ACC Recommends New Regulations for Gov’t Doctors Working Privately

The Anti-Corruption Commission (ACC) of the Maldives has proposed the development of regulations governing government hospital doctors who also practise in private clinics. 

This recommendation is part of the recently published “Health Welfare System’s Corruption Risk Assessment” report, which highlighted gaps in the Maldives’ healthcare regulatory framework.

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The report identifies a lack of essential regulations necessary to ensure a robust healthcare system, including standards for diagnosis, pricing in private facilities, treatment planning, and clinical practice guidelines. 

We are pleased to announce the publication of the Health Welfare Risk Assessment by the Commission.
For more information: https://t.co/swtncYFG5Z pic.twitter.com/sXSs1IgzWL— ACC-MALDIVES (@ACC_Maldives) October 10, 2024

Notably, the ACC has pointed out the absence of regulations specifically addressing government-employed doctors working privately, a situation they believe presents a conflict of interest. The ACC observed that this often leads to reduced patient consultation time and inadequate service monitoring.

The Commission also noted that the lack of regulatory standards makes it difficult to determine the medical necessity of diagnostic tests, potentially leading to unnecessary tests or repeated procedures. Implementing such regulations, ACC asserts, would facilitate appropriate testing based on medical conditions and could reduce costs under the Aasandha national health insurance programme.

A key challenge identified in the report is the lack of a formal referral system, which can delay patient referrals abroad and encourage “doctor shopping” within the country. This not only creates financial strain on patients but also on Aasandha, the report stated.

The ACC commented that these issues make it difficult to control welfare-related expenditures, as there are no guidelines to standardise costs effectively. To address this, the Commission has recommended establishing a structured referral system.

The report further noted the absence of guidelines for regulating medication prices based on strength and volume, as well as the lack of oversight in managing imported medicines. The ACC believes this regulatory gap hampers the timely delivery of services through Aasandha and creates opportunities for corruption.

The Commission emphasised that without regulations guiding health service decisions, there is a risk of decisions being made that may not serve the public’s best interests. The report concludes by cautioning that the absence of these essential healthcare regulations compromises citizens’ right to good health and increases the likelihood of corruption within the health sector.