KARACHI:The admitted patients in three major hospitals of Karachi could not get full cover of medicines since the last decade, according to an investigation report released on Sunday.
The admitted patients at the three major hospitals – Dr Ruth Pfau Civil Hospital, Jinnah Postgraduate Medical Centre (JPMC), Abbasi Shaheed Hospital – are being compelled to purchase some medicines, particularly costly, from private stores with their own money, however, the hospitals are legally bound to provide full medicines cover to them, said the investigation report made by senior journalist M Nawaz Khuhro under an investigative reporting fellowship.
Top health officials usually heap blame on population rise, price hike, budget limits, and huge number of patients which are nothing but lame excuses. The health experts describe such excuses as misinformation and disinformation. Several patients at these hospitals interviewed who said that full cover of medicines is not being provided. Independent experts are of the view that patients are deprived of due medicines cover due to corruption from top to bottom level. They said that patients’ medicines are sold to private stores.
In an interview, Dr SM Qaiser Sajjad, Honourary Secretary General, Pakistan Medical Association, who is also active health expert, said that a maximum of 50% medicine cover is being provided to admitted patients in ASH, JPMC and CHK in Karachi, which is low. He said that medicine stocks in those hospitals usually ended within three to four days after arrival, as a result, medicine cover for the patients sometimes went below 50%.
In an interview, Abid Hussain, a health expert, who monitors these major hospitals for a decade, said in view of his personal observations that patients at JPMC, CHK and ASH were not getting proper medicines cover. He said that at JPMC and CHK, estimated 65-70 percent of required medicines are being provided to the admitted patients, while their OPD patients are getting 50-60 percent of required medicines. However, at ASH, the admitted patients are getting 25-35of required medicines. He said that the Sindh government gives a low budget for ASH as compared to JPMC and CHK.
He, who visits these three major hospitals frequently and meet officials and other staff for information about condition of patients and medical provision, alleged that some share of patients’ medicines, particularly costly, at these hospitals are being sold to stores in connivances with paramedics, nurses and doctors while some share of this corruption is also provided to top officials of the hospital.
OPD services at Dr Ruth Pfau Civil Hospital Karachi cater to 7,000 patients daily, the Jinnah Postgraduate Medical Centre (JPMC) provides treatment to 8,000 patients, and Abbasi Shaheed Hospital caters to 5,000 patients each day. The delays in issuance of tenders to purchase medicines on centralized basis policy is the major reason behind the shortage of drugs in the hospital.
According to a study in BMJ Open, a leading multidisciplinary medical journal, 89% physicians and 93.2% pharmacists reported that medicines shortages have led to adverse effect on treatment including treatment delay, complications of treatment, substandard treatment, prolonged hospital stay, increase treatment cost and even death of the patient.
Despite the rise in health budget by federal and Sindh governments, these major hospitals often face medicine shortages, putting lives of patients at stake as poor patients could not afford purchasing costly medicines from the private stores. In fiscal year 2020-21, Sindh health department budget was raised by 16.1 percent to Rs139.18 billion, but there is no improvement in medicines provision to the patients.
According to a federal finance ministry’s survey, health expenditures have increased gradually to 1.2 percent in 2019-20 from 0.7 in 2011-12. The survey says after the passage of 18th constitutional amendment, provision of health services is the mandate of the provincial governments however, the Federal Government has supported various health related projects through Public Sector Development Programme (PSDP), for fulfillment of Sustainable Development Goals (SDGs) and overall health status in the country.
During FY2021, PSDP allocations of Rs 20,193.9 million were made for 71 health sector projects. In addition, the government has introduced an especial programme with an outlay of Rs 70 billion to mitigate the impact of COVID-19 pandemic. But despite this, full medical cover is not being provided to the admitted patients which is injustice.
They said that doctors also prescribed such medicines which were not in the stock of hospitals’ pharmacies, a blame which health expert Mr Abid endorsed. Abid also said that there was a cartel between doctors and medical stores as doctors prescribed certain medicines which were not at hospitals’ stocks and were only available at medical stores.
A survey regarding drug shortage in tertiary care hospitals of Karachi in which 472 physicians and pharmacists participated says the shortage of injectable forms of drug is more common, accounting for 52.2 % shortage. The survey said that the main cause of drugs’ shortage is the increase drugs’ price which was rated by more than 36% of participants. The adverse outcomes due to drugs’ shortage patients face are length of stay (25%) and cost of treatment (14%) increases reported by respondents.
Those physicians and pharmacists who are working in public and private hospital sectors have to face drugs’ shortage problems. The shortage of drugs happens due to various causes and healthcare staff have to bear several challenges furthermore, all of these in the end have negative consequences on patient health, the survey added.
To seek comments of the Sindh health minister on the medicine issue, health department PRO was contacted several times, but he did not respond. Another Lady PRO of the minister, however, kept me for waiting for the interview. Lastly, she said that the health minister is out of the city and when she comes, time would be given for the interview.