NEW DELHI: Almost 80% of the drugs purchased for Central Government Health Scheme (CGHS)
dispensaries in Delhi between
2002 and 2007 were bought from local chemist while only 20% were
procured through the centralized route. In absolute numbers, the value of medicines purchased through local chemists stood at Rs 366.33 crore of the total expenditure of Rs 459.21 crore.
Similar was the story with CGHS dispensaries (which provide health care facilities for central government employees and pensioners and their dependents residing in CGHS covered cities) in Hyderabad, Bangalore, Allahabad, Patna, Kolkata, Mumbai, Pune and Guwahati.
Almost 74%-91% of the drug purchases between 2002 and 2007 in these dispensaries were from local chemists, according to the Public Accounts Committee's latest report. Also, most of the medicines in the formulary (centralized drug list) did not have a rate contract.
The report said the committee was given to understand that the purchase system of approaching local chemists was introduced to enable the CGHS dispensaries to supply to the beneficiaries those medicines which were not in stock.
"Audit had pointed out that there was procurement of smaller number of medicines from the formulary list. According to the audit, CGHS dispensaries made extensive purchases of medicines from local chemists ignoring the quality and cost effectiveness of these purchases," the PAC report said.
The major suppliers of these drugs purchased in bulk were generally the well-established larger pharma companies who were providing discounts upto 40% on MRP, the report said.
But over the period of time the system degenerated. The committee's examination of the subject has revealed that such degeneration crept in as there was no database regarding procurement, distribution and inventory management of the drugs for which no effective monitoring could be put in place to ascertain the reasons of largescale procurement through local purchases.
However, the committee headed by Murli Manohar Joshi added that the health ministry lately has swung into action and taken a number of measures to cut down on local purchases as well as to bring in efficiency in the procurement system.
PAC said that the measures included computerization of all the dispensaries in Delhi, culling out a list of about 262 medicines that were not in the formulary of Medical Stores Organization (MSO) but frequently prescribed by doctors and procured locally, and entering into a rate contract for all these drugs.
CGHS – A HELL FOR THE NEEDY AND SICK PATIENTS
ReplyDeleteThe very aim of instituting CGHS is defeated at Delhi, particularly in Vikaspuri Branch and CGHS North Zone. Nursing and laboratory facilities are not available. Receipts are not given. The appointments in Geriatric Clinic (Medical) are given after two months. One clerk in Vikaspuri Branch attends office at will. No file moves normally. Patients are being harassed. Medical claims are being delayed for years or rejected on false grounds. One claim was paid after 2 yrs. Another claim for admission as emergency at Artemis Hospital, Gurgaon on 31 August 2009 for surgical intervention of Gall stone acute pancreatitis was rejected twice by CGHS North Zone office (Ref. 2892/10/CGHS/NZ/3/11/10, without seeking experts opinion. Doctors were rude in talking, when I submitted the file second time on 3/11/10 in CGHS (NZ). Additional Director told me Gall stone pancreatitis do not require emergency operation, while literature says it is life threatening and needs emergency treatment. He made the remark without seeing the condition of the patient! He also blamed the surgeon for operating the patient. He asked me to go to court for the claim, without going through the file. They say they refer such cases to surgical specialists, but their remarks are kept confidential. When literature says, it is life threatening condition and needs emergency treatment why should they refer the file to surgical specialists and reject it on false grounds. Ministry of Health should immediately improve the situation of these CGHS centres.
M.A.Padmanabha Rao, PhD (AIIMS),
(CGHS card P 015551, BEN ID: 878426)
Former Professor of Medical physics, raomap@yahoo.com