Can reforming public procurement of drugs alone address consumer woes in Assam

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Can reforming public procurement of drugs alone address consumer woes in Assam

July 05, 2011, Guwahati, Assam
Ensuring availability of essential medicines in public health institutions across Assam is critical for consumer welfare said Dr J B Ekka, MD of National Rural Health Mission (NRHM), Assam during a dissemination meeting organised here today. Consumer often have to buy medicines prescribed in public hospitals from private chemists as revealed from the study undertaken by CUTS and the Ant in three towns of Assam. This dissemination seminar was jointly organised by OKD Institute of Social Change and Development, Consumer Unity & Trust Society (CUTS) and The Ant to share findings of this study ‘Collusive behaviour in healthcare delivery’ undertaken in two states of Assam and Chhattisgarh.

Rijit Sengupta of CUTS presented the findings of the study which point towards possible concerted arrangements between providers in public healthcare, leading to high cost being paid by consumers. In such a scenario, it is uncertain whether only ensuring supply of medicines in public hospital without simultaneous supervision of behaviour of providers would ultimately help the consumers. The study was carried out through multiple stage survey in four public hospitals in Guwahati, Bongaigaon and Nagaon.

The survey revealed that a large number of respondents bought medicines from private sources while getting treated at public hospitals. When drugs bought from private sources were minutely analysed and reconciled with the (respective) hospital stock – it was revealed that a significant percentage of them were available in the stock, and yet not provided to the patients. This calls for investigation by the state government as was demanded by the stakeholders present in the workshop. There was consensus that rather than taking time-bound measures, it would be useful for the state government to take small, easily implementable steps that would make lasting and measurable impacts with regards to availability of healthcare to consumers.

A very high percentage of incompleteness of diagnosis was also revealed from the analysis of prescriptions in these hospitals. These prescriptions did not bear any evidence of ‘signs and symptoms’ and/or ‘preliminary diagnosis’ in them. Absence of such written record of ailment is a fundamental flaw in medical investigation, and should not be tolerated at any cost.

The discussions hinted towards the need for the government to engage the civil society to monitor the stock of hospital stocks in public hospitals. Prescription audit is already being planned by the government and it would be necessary for the government to engage cicvil society in this process. Round-the-year supply and easy distribution of drugs in public hospitals – combined with a transparent process of monitoring and tracking its implementation would ensure that financial burden of healthcare on the ordinary Assamese consumer is addressed.

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Rijit Sengupta:, + 91 98292 85928;