Hospital beds up, doctors still missing

The government is increasing hospital bed capacity without adequately addressing staffing gaps, raising questions of whether any meaningful improvements in patient care would come from the initiative.

Within three months of taking office, the current administration has also embarked on hospital expansion initiatives, as the previous two governments did, approving the addition of another 1,100 beds in public hospitals.

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The expansion comes even though 9,407 doctor posts -- around 23 percent of the sanctioned physician positions in public hospitals -- remain vacant.

The challenge is set to grow further as the government has decided to upgrade all Upazila Health Complexes (UHCs) to 101-bed hospitals. More than 400 facilities with 50 beds or fewer will need to be upgraded.

The wholesale plan will require a substantial increase in the health workforce, but the country’s pipeline for recruiting doctors remains inadequate to meet the growing demand.

The government is currently processing four Bangladesh Civil Service (BCS) examinations through which 4,113 doctors are expected to join government service. Besides, the Director General of Health Services (DGHS) proposed recruiting 5,000 more doctors.

However, that number is insufficient to fill existing vacancies, support the newly added beds and meet the future workforce requirements arising from the planned expansion of UHCs, according to officials and experts.

“Successive governments focused on hospital buildings and bed expansion but failed to ensure the essentials needed for delivering services,” said Prof Rashid-E-Mahbub, convener of Doctors Platform for People’s Health.

In Bangladesh, occupancy rates in most government hospitals exceed their official capacity, prompting successive governments to expand healthcare infrastructure and increase the number of beds.

When a hospital with adequate physical space seeks approval for additional beds, the health ministry usually reviews its occupancy rate before forwarding the proposal to the finance ministry, as the expansion requires additional funding, said a health ministry official.

Once approved, the hospital receives allocations to cover the additional patients’ food costs.

However, adequate manpower and sufficient budgetary provisions for medicines are often not ensured, leaving hospital authorities struggling to cope with the increased patient load, the official said, requesting anonymity.

ADDING BEDS, BUT NO MANPOWER

Between April 25 and May 24 this year, the health ministry approved 1,076 beds across nine public hospitals, according to health ministry documents.

Of these, the highest number -- 500 beds -- was added to Mugda Medical College Hospital. Three district hospitals in Narsingdi, Rajbari and Rangamati received 150 beds each, while five upazila health complexes were allocated a total of 126 new beds.

Between November 2024 and September 2025, the interim government approved 1,212 beds in 12 hospitals, documents show.

Of them, 500 beds were approved for the second unit of the National Institute of Neurosciences and Hospital (NINS) and another 500 for the newly built Kushtia Medical College Hospital. The remaining beds were allocated to nine upazila health complexes and one trauma centre.

None of the hospitals has received a revised organogram yet.

The 500-bed Kushtia Medical College Hospital was approved in November 2024, but its proposed organogram for around 1,700 personnel is still pending with the health ministry.

Its director, Anwarul Kabir, said the hospital currently has only 45 doctors and 180 nurses -- capable of operating around 350 beds -- while cabins remain closed due to manpower shortages.

A new 500-bed unit of NINS has remained largely unused for over six months since its inauguration due to manpower and budget shortages, despite having furniture and equipment in place.

Only a few tests -- CT scan, MRI and X-ray -- are currently being conducted there.

Health Minister Sardar Md Sakhawat Husain recently said it would be made fully functional from August 15.

Between January 2023 and July 2024, the then Awami League government approved 486 beds across 12 hospitals, but many of the hospitals did not receive revised organograms.

Joypurhat District Hospital was upgraded to 250 beds in October 2023 but is still operating with manpower for a 100-bed facility.

Superintendent Sardar Rashed Mobarok said a new organogram for 250 beds was received in February this year but has not yet come into effect.

EXPANSION AMID MANPOWER SHORTAGE

On June 3, the health minister said the government had decided to upgrade all existing upazila hospitals to 101-bed facilities to improve health services, following a meeting chaired by Prime Minister Tarique Rahman.

Preparations have already begun, though no timeframe was specified.

Responding in parliament on June 10, the health minister said 19 UHCs had been upgraded to 100 beds, with seven more underway and plans in place to upgrade the remaining 408 to 101-bed facilities.

He also said 23,223 posts, which is around 20 percent of the sanctioned positions, remain vacant, including doctors, nurses and other health workers.

Around 20 lawmakers from different districts questioned the manpower shortages at hospitals in their respective constituencies on that day.

Under the government’s standard staffing structure, a 50-bed hospital requires 105 personnel, including 40 doctors, while a 100-bed facility needs 153 staff, including 70 doctors.

Upgrading all UHCs will require about 20,000 additional personnel, including more than 12,000 doctors.

However, the pipeline for recruiting doctors remains weak.

The health minister told parliament that 4,113 doctors would be recruited through the 45th, 46th, 47th and 50th BCS examinations.

The government plans to recruit 100,000 health workers, he added.

WHAT EXPERTS AND OFFICIALS SAY

Governments often build healthcare infrastructure but leave doctors to deliver services without adequate manpower, equipment, medicines, maintenance and operational support, said Prof Mahbub, also former president of Bangladesh Medical Association.

On the decision to upgrade all UHCs to 101-bed facilities, he said healthcare needs vary by area and should be based on population and disease burden.

Infrastructure projects are often driven by political considerations rather than service needs, resulting in public funds being spent on buildings and equipment that many facilities cannot properly use, he said.

Contacted, MA Muhith, state minister for health, said hospitals nationwide are operating far beyond capacity, with patient numbers often two to three times the available beds, forcing many to be treated on the floor.

“This is why 50-bed hospitals are being expanded to 100 beds, as many facilities already have around 200 patients waiting for care. Without increasing bed capacity, patients would end up in corridors,” he told The Daily Star.

He, however, said that bed expansion alone is not enough and stressed the urgent need to recruit doctors and fill vacant posts.

“Patients cannot wait months for recruitment or years for construction. The government is working on all three fronts simultaneously -- expanding beds, recruiting doctors and building infrastructure,” he added.

Pravath Chandra Biswas, director general of DGHS, told this correspondent on June 18 that they have already written to the health ministry seeking recruitment of 5,000 doctors alongside the ongoing BCS process.