ACC recommends regulation on govt hospital doctors working in private clinics

Anti Corruption Commission (ACC) has recommended the formulation of a regulation on government hospital doctors working at private clinics.

According to the 'Health Welfare System's Corruption Risk Assessment' paper, Maldives lacks many regulations required for a comprehensive health care system. These include:

- Diagnosis regulations

- Price setting in private facilities

- Treatment plan regulations

- Treatment and practice guidelines

The study also highlighted that Maldives does not have regulations regarding government hospital doctors who also work in private settings, adding that this leads to conflict of interest. ACC also said it was observed that in such situations, patients are not given the adequate time, and that service monitoring and evaluation is not effectively carried out.

“The lack of a proper monitoring and evaluation system can lead to illegal profiteering,” ACC's paper said.

As such, the Commission recommends a guideline on government hospital doctors working in private clinics.

ACC also said that due to the lack of important regulations, there are no standards to determine whether tests carried out are medically necessary. The regulations would facilitate tests related to the medical conditions to be carried out, and avoid repetitions, the Commission also said.

This would also decrease Aasandha expenditure, the paper reads.

No proper referral system

The lack of regulations to facilitate a strong referral system in Maldives is also a challenge to ensuring the integrity of the health welfare system, the study said.

The lack of a referral system in some cases delays patients being referred abroad, resulting in the patient having to go "doctor shopping" or see different doctors in the country. This causes financial strain on both the patient and Aasandha, said ACC.

"They highlighted that there are difficulties in reducing the expenses required to be made from Aasandha and NSPA, within the welfare system. This is because the current system does not allow for a specific approach to such expenditures, due to the lack of guidelines to regulate expenses," the Commission further wrote.

As such, ACC recommends the establishment of a referral system as well.

It was also pointed out that necessary regulations do not exist to ensure integrity in matters relating to medications, specifically in setting prices for medications based on medication strength and volume. It was also identified that no written guidelines exist on monitoring the central management system of imported medication.

The lack of the rules hinders the prompt delivery of services by Aasandha, and facilitates corruption to expedite the work and services, ACC said. The lack of such documents to guide action in matters directly related to the lives of the people such as health services leads to decisions that are not in the best interest of the people, the commission further said.

"This will lead to corruption. It will also deprive the people of their basic right to live in good health," the report states.