Shortage of medicines at public hospitals forcing patients to buy drugs out of their own pockets

By M. Waqar Bhatti
November 19, 2018

Thousands of needy patients visiting Sindh’s tertiary-care hospitals, including Dr Ruth KM Pfau Civil Hospital Karachi (CHK), Jinnah Postgraduate Medical Centre (JPMC), National Institute of Child Health (NICH) and others, are being asked to purchase medicines out of their own pockets as public hospitals in Karachi and rest of Sindh are facing an acute shortage of medicines, surgical items and consumables due to red tape and bureaucratic hurdles in the central procurement system for medicines.

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Around 85 per cent medicines for all the public hospitals in Sindh are procured through a centralised system, the central rate contract system, while 15 per cent medicines are procured locally.

The centralised system to purchase medicines for all the health facilities in the province was formed during the fiscal year 2014-15 due to disparities in the prices of medicines in various districts of the province. Before then, the health facilities were allowed to purchase medicines themselves since 2007.

The alarming shortage of medicines at provincial hospitals came into the health authorities’ notice when the health department sent letters to the CHK and JPMC, asking them to provide a large number of essential medicines to the office of Director Health Karachi, which has been assigned the responsibility for providing health emergency services at the International Defence Exhibition and Seminar (IDEAS) scheduled between November 27 and 30 in Karachi.

“We were shocked to see the letter from the health department, in which they had asked us to arrange medicines for the defence exhibition. Those sitting in the health department did not even know that hospitals are facing acute shortage of medicines for the last many months as tenders have not been issued for the purchase of medicines,” an official at one of the major tertiary-care hospitals told The News, on the condition of anonymity.

Medical superintendents and executive directors of all the major hospitals in Karachi also confirmed that they had been facing an acute shortage of medicines, consumables and surgical items as the health department had not issued any tender for the purchase of medicines and other consumables this year, compelling patients to buy medicines and other medical items out of their own pockets.

“Crisis of medicines and other consumables is worsening with each passing day and only we know how we are managing the situation given our limited resources. Providing medicines to thousands of patients on a daily basis with limited resources is impossible”, said Dr. Sabir Memon, medical superintendent of the CHK.

He added that delay in the issuance of tenders for the central procurement of medicines as well as a rise in the value of dollar were two major causes of the shortage of medicines as importers of surgical items and imported medical stuff were reluctant to provide these supplies on older rates.

“Daily 7,000 patients visit the OPDs [outpatient departments] of the CHK while 1,500 patients are brought to our emergency and providing them all the required medicines, arranging surgical supplies and consumables is becoming immensely difficult for us,” Dr. Memon explained.

The administration of the JPMC has also been facing the same crisis with patients being asked to buy medicines and arrange surgical stuff themselves as the health department has not supplied the required stock of medicines and medical consumables for the second quarter of the fiscal year. The hospital had been allowed by the health department to buy medicines for the first quarter on an emergency basis.

JPMC Executive Director Dr. Seemin Jamali said the health facility had been facing an acute shortage of medicines since the last one month as the government had not issued tenders for the procurement of medicines and other related items. She added that the JMPC was acquiring medicines for needy patients from other sources, including philanthropists and non-governmental organisations.

It may be mentioned here that the Sindh cabinet gave an exemption for the procurement of medicines from the already released funds at the approved rate of the last tender of the central rate contract system in its meeting in September this year and directed the health department not to seek such an exemption again.

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