'Overhaul medicine purchase system for transparency'

NAGPUR: The Jan Arogya Abhiyan (JAA), a state-level network of people's science organization, health NGOs, trade unions and women's organization working for making the public healthcare delivery system more people-oriented and accountable, is now demanding a complete overhaul of the medicine purchase system, enacting a law to prevent patients' rights in private hospitals and forming a state monitoring and planning committee to make the health sector more transparent and deliverable.
JAA, a branch of the national-level body called Jan Swasthya Abhiyan (JSA), has been working in Maharashtra for the last eleven years for improving the reach of public health system in remote areas. The movement comprising private practitioners, NGOs and activists has long been demanding access to healthcare at affordable cost and at every place. "As an organization we have made enough efforts to take our demands to all the three health ministers (Dr Vimal Mundhada, Rajendra Shinge and Dr Suresh Shetty) since formation of our organization on issues concerning public health. But somehow, except for assurances, we couldn't get the things going. The present health minister doesn't have either inclination or the will to deliberate on such issues. Hence we are forced to take our demands to the government through the media," said Dr Anant Phadke, JAA coordinator from Pune here on Friday. He and other JAA members are in city for the national convention of JSA.
Calling for overhaul of medicine procurement and distribution system in Maharashtra, Satish Gogulwar, Vidarbha coordinator of JAA said that the existing system had many flaws due to which medicines and services could not reach the neglected and poor people. "JAA conducted a statewide survey in November last year in five districts of Nandurbar, Thane, Osmanabad, Amravati and Pune which showed that out of 69 essential medicines that should have been available at all the primary health centres (PHCs), almost 52% were not available at all. We suggest a system on lines with Tamil Nadu where the cost of medicines available in government hospitals is 63% less compared to Maharashtra and there is no shortage. States like Kerala have already replicated the model and Rajasthan and Bihar are in the process. Why is Maharashtra so averse to such a system," questioned Gogulwar.
Bandu Sane, another JAA member working for tribals of Melghat, criticized the health ministry and said that enacting a law to protect doctors from attack by patients and relatives was a good decision but it was sad that the same government does not see need for such a law for protection of patient's rights. "We have been demanding amendments to the Bombay Nursing Home Registration Act with provisions for patients' rights since past five years with support from the Indian Medical Association. But all the three past health ministers have turned a deaf ear to them," he said.
Dr Suhas Kolhekar, an activist, opposed privatization of radiology services like X-ray, CT scan, sonography in government sector. The government is justifying privatization on grounds of non-availability of trained technical staff to run machines. "But how that problem would be solved with privatization? You pay better salaries and you will have trained staff even in rural setup as the government job is always a preferred option. Even part time basis appointment of private technicians in government can improve the system. But privatizing will completely kill the system and deprive the tribals and poor people who are otherwise also ill-treated," she said.
Dr Abhay Shukla, a JSA member from Pune, demanded a state monitoring and planning committee at the earliest to bring more transparency in the health system. Since 2007, Maharashtra has had a successful experiment of community based monitoring and planning in five districts in the state which has extended to 13 districts this year. "Syeda Hameed, member of the Planning Commission, too appreciated this model. Such committees have been formed from village to district level keeping a watch on systematic implementation of policies. But a similar committee at the state level is still pending," he said.