Two thirds of the country's over 15,000 private clinics and diagnostic centres have been running without any valid licence since 2018 facing almost no consequences.
The Directorate General of Health Services (DGHS) did nothing but send notices to these facilities and make public announcements in newspapers, officials admitted.
The renewal of licences has been slow since 2018, when the DGHS began "digitalising" the process, said Aminul Hasan, director of hospitals and clinics at the DGHS.
"Of about 15,000 private clinics and diagnostic centres, some 5,000 have proper licences… They did not come forward for renewal of the licences," he told The Daily Star yesterday.
Clinics and diagnostic centres need environmental clearance, employee details, city corporation clearance, tax certificates and other documents to get their licence renewed every year, he explained.
"Most of these facilities could not get their licence updated because they failed to provide those documents."
Meanwhile, the DGHS is toothless when it comes to taking corrective measures.
The facilities are governed under The Medical Practice and Private Clinics and Laboratories (Regulation) Ordinance, 1982.
"According to this ordinance, we cannot do anything, except declare them illegal. Those who do not have renewed licences are illegal," Aminul said.
"We regularly send them notices and publish announcements in the newspapers."
Manpower shortage is also a major issue, he said. There are three officials to look after the licences of around 5,000 clinics and diagnostic centres in Dhaka.
The issue of licences is being discussed widely after it became known last week that the DGHS signed an agreement with Regent Hospital while being fully aware that the hospital's licence had expired in 2014.
A mobile court of Rab raided the hospital's Uttara branch on July 7 and recovered stashes of fake Covid-19 test results. The hospital gave test results to patients without testing their samples.
"This [Regent Hospital] is the tip of the iceberg of irregularities at private clinics and diagnostic centres," said Prof Be-Nazir Ahmed, former director (disease control) at the DGHS.
"People involved in this sector are familiar with the term Bucket Test," he said. It means samples are collected and tossed into a bucket and then test results are given randomly, the former high official explained.
"This is a common practice…. For this, the patients lose money and the treatment gets misguided. The consequences are severe for the victims," he said.
Experts said the DGHS must not shrug off its responsibilities.
Prof Nazrul Islam, former vice-chancellor of Bangabandhu Sheikh Mujib Medical University, said, "A thorough and detailed enquiry is needed to find out why the DGHS and the health ministry failed to make private hospitals and clinics accountable. The ministry and DGHS officials should keep in mind that purchasing equipment is not their only task."
The DGHS has to be liable for the corruption done by unauthorised clinics and diagnostic centres in the name of treatment, he said.
"The unauthorised facilities are playing with the lives of innocent people."
Be-Nazir said that the licencing process should be decentralised with strict monitoring.
"For example, in upazilas, health and family planning officers will issue and renew licenses. Civil surgeons will do the same for facilities in the districts," he added.
Contacted, Moniruzzaman Bhuiyan, president of Bangladesh Private Clinics and Diagnostic Owners' Association, acknowledged that many of the facilities did not have licences.
"But they are in the process of renewal," he said.