The DMCH has no ambulance service of its own and has no control over this flourishing business which is controlled by a section of employees of the hospital in collaboration with some private clinic owners.

"We have business deals with private clinics. The rides are free but for each patient we take for admission we get five to ten per cent commission on the admission fees," said one of the drivers on condition of anonymity.

Misleading information like better facilities, modern equipment, air-conditioned rooms and expert doctors on duty round the clock are publicised to attract patients waiting in the outpatient department.

The most common patients the middlemen prefer to grab are those suffering burns, bone fractures and spine and brain injuries. Ward boys inside the outpatient department are often used as promoters of private clinic business. Waiting patients are often talked into seeking treatment at private clinics.

"Usually we get good commissions for patients with bone fractures as the clinic stay for the patient is longer than usual and the expenditures are also quite high," said another ambulance driver.

On average each clinic pays up to Tk 1,000 to a middleman who brings patients from the DMCH.

Jasim Uddin, who had suffered a fractured ankle, was unable to find a bed in the orthopaedic ward of the DMCH, and was instantly offered help at the main gate of the outpatient department by one of the ambulance drivers.

"Sir, would you like to get treatment at a private clinic? We have concessions and also better facilities with doctors on observation round the clock," came the offer.

"No, I would not like to go to a private clinic," the annoyed man in his mid-40s shouted at the drivers who encircled him on his crutches.

Eventually, however, after a few minutes of harassment, Jasim conceded and boarded one of the ambulances.

The private ambulance drivers also prevent patients from hiring taxis to take them home upon release.

"We are forced to rent the ambulances parked outside the emergency gate of the hospital," said Shawkat Hossain, a relative of a patient released last week.

He continued, "I preferred to rent a taxi but one of the men identifying himself as an official of the ambulance rental business threatened the taxi driver not to carry any patients."

The taxis, parked close to the emergency gate of the hospital, are never allowed to pick up patients. In the past, several taxis have been damaged while trying to pick up patients from the emergency gate of the hospital.

"There is a big gang from the hospital and private clinics at the emergency gate of the hospital who controls the ambulance business. We dare not speak out against the business. They enter our wards with trolleys and pick up patients right in front of us often without any release order," said a medical officer at the neurosurgery ward.

The health directorate has remained silent on the issue and never interfered. Contacted, a health directorate official said, "We have no business that takes place outside the boundary of the hospital. We are only concerned about what takes place inside."