News
Patients disgruntled, hospital medicine supply chain out of joint
View(s):By Kasun Warakapitiya
The health sector is grappling with non-availability of certain medicines and equipment in state-run hospitals.
This is despite the existence of a so-called comprehensive medical supplies information management system “SWSTHA” which provides information on availability, quantity, and also pinpoints shortages.
A Sunday Times investigation reveals that the unavailability of medicine at hospitals stems from an array of issues including mismanagement, communication issues between the ministry and authorities, purchase process lapses, issues in distribution as well as the lack of data analysis on availability of medicines, issues in updating the system and creating action plans to remedy shortages.
It was noticeable that different hospitals face shortages of different drugs and availability is inconsistent and unpredictable.
The shortage of drugs at outpatient departments (OPD) at rural, base, teaching as well as national hospitals, was visible as the patients were told to purchase the medicine from pharmacies, or only given what is available.
However, a cross section of medical professionals in provincial, suburban as well as main state hospitals said that they prioritise patients in emergency treatment units, intensive care units as well as patients in wards, and manage the available medicine.
Doctors, according to the severity, and availability of substitutes for in house patients try to buy from pharmacies, yet that too, faces finance restrictions.
If that option is unavailable, patients’ family members would be asked to buy medicine from private pharmacies.
Patients who come to clinics as well as OPD to get medication are given second priority and are either asked to buy from pharmacies or wait until the hospital gets supplies.
Medicines for cancer, cardiovascular diseases, diabetes, cholesterol, antibiotics as well as pain killers are in short supply.
A cross-section of interviews of patients who arrived at the Colombo National hospital to get medicine revealed a severe shortage of medicine at provincial and base hospitals, which makes them go to teaching and national hospitals in big cities.
R.M Gunathilake, 80, a retired school van operator who lives in Homagama complained that the shortage of medicine is severe at the base hospital in her residential area.
The retired school van operator said that once a month he makes an arduous journey to the Colombo hospital to get medication for his wife and himself. He has registered in the Colombo hospital’s clinic so he and his wife would have a better chance of getting medication.
Long queues form in front of several counters where medication is distributed. Some wait over three to five hours. And yet, some patients do not get all the medicines prescribed to them.
Elderly patients suffering from non-communicable diseases are forced to wait in a queue while their children accompany them.
H.A Hemahetti, 66, from Horana, who suffers from heart ailments and had also undergone bypass surgery last year told the Sunday Times that she had waited for three hours in a queue to get her heart medication as well as insulin and cholesterol pills. “I was only able to get 12 out of the 15 prescribed medicines,” she said.
Ms Hemahetti complained that she was told to purchase the remaining medicine from private pharmacies, and spent Rs 4,600 to buy just three tablets for two weeks.
Inconsistent supply of medicine is common in the outpatient department of the National Hospital, where a certain medication available one month is unavailable for the next two months.
Ven., Kuligoda Wimalwansha Thera, 69, who suffers from kidney disease said: “If I get the kidney medication tablet this month, the next two months I would not get it from National Hospital OPD.’’
Patients complained that insulin, heart medication, cholesterol medication, painkillers as well as some antibiotics are in short supply. Shortages have been persistent for several months.
S.D Kumara, another heart patient said medication is in short supply at the hospital as well as at the state pharmacy Osusala in Town Hall.
The pill he got free from the National Hospital costs Rs 8 at state pharmacies, yet it is sold for Rs 60 at private pharmacies, he said.
Media spokesman of the Government Medical Officers Association (GMOA) Dr Chamil Wijesinghe told the Sunday Times that around 180 medicines out of 850 are either in short supply or inconsistently available according to the medical supplies management system.
According to him, hospitals have shortages of 40 to 50 medicines at any one time.
“Health authorities should create short, mid- and long-term plans to manage and reduce the shortage of drugs.’’
According to him, in the short-term, the exact requirement of drugs needs to be analysed and emergency purchasing should be made to end shortages. As mid and long-term measures, purchases should be restructured, while improving the coordination of distribution of drugs.
Deputy Director General of the Medical Supplies Division (MSD) of the Health Ministry, Dr Lakshman Edirisinghe said that he would respond next week.
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