Recommendation for separate ‘health service’ with pay structure, PSC for physicians

The Health Sector Reform Commission has recommended establishing a new civil service incorporating the human resources from the current health service, other relevant cadres and others, who work under the health and family welfare ministry.

The Commission also recommended the name of the new service to be ‘Bangladesh Health Service (BHS)’.

In its report, the Reform Commission also recommended setting up a separate secretariat with a physician as its chief, forming a new Public Service Commission (PSC) and a separate pay structure for the physicians.

If the recommendations are implemented, there will be no ministry-based administrative system in the health sector. The Commission, however, spoke about keeping an alternative system for the current BCS cadres in health for moving to new service.

Currently, health is one of the 26 BCS cadres recruited through the Public Service Commission (PSC). The salary structure is also like other cadres.

The health sector is run under two departments of the health and family welfare ministry, with the administration officials remaining in charge of those.

The Health Sector Reform Commission submitted its report to Chief Adviser Muhammad Yunus today. The Commission, led by National Professor AK Azad Khan, made 32 recommendations in the report.

One of the recommendations is to form an independent and permanent “Bangladesh Health Commission”.

The Chief Adviser’s press wing shared the report with newspersons.

Currently, 26 cadres are recruited for the Bangladesh Civil Service through the PSC. Recently, the Public Administration Reform Commission in its report to the government recommended dividing the cadres into 13 services; it also recommended setting up three PSCs for recruitment and promotions.

Of those three PSC, two were recommended for the education (over 30,000 officials) and health (nearly 16,000 officials) sectors , two largest cadres in terms of number of officials. Their names would be PSC (Education) and PSC (Health). The third PSC would be named PSC (General) for the remaining services.

Currently, PSC has been working for recruiting BCS cadres and non-cadres.

Now, what the Health Sector Reform Commission has recommended is akin to initiating radical changes in the current health sector.

One of the recommendations of the Commission said to ensure professionalism, efficiency and accountability of services, a new civil service, administratively autonomous and profession-based, will have to be formed with the existing health cadre, other related cadres and all other human resources under the health and family welfare ministry.

The Commission also recommended changing the existing organogram. According to the Commission, there will be 11 regional health authorities under the “health services”. Of those, one each at eight divisional headquarters, and one each in Dhaka city, Chattogram city and in the Chittagong Hill Tracts will be established.

For the health service, a separate secretariat will also be set up. An experienced physician with the status of a principal secretary will be at the helm of the sector. He would be called “chief of BHS”.

Under him, three deputy heads of the rank of Senior Secretary will be appointed to manage the three main sectors - public health, clinical services and medical and other related education. They will be named Deputy Chief of Health (DCH).

The Commission said a post of Director General (DG) will be created for all the sectors who will have the status of a secretary and the Deputy Chief of Health will be his reporting boss.

The Health Sector Reform Commission said there will be no separate secretariat for the health services. All the files from the DG level will go directly to the Deputy Chief of Health of the Bangladesh Health Services.

The Commission also put emphasis on decentralisation of health services. Speaking about this, the Commission said the highest possible level of administration and financial relaxation at the divisional, district and upazila level has to be allowed. Besides, in some cases, there has to be autonomy.

It further said upazila-wise budget and plans will have to be taken and implemented considering the health situation, type of health problems and epidemiological necessity. The divisional level activities will be run under autonomous regional health authorities, which will be accountable to the Bangladesh Health Services. The responsibilities for recruitment, transfer and procurement and other financial issues will have to be implementably decentralised.

The Commission also recommended forming a high level search committee, which would recommend people for recruiting in posts like chief of BHS, deputy chief of BHS, medical university Vice-Chancellor, pro-vice-chancellor, director general, medical college principals maintaining transparency and political neutrality.