Let the proposal for 100% free primary healthcare be implemented

Health is a fundamental human right. For building a developed and humane society, affordable and uninterrupted access to healthcare is extremely important. However, the reality is that a large portion of the population in our country—especially those living in rural areas—are still deprived of essential primary healthcare. And those who do receive it often have to bear high costs. To address this situation, making primary healthcare 100% free is now a demand of the time. The encouraging news is that the Health Sector Reform Commission has proposed the provision of 100% free primary healthcare. Additionally, they have recommended amending the Constitution to include primary healthcare as a fundamental right.

According to news published on Tuesday, May 6, the Health Sector Reform Commission submitted its final report to Chief Adviser Muhammad Yunus on Monday. The report was handed over at an event held at the state guesthouse Jamuna, led by the Commission’s head, National Professor Dr. A.K. Azad Khan. The reform report includes 32 recommendations, such as extending service hours at government hospitals until 5 PM, setting service fees in private hospitals, barring pharmaceutical company representatives from meeting with doctors, ensuring the availability of essential medicines, producing raw materials for medicines locally, and forming an independent health service body. Officials have said it could take two years to implement these recommendations. Emphasizing their importance, Chief Adviser Professor Muhammad Yunus has instructed that those recommendations which can be implemented immediately should be prioritized.

Although the recommendations have been praised, some of them may seem like lofty ideals. For instance, the suggestion to provide at least 10 minutes of attention per patient is rarely achieved in Bangladesh—even for high consultation fees, let alone for free. The recommendations state that to establish a fair and financially secure healthcare system, 100% free primary healthcare must be ensured. This would include maternal and child health, vaccinations, treatment of common diseases, and preventive care provided at government hospitals. Even diagnostic tests, medicines, and surgical services would be free for patients. If implemented, this would reduce out-of-pocket healthcare expenses.

This model has been successfully implemented in many countries around the world. According to the World Health Organization, primary healthcare systems should encompass disease prevention, treatment, rehabilitation, and care based on an individual’s health needs. Dr. Abu Mohammad Zakir Hossain, a member of the Health Sector Reform Commission, mentioned that while some basic healthcare services are theoretically free at government hospitals, in practice they are often unavailable. Medicines are supposed to be free, but they are frequently out of stock. Medical equipment in government hospitals often remains unusable for years, forcing patients to get tests done externally. The commission's proposal is to make primary healthcare completely free, ensuring patients incur no personal expense when admitted to the hospital.

Even if half of these recommendations are implemented, it would signify a major advancement for Bangladesh. Currently, the so-called free primary healthcare services leave many with bitter experiences. Other than a few inexpensive medicines, nothing is truly free. Forget test costs—many district and sub-district level government hospitals don’t even have the facilities for such services. Still, we hope the recommendations will be implemented as soon as possible. Achieving 100% free primary healthcare requires political will and good governance. This will not only establish healthcare as a fundamental right but also reduce economic inequality in the health sector. Developed countries have already brought about revolutionary changes in public health by adopting this model. Bangladesh can too—if we genuinely commit to it.