcement of those laws. While many may favour mobile courts for the sake of swift justice and public welfare, without the proper application of constitutional law and a stable democratic environment, the scope of mobile courts cannot be significantly expanded.

So, while we commend the civil surgeons for raising the demand to operate mobile courts, we also emphasise the need for clear guidelines regarding their scope of authority.