Doctors-pharma companies harming patients
Tribune, October 22, 2011
21 – A recent independent report has revealed how patients
in select cities in Assam have suffered due to the State
Health Department’s failure to curb collusive behaviour
among some doctors, pharmaceutical companies, and other
The findings highlight serious hurdles in the health
sector that has attracted attention for wrong reasons in
recent times. Assam’s Infant mortality rate is higher than
the national average, while the Maternal Mortality Rate
(per 100,000 live births) hovers at 480, the highest in
The report – Unholly Alliances in Healthcare Services - by
Consumer Unity and Trust Society (CUTS) International, and
supported by Oxfam India, focuses on ‘Collusive Behaviour
in Healthcare and Impact on Consumers’ with evidence from
Assam and Chattisgarh.
A serious finding of the study was that households
belonging to the low income class spent a larger share of
their monthly income on healthcare. In Assam, the amount
spent by this group on healthcare was 20.56 per cent,
against 14.14 per cent in the case of Chattisgarh.
An analysis of information gathered from 210 respondents
in Assam portrayed a disturbing scenario. The respondents
from Gauhati Medical College Hospital, Civil Hospital
Nagaon, Urban Health Centre, Nagaon, and Civil Hospital
and Primary Health Centre, Bongaigaon revealed that on an
average the cost of drugs prescribed per prescription in
public hospitals were high, where a major part of
medicines were brought from private sources.
The report, which involved Assam based NGO the Action
North East Trust (The Ant), mentions that although a high
proportion of ‘rational drugs’ were prescribed in some
hospitals, there were also a significant percentage of
‘irrational drug’ prescription, which added to the
financial burden of patients. This hints at collusive
behaviour involving doctors and pharmacists.
Among the matters of concern was the fact that medicines
were ‘mostly obtained from private/outside sources in
three of the four public health institutions surveyed’.
When asked, the respondents mentioned ‘non-availability of
medicines in public healthcare institutions’ as the main
reason for buying medicines from private sources. The
exception was the Urban Health Centre, Nagaon in which
only a few respondents indicated that they had to buy
medicines from outside sources.
Another worrying trend was ‘incompleteness of diagnosis’,
a frequent experience across the health institutions. The
study favoured greater supervision to ensure that
comprehensive diagnosis is carried out and also recorded
in the prescriptions for future reference.
In the case of Gauhati Medical College Hospital and Civil
Hospital Nagaon, the survey exposed an alarming trend of
incomplete diagnosis. In GMCH, the completeness of
diagnosis was 10 per cent, while in Civil Hospital Nagaon
it was just eight per cent.
An analysis of the Stock Lists from the surveyed health
institutions showed many of the drugs were absent, and
therefore patients had to purchase those from private
sources. Strangely, a number of drugs obtained by the
consumers from private sources were available as recorded
on the Stock Lists.
Gauhati Medical College Hospital fared poorly in this
regard, and the report describes it as alarming: ‘Of the
196 drugs that were brought by the surveyed consumers from
private sources, 49 per cent were available in the stock
CUTS international has urged the Assam Government to
immediately intervene and initiate investigation in the
health institutions so that patients, many of the poor and
underprivileged, have better access to healthcare.
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