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Paucity of medicines in public hospitals

Assam Tribune, February 21, 2011
A study undertaken in Guwahati, Nagaon and Bongaigaon has revealed that only 20 per cent of those surveyed could obtain prescribed medicines from public hospitals, while being treated there. The rest had to rely on private pharmacies to buy a range of medicines, often at high costs.

Procuring drugs from private chemists increased healthcare costs for patients and families, who depend on public health institutions to get medical care that is affordable. The survey reveals a situation in which patients are compelled to pay high prices for medicines even while getting treatment in public health institutions.

Consumer Unity & Trust Society (CUTS) and The Action North-East Trust (the ant) conducted the surveys as part of a project being implemented in Assam: “to raise awareness among citizen consumers so that they have a right to quality healthcare at affordable prices,” an official statement from CUTS mentioned.

According to those who did the survey, the findings undermine the intent of the Assam Public Health Bill 2010 that was adopted a year ago by the state government. This landmark law aims to ease access to healthcare services for the ordinary Assamese.

A reason for buying drugs from private sources could be short supply of medicines in public hospitals. The other reason could be a mercenary motive of forcing patients to buy medicines from private sources outside public hospitals, in spite of supplies being available within the public hospital. This could indicate collusive arrangements between hospitals and chemists/pharmaceutical companies, a member of CUTS stated.

A major objective of the recent survey is “to advocate state authorities to address challenges in healthcare delivery, which further impoverish the poor”. Alarmed by the findings, CUTS and the Action Northeast Trust now plan to dig deeper in order to assess the status of healthcare in the state and inform authorities as well as citizens at large.

Both the collaborating agencies behind the study believe, the Assam government has shown its commitment towards providing affordable healthcare for the people through legislation. But, there is an urgent need to ensure effective implementation of such good intent to reduce the financial burden of healthcare expenses for the common person.

The CUTS and the ant project also aims to highlight the practice of paying commissions to doctors for referring patients to private diagnostic laboratories and pathological laboratories. Such amounts are extracted from the consumers, who are often unaware of the collusive behaviour.

Existence of such a practice motivates doctors to refer patients more frequently for tests than might be necessary. Interactions with diagnostic clinics and pathological labs in the three towns in Assam revealed that paying commissions and cuts to referring doctors was a common practice. A third of the providers contacted during the survey indicated having paid such commissions.

It has been argued that the state government needs to ensure that minimum standards of services are offered across healthcare institutions in the state through speedy adoption of the model Clinical Establishment (Registration and Regulation) Bill 2010 in Assam. This would bring some uniformity of healthcare services across private and public providers in the state, which has serious drawbacks in the health sector.

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