Medicine supply disappoints
By Raghav Ramful
Published on 1st August, 2008
Most of us must have surely gone to a public hospital to do away with a fever, soothe a back pain or heal an injury. After being examined by the doctor in attendance, you must surely have found your way to the hospital pharmacy to grab your dose of drugs and medicine vital for your recovery.
So far, so good. There are no traps. The medicines you are given are genuine, even if the words scribbled on that tiny piece of paper you present to the pharmacist are incomprehensible. As a matter of fact, the government spends around Rs 325 million per year to buy medicines that have to be compliant with international norms. In the same vein, there are some 7.5 million medical examinations and admissions registered in our public hospitals and public health centres every year. Moreover, doctors give away some three million prescriptions on a yearly basis.
However, the management mechanism in place for the distribution of medicine and drugs in our public hospitals fall short of the required number as observed by the Fact Finding committee headed by Magistrate Raj Pentiah, who had the task of investigating into the quality of some medicines available. While dwelling on their initial assignment, the committee also noticed many loopholes in the procedures and the management of medicines in our hospitals at different levels - from the importing stage, to storing and distribution.
The committee has recommended a series of remedial measures to be taken with heavy emphasis on the necessity for a computerised system to manage the distribution of medicines. “The Stock Control Unit need to be fully computerised in order to effectively control and be informed of stock (a) at the Pharmacy Unit, (b) Central Supply Division and (c) which may be in transit etc. Based on these figures it will be possible to make a proper annual methodological planning,” underlines the committee.
Members of the committee also suggested that the setting up of a computerised system would ensure many advantages. One of them would be the efficient control of medicines at any time, vital and reliable figures available and monitoring closely the stock of medicines and their expiry dates.
“The new system would also prevent rupture of stock as frequently as it occurs at present and alleviate the severe storage problems the Ministry of Health and Quality of Life is facing at the present moment and save a considerable amount of money wasted in demurrage fees.” The committee adds that even if the propositions they have made are not ideal, it would however help in solving around 80% of the problems concerning quality of medicines.
Curbing wastage
The government’s decision to create a Quality Control Laboratory has been appreciated by the committee and they have recommended that obligatory tests be carried out on medicine samples that are purchased.
As far as the Ministry of Health is concerned, the recommendations of the committee figure high on their agenda. “The Cabinet has already taken note of the report, and we have already gone way ahead to set up a technical committee to analyse the recommendations of the report,” says a high officer from the Ministry. Meanwhile, to prevent wastage the committee has suggested that patients be made more responsible. The implementation of a ‘well structured paid prescription system’ has also been raised along with the political will needed to implement this recommendation. A fixed sum of Rs 25 has been suggested for every prescription excluding those benefiting from social security and the handicapped. “It would implicitly bring a sense of responsibility to the beneficiaries of the health care system and would discourage abuse and misuse of the health care service,” says the report. It also mentions that the money collected would in turn go towards improving the service.
Purchase procedures
While dealing with the purchasing procedures for medicines, the committee suggested a carefully structured tender document prepared by experts in the field. These documents, they underline, should contain certain strict conditions with which bidders should comply. Taking into consideration the nature of the products and services concerned, the committee suggested that the Evaluation Committee responsible for analysing the offers received should meet at the earliest after the opening of the bids as it would save precious time and in turn the awarding of the contracts would not be delayed.
Meanwhile, ordering of medicines seems to be the biggest task faced by the pharmaceutical department of the government. For the smooth running of this procedure, the committee recommended that the Ministry of Health provides for a competent and well experienced officer in the field to take over the entire responsibility and supervise the purchasing exercise from the time the tender is launched.
With the creation of this post, the committee believes that there will be constant supervision to regulate the procurement procedure and there will be one person accountable for every action/ inaction or decision taken as far as buying of drugs is concerned.
However, the management mechanism in place for the distribution of medicine and drugs in our public hospitals fall short of the required number as observed by the Fact Finding committee headed by Magistrate Raj Pentiah, who had the task of investigating into the quality of some medicines available. While dwelling on their initial assignment, the committee also noticed many loopholes in the procedures and the management of medicines in our hospitals at different levels - from the importing stage, to storing and distribution.
The committee has recommended a series of remedial measures to be taken with heavy emphasis on the necessity for a computerised system to manage the distribution of medicines. “The Stock Control Unit need to be fully computerised in order to effectively control and be informed of stock (a) at the Pharmacy Unit, (b) Central Supply Division and (c) which may be in transit etc. Based on these figures it will be possible to make a proper annual methodological planning,” underlines the committee.
Members of the committee also suggested that the setting up of a computerised system would ensure many advantages. One of them would be the efficient control of medicines at any time, vital and reliable figures available and monitoring closely the stock of medicines and their expiry dates.
“The new system would also prevent rupture of stock as frequently as it occurs at present and alleviate the severe storage problems the Ministry of Health and Quality of Life is facing at the present moment and save a considerable amount of money wasted in demurrage fees.” The committee adds that even if the propositions they have made are not ideal, it would however help in solving around 80% of the problems concerning quality of medicines.
Curbing wastage
The government’s decision to create a Quality Control Laboratory has been appreciated by the committee and they have recommended that obligatory tests be carried out on medicine samples that are purchased.
As far as the Ministry of Health is concerned, the recommendations of the committee figure high on their agenda. “The Cabinet has already taken note of the report, and we have already gone way ahead to set up a technical committee to analyse the recommendations of the report,” says a high officer from the Ministry. Meanwhile, to prevent wastage the committee has suggested that patients be made more responsible. The implementation of a ‘well structured paid prescription system’ has also been raised along with the political will needed to implement this recommendation. A fixed sum of Rs 25 has been suggested for every prescription excluding those benefiting from social security and the handicapped. “It would implicitly bring a sense of responsibility to the beneficiaries of the health care system and would discourage abuse and misuse of the health care service,” says the report. It also mentions that the money collected would in turn go towards improving the service.
Purchase procedures
While dealing with the purchasing procedures for medicines, the committee suggested a carefully structured tender document prepared by experts in the field. These documents, they underline, should contain certain strict conditions with which bidders should comply. Taking into consideration the nature of the products and services concerned, the committee suggested that the Evaluation Committee responsible for analysing the offers received should meet at the earliest after the opening of the bids as it would save precious time and in turn the awarding of the contracts would not be delayed.
Meanwhile, ordering of medicines seems to be the biggest task faced by the pharmaceutical department of the government. For the smooth running of this procedure, the committee recommended that the Ministry of Health provides for a competent and well experienced officer in the field to take over the entire responsibility and supervise the purchasing exercise from the time the tender is launched.
With the creation of this post, the committee believes that there will be constant supervision to regulate the procurement procedure and there will be one person accountable for every action/ inaction or decision taken as far as buying of drugs is concerned.