Bangladesh Development Reports
The country’s modern hospitals in the private sector have been availing tax-benefits on the import of medical equipment for year after year but they are not passing on any benefit to their patients, particularly those who cannot afford expensive treatment.
Some 24 private ‘referral’ hospitals, which usually charge high fees on patients, have been availing the duty-free facility on the import of medical and hospital equipment since 2005, reports the Financial Express.
But the patients coming from poor and low income families can never take the services of these hospitals because of the expensive nature of their treatment although the government has been making available direct incentives to the latter in the form of tax rebate.
The government has not attached any condition with regard to providing some relief to the poor patients while offering the tax benefit to the posh hospitals.
The National Board of Revenue (NBR) offers duty-free facility on import of equipment for setting up referral hospitals.
To earn the ‘referral’ status a hospital does need to have advanced research facility and install the machinery within three months from the date of duty-free import.
A mono-disciplinary hospital with at least 100 beds or multi disciplinary one with 150 beds can be termed as referral hospital having the registration from the ministry of health.
Under the conditions, at least two experienced doctors should supervise each department of those hospitals. The hospitals should have capacities to give consultancy services to other hospitals.
A committee, comprising customs and health directorate officials, inspects the hospitals to ensure that the medical machinery and equipment are properly installed.
The NBR can revoke the tax-free facility and collect entire exempted amount if the committee finds any irregularities in installation of medical equipment.
In 2009, the NBR relaxed the duty-free facility for 150-bed hospitals to allow more hospitals to be enlisted as referral hospital.
With the relaxation, medium level hospitals are now able to avail the referral hospital facility.
The hospitals have been saving millions of taka enjoying tax-free facility on import of hundreds of medical equipment.
The NBR introduced the measure in 2005 under which referral hospitals will not have to pay any import duty, value added tax (VAT) or supplementary duty (SD) on import of medical equipment and reagents.
There is an allegation of abuse of the tax exemption facility by some hospitals due to poor monitoring system.
Officials said the department concerned does not have necessary logistics and manpower to continuously monitor the use of duty-free imports of medical equipment.
They said the government has offered the facility for those hospitals to conduct intensive research and provide consultancy to other hospitals.
After visiting a few hospitals, this correspondent found only two to three hospitals having the research facility while others, including posh ones, are running activity as general hospitals while enjoying facilities of a referral hospital.
To address the issue, the customs intelligence and investigation directorate recently launched an investigation to find out the violations of conditions ser in the official rules.
A probe committee has been formed to look into the matter following instruction from the NBR chairman.
Initially, some 10 referral hospitals will come under investigation.
A senior customs official said the referral hospital facility aimed at checking the flight of foreign currency for treatment purposes abroad and creating advanced health facility in the country.
“Generally, a referral hospital is a hospital that a patient is referred to by other health-care centres because it is better equipped and has specially trained physicians for better as well as special treatment,” he added.
Talking to the FE, Bangladesh private hospitals, clinic and diagnostic owners’ association president Professor Dr Moniruzzaman Bhuyan said there is a rule to keep 5.0 per cent free bed or free treatment to the poor patients.
“I believe hospitals are providing more than that of the said facility,” he said.
He, however, felt the necessity to monitor those hospitals that are availing duty-free facility but not complying with the stipulated conditions.
“Private sector is providing 60 per cent of the health care services in the country contributing to the growth of the sector,” he said.
The referral hospitals are: BIRDEM, National heart foundation, Apollo, Zainul Haque Sikder Womens medical college and hospital, Khawaja Yunous Ali Medical Collage, Ibrahim Iqbal memorial hospital, Jalalabad Rajib-Rabeya medical, United Hospital, Square, Salauddin specialised hospital, Ad-din, delta, Labaid, Green life, Enam medical, Bangabandhu memorial hospital, Sumona hospital, Monsur Ali medical college, Dr Sirajul Islam, Care specialized hospital, Samorita, Gazi medical college, Ali hospital.
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