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Health DG gives green light to doctors to prescribe external purchases
View(s):By Kumudini Hettiarachchi
The green light for state hospital doctors to prescribe medicines or consumables to be purchased externally if the needed item is not available, has been given by a top-level health official this week.
The Director-General (DG) of Health Services, Dr. Asela Gunawardena, has formally given permission for such measures under ‘Guidelines to Heads of Institutions, Consultants (Medical & Dental) and Medical Officers/Dental Surgeons on the Purchase of Pharmaceuticals, Surgical Consumables and Laboratory Tests’ issued on July 16.
With the guidelines have also been issued a sample form on the ‘Declaration of willingness to provide Required Pharmaceuticals/Surgical Items’. It includes a part by the ‘Certifying Officer of Non-Availability of the item in the Institution’. The form has to be signed by the Consultant, the patient’s relative and the Head of the institution.
The Sunday Times, in a report headlined ‘Doctors urge clear directive for optimal patient care’ on June 29, 2025, highlighted the quandary faced by doctors. The Association of Medical Specialists (AMS), in a letter dated June 22 to the Health Minister, had sought urgent clarification on the “official stand” with regard to requesting patients to make such purchases, while the College of Surgeons of Sri Lanka (CSSL) and the Ceylon College of Physicians (CCP) also echoed similar sentiments.
In the latest guidelines, the DG states that in the Outpatient Department (OPD), Consultants and Medical Officers/Dental Surgeons may prescribe a drug/dental consumables for “outside purchase” in the “best interest” of the patient, after making sure the item is out of stock in the institution.
He also states that to avoid disruption of patient care in inward settings and clinics, if the patient or next of kin expresses willingness to purchase the required item under the patient’s name, such a request may be accommodated, while maintaining the highest ethical standards throughout the process.
“For inward care and clinics, the relevant Consultants must be certain about the unavailability of the relevant item within the institution before prescribing it for outside purchase, when the patient or next of kin expresses willingness to purchase the required item under the patient’s name and such willingness should be obtained in written format,” the guidelines state.
Referring to investigations, the guidelines state that if unavailable within the institution, but is essential for diagnosis or continuity of care in inward settings and clinics, they may be carried out externally, subject to the authorization of the head of the institution. This should be in cases where the patient or next of kin is willing to bear the cost and this process should be temporary, until investigations are made available in the institution.
With regard to donations, the DG reiterates that heads of institutions should establish a “transparent mechanism” for accepting such items directly from a patient or supplier, in cases where the item cannot be handed over to the patient due to technical reasons. These items should be recorded in a separate donation registry and issued to the relevant department or unit under the patient’s name, while information with regard to such donations should be compiled and submitted as a monthly report to the Drug and Therapeutics Committee (DTC) of the institution as well as the Medical Supplies Division (MSD).
While underscoring that the Health Ministry is committed to ensuring the uninterrupted supply of pharmaceuticals and surgical consumables to all state-sector healthcare institutions, the DG points out that in an event of a shortage, the relevant institutions are required to proceed with local purchases in accordance with the Manual on Local Purchase of Medical Supplies – 2023.
Heads of institutions are expected to closely monitor inventory levels to identify potential shortages in advance and take timely action. They should establish a standardised, daily reporting system that informs Consultants and Medical Officers in the OPD of the current stock levels. A similar standardised mechanism should also be put in place to keep unit/ward Consultants updated on availability, he adds.
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