The affluent are seeking medicare abroad and the poor are going to the quacks. What then remains of the confidence in our health care system, public and private sector put together?

The statistics contained in the report should get the relevant people in the government thinking. As of now the percentage of people that rated government service as 'good' has come down to ten from 38 five years ago, and those resorting to quacks have gone up to 49 from 30 during the same period.

There are some cogent reasons why people are turning away from public health services and the government must urgently address the causes if it wants to arrest the decline in health delivery system.

One of the causes of poor service of public health system is the spurt of private clinics and hospitals, which attract government doctors at the expense of their primary responsibility. The doctors posted at the rural health centres including the upazillas often remain absent from their work place.

Among the developing countries, Bangladesh is credited with having very good primary healthcare infrastructure facilities. But the system has been badly let down by the mismatch between planning and implementation.

We feel that apart from improving government medicare system in terms of the quality of service the quacks also must be brought under some sort of control.

A situation where the quacks are a major provider of health care is perhaps too much to endure, even for a country like ours.