Rajshahi Correspondent:

Patients and their relatives at Puthia Upazila Health Complex in Rajshahi are increasingly distressed by the rampant presence of medical representatives and middlemen (dalals) operating within the government facility.

These intermediaries, including some contract-based hospital staff, exploit patients by coercing them into unnecessary tests at private clinics and diagnostic centres.

Investigations reveal several salaried hospital employees funnel patients to private centres in exchange for commissions reportedly reaching 40%. Although medical representatives are officially permitted to meet doctors only three days a week after 2pm, this regulation is widely ignored, with unauthorised personnel freely accessing the premises.

Local residents describe the 50-bed facility as chaotic, with many patients falling victim to fraud. Middlemen reportedly confiscate prescriptions and pressure patients to undergo costly tests at affiliated private centres.

In recent years, protests led by activist Shamim demanding a “Dalal-free Puthia Medical” were met with violent retaliation by middlemen. Despite police intervention, the hospital remains under the sway of these syndicates, enabled by weak oversight and collusion with local private healthcare interests.

An anonymous hospital official disclosed the presence of about 15 pathology centres and 10 illegal clinics nearby, each with middlemen funnelling patients. Doctors allegedly receive monthly commissions between Tk30,000 and 70,000 from these centres.

Official data shows Puthia Upazila hosts 23 diagnostic centres and 13 clinics, most employing multiple middlemen — primarily women — who earn Tk6,000 to 7,000 monthly plus commissions. A community medical officer, speaking anonymously, noted that staff often feels powerless to resist middlemen due to their strong local influence. Residential Medical Officer Dr Md Janab Ali Mustafiz stated that middlemen quickly leave when authorities approach but return once vigilance lapses.

Puthia Upazila Health and Family Planning Officer Dr Suchana Manohara, recently appointed, vowed to eradicate middlemen from the hospital and promised strict action against any staff involved.

Upazila Nirbahi Officer (UNO) Liakat Salman, previously unaware of the issue, assured that proper measures will be taken to identify and address the problem.