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Assam Tribune, October 22, 2011

GUWAHATI, Oct 21 – A recent independent report has revealed how patients in select cities in Assam have suffered due to the State Health Department’s failure to curb collusive behaviour among some doctors, pharmaceutical companies, and other stakeholders.
The findings highlight serious hurdles in the health sector that has attracted attention for wrong reasons in recent times. Assam’s Infant mortality rate is higher than the national average, while the Maternal Mortality Rate (per 100,000 live births) hovers at 480, the highest in the country.

The report – Unholly Alliances in Healthcare Services – by Consumer Unity and Trust Society (CUTS) International, and supported by Oxfam India, focuses on ‘Collusive Behaviour in Healthcare and Impact on Consumers’ with evidence from Assam and Chattisgarh.

A serious finding of the study was that households belonging to the low income class spent a larger share of their monthly income on healthcare. In Assam, the amount spent by this group on healthcare was 20.56 per cent, against 14.14 per cent in the case of Chattisgarh.

An analysis of information gathered from 210 respondents in Assam portrayed a disturbing scenario. The respondents from Gauhati Medical College Hospital, Civil Hospital Nagaon, Urban Health Centre, Nagaon, and Civil Hospital and Primary Health Centre, Bongaigaon revealed that on an average the cost of drugs prescribed per prescription in public hospitals were high, where a major part of medicines were brought from private sources.

The report, which involved Assam based NGO the Action North East Trust (The Ant), mentions that although a high proportion of ‘rational drugs’ were prescribed in some hospitals, there were also a significant percentage of ‘irrational drug’ prescription, which added to the financial burden of patients. This hints at collusive behaviour involving doctors and pharmacists.

Among the matters of concern was the fact that medicines were ‘mostly obtained from private/outside sources in three of the four public health institutions surveyed’.

When asked, the respondents mentioned ‘non-availability of medicines in public healthcare institutions’ as the main reason for buying medicines from private sources. The exception was the Urban Health Centre, Nagaon in which only a few respondents indicated that they had to buy medicines from outside sources.

Another worrying trend was ‘incompleteness of diagnosis’, a frequent experience across the health institutions. The study favoured greater supervision to ensure that comprehensive diagnosis is carried out and also recorded in the prescriptions for future reference.

In the case of Gauhati Medical College Hospital and Civil Hospital Nagaon, the survey exposed an alarming trend of incomplete diagnosis. In GMCH, the completeness of diagnosis was 10 per cent, while in Civil Hospital Nagaon it was just eight per cent.

An analysis of the Stock Lists from the surveyed health institutions showed many of the drugs were absent, and therefore patients had to purchase those from private sources. Strangely, a number of drugs obtained by the consumers from private sources were available as recorded on the Stock Lists.

Gauhati Medical College Hospital fared poorly in this regard, and the report describes it as alarming: ‘Of the 196 drugs that were brought by the surveyed consumers from private sources, 49 per cent were available in the stock register’.

CUTS international has urged the Assam Government to immediately intervene and initiate investigation in the health institutions so that patients, many of the poor and underprivileged, have better access to healthcare.

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