Patients face a bitter deal
By Asif Fuard and Vanessa Sridharan
Patients are having to pay a heavy price due to mismanagement and
inefficiency in the chain of distribution of medical drugs to government
hospitals, The Sunday Times learns.
the top of the chain of distribution is the State Pharmaceutical
Corporation (SPC) that sells the drugs to the Medical Supplies Division
MSD which in turn distributes the drugs to government hospitals
where patients are able to get them free of charge.
most of the time patients are turned away by hospital officials
who tell them that they are out of stock due to an SPC delay in
providing the drugs on time to the MSD.
MSD is the sole distributor of drugs to the country’s public
health sector and 90% of these drugs are obtained from the SPC.
The MSD orders the drugs from the SPC a year in advance prior to
distribution and on an estimated quotation these drugs are distributed
to all government hospitals.
The Sunday Times learns that the SPC has not been consistent in
supplying the ordered quantity of drugs to the MSD, resulting in
hospitals running out of stocks. It is also learnt that sometimes
the SPC in a desperate bid to provide the MSD with drugs supplies
them with drugs that are close to their expiry dates. This forces
government hospitals to destroy medicines worth about Rs. 15-20
million a year, according to estimates by government health authorities.
Sunday Times also learns that last year the treasury had allocated
the MSD Rs. 7000 million which was largely spent on buying drugs
from SPC. Despite the SPC’s drawbacks and inefficiencies the
MSD continues to buy drugs from it because of its nominal prices.
when we contacted SPC director Sarath Silva he said they always
provided the drugs on time and there has never been a shortage of
Underlying another problem, MSD Director Dr. B.V. Beneragama said
most of the hospitals didn’t forward the estimated drug quotation
on time and sometimes they even over estimated the quota which resulted
in a wastage of drugs.
order the drugs from the SPC one year prior to the distribution
date. We supply our drugs on time but sometimes we have certain
difficulties. Sometimes hospitals open new wards and expect us to
provide them with drugs immediately. These are some of the problems
we face. These problems could be looked into if we had a drug review
committee to keep tab on the hospitals’ use of drugs. This
would prevent drugs from going waste.
the Sri Jayewardenepura hospital, a semi government institution
is in turmoil after authorities handed over the running of the pharmacy
to the SPC which authorities say would reduce the inefficiency in
the system.(Please see box). However trade unions are up in arms
and they charge this may be the first move towards privatising the
Health Sector in Sri Lanka. Hospital staff who are entitled to free
medical benefits for themselves and their families fear that they
will lose these benefits as a result of the SPC takeover.
most affected by the hand-over are the kidney transplant patients.These
patients were able to obtain their monthly quota of drugs for a
nominal fee of Rs. 200. But now after the SPC takeover of the pharmacy
they have to pay Rs. 35,000, The Sunday Times learns.
the hospital’s Chairman D.D.Ranasinghe defended the move saying
it was necessary to minimize wastage of resources and improve efficiency.
The Sunday Times learns that the Government grants the Sri Jayewardenepura
Hospital Rs. 440 million a year which officials say is not enough
to run the institution since staff salaries alone come to about
Rs. 470 million a year.
When we contacted Health Minister Nimal Siripala De Silva he first
said the allegations were wrong and then cut off the line. When
we called the same number another voice answered and said we had
got a wrong number.
Sri Jayewardenepura hospital is facing a crisis with more than 400
kidney patients who used to get their monthly quota of medication
for a nominal Rs. 200 now being forced to buy the drugs at an exorbitant
amount of Rs.35,000.
patients who are mainly from low income groups have joined hands
with other kidney transplant patients to set up an organization,
the Kidney Transplant Patients Association (KTPA).
of them feel robbed of the free medication that was provided to
them until the pharmacy was handed over to SPC. The Kidney Transplant
Patients’ Association secretary S.M.S Perera said; “We
used to pay Rs.200 a month for all our drugs now we have to pay
Rs. 35,000 a month and even then sometimes the drugs are out of
stock. Sometimes we have to come to hospital every week to see if
a particular drug is available. We have sent a letter to the Director
of the Hospital asking him not to privatise the pharmacy since most
of us cannot afford to pay for these drugs and we are awaiting a
Hearath, a kidney specialist at the Sri Jayewardenepura Hospital
said most kidney transplant patients need these drugs to survive
after the transplant and all Government Hospitals give these drugs
free of charge and it should be the same practice at Sri Jayewardenepura
The Sunday Times also learns that the Sri Jayewardenepura Hospital
owes the MSD Rs. 200 million and in order to cut off this debt they
have pushed the burden on to the patients who were obtaining drugs