According to the exiting Private Clinic and Medical Practitioners Ordinance 1982, a doctor cannot take more than Tk 40 per private consultation and Tk 20 for each follow-up from a patient.

A visit to a number of chambers of the private medical practitioners in city's Dhanmondi and Green Road areas revealed that a patient, regardless of his financial status, has to pay a specialist physician Tk 400-500 on an average.

"The law has become obsolete as its provision for Tk 40 per patient as private consultation fee does not match the present market situation," said Dr Md Abdur Rashid, director of hospital at the DHS.

"Realising the ineffectiveness of the law in the present context, even the government does not want to investigate whether the private practitioners are really obeying it or not," a DHS officer said requesting anonymity.

The law will be updated soon possibly fixing afresh the fees of private practitioners in consistence with general people's capability, Dr Rashid said adding that the process is at the final stage. He, however, could not specify when it would be implemented.

On why the government is not taking action against doctors charging indiscriminate fees, Dr Rashid said, "We [DHS] have nothing to do as no complaints in this regard have so far come to us."

Meanwhile, the private medical practitioners are against the government's move to fix a fee for private medical consultation.

A private medical practitioner has the right to take high fees from a patient in a free market economy, said Bangladesh Private Medical Practitioners' Association (BPMPA) President Dr Mosaddeque Hossain Biswas.

He admitted that about 90 percent people of the country cannot afford to go to the private medical practitioners due to their high fees. "If proper health services at hospitals could be ensured by developing a suitable system through improved reference system, decentralisation of health services and people's awareness, they would not need to go to the private practitioners," he said.

The BPMPA president asserted that the government should sit with the doctors and other stakeholders related to the health sector before fixing the private medical consultation charges.

Renowned child specialist Dr AQM Talukder is, however, against the refixing of the fees. "Compared to other countries, the private consultation fees here is not much at all. A doctor takes Tk 20,000 from a patient for private consultation in England," he said.

He also echoed the BPMPA president's view that the government should sit with the doctors before fixing the rate of private medical consultation fee.

"The government can fix the charges of private medical consultation, but it should be done in case of other professions also," Gastroen-rologist Dr Swapan Chandra Dhar viewed.

Echoing this view, Dr Zahidul Haque, registrar of Bangladesh Medical and Dental Council (BMDC), said doctors may have logic in charging high fees from patients as other professionals like the lawyers and engineers do not hesitate to realise huge amount of money from their clients.

Noted plastic surgeon Dr Samanta Lal Sen, however, thinks the rate of the practitioners should remain within the reach of general people.

"I think the fees charged by the private medical practitioners are very reasonable compared to those in other countries," President of Bangladesh Private Clinic and Diagnostic Owners' Association Maniruzzaman Bhuiyan said emphatically.

On the BMDC roles to solve the problem, Dr Zahidul Haque said it has no authority to do anything in this regard.