By Daya Sagar
A LOOK THROUGH THE MIST Part-II
To be brief as on date common man has lost faith in the government institutions and believes more in visiting private nursing homes / private hospitals or and even visiting some government doctor in his / her private clinic. The result has been that some government doctors who are very sincere / truthful to their profession are this day feeling discouraged and the administration too does not respond to their fair demands / suggestions since the influence / pressures from the ‘private practitioners’ are more dominating.
In view of that Inspite governments spending crores of rupees on the salaries of the doctors / medical establishments people do not trust / do not feel safe in government institutions and unless compelled by the financial/ time constraints even a labourer this day prefers visiting a private clinic.
Many may be heard laying accusations on the medical practitioners that they could be found prescribing undue investigations, over drugging, drugs labelled with unfair MRP and the like .
One patient complained that even when he had a routine stomach / gastric problem a senior retired doctor holding super specialist degree ( D.M) before prescribing any regular treatment asked him to get done a number of investigations costing over Rs.4000. The super specialist doctor had all the reasons to justify pleading that since the patient had come to a super specialist his problem need be closely pinned since he might have not got cured by other MBBS or MD where as that patient had even for a routine problem gone to a super specialist. So, for argument sake, even if the DM doctor had otherwise intentions still there could be no reason to doubt his intentions.
So, the general environment in the health care sector need be corrected so that patients start developing some faith in the doctors what is otherwise also is the need of the society since more than 70 % of the Indian population depends on the government health care as well as it is mostly MBBS ( in some cases MD/MS) doctor who is rendering services in the suburbs and rural areas. People too should not rush to super specialists even for routine ailments.
But the allegations against the health services cannot be completely brushed aside so simply. Had it not been so demands like withdrawing permission for doing private practice to government doctors and the one to put in place a system of ‘prescription audit’ would not have been made by some social activists on the governments, if not for all doctors at least for government doctors. No doubt the present J&K Government headed by Mehbooba Mufti has issued some orders in this regard but on ground there is neither any regular Audit Cell nor there has been made any progress in this regard. Imagine the need of staff / infrastructure for a regular Audit Cell that has to if practically cover a few hundred medical units / individuals.
Similarly government had ordered that atleast government doctors need to write the prescription by chemical name( generic name ) atleast for the medicines that are in the National List of Essential Medicines ( NLEM 2011 has around 348 such allopathic drugs) but even that has not been implemented.
To quoted Amlodipine 5mg is commonly prescribed by patients of high blood pressure and the same drug under brand name Amtas 5mg is marked with MRP as high as INR 42 for 15Tab and under brand name Amodep-5 with MRP as low as INR 13.15 for 14 Tab but many doctors may be still prescribing Amtas 5mg.
The same drug is supplied with chemical name by BPPI under the Jan Aushadi Scheme marked with MRP of Rs 2.65 for 10 Tab. Similarly a patient of diabetes is prescribed by brand name Gluconorm VG-2 MRP Rs 273.77 for 15 Tab of Lupin where as in case it is prescribed by chemical name (GLIMEPIRIDE 2MG +METFORMIN 500MG TABLET + Voblibose 0.2mg ) it could be got from BPPI ( Bureau of Pharma Public Enterprises of India ) Jan Aushadi for just under Rs 35 for 15 tab .Imagine the relief to the patients in case prescriptions are written with chemical name and the prescription audit is enforced.
And of course there is no any justification to keep the provision of private practice by government doctors , the same should be withdrawn since this day it has started doing mare damage to the society than a very little relief that it may be giving.
Government institutions in case perform judiciously the private practitioners and private hospitals would be subjected to check and exploitation of the patients &of their attendants would be reduced to a great extent. Government doctors should not be allowed to rear interests in private trade. Rather even the NPA should not be allowed to any government doctor and in case the government feels that salary is less that can be increased. And in case still NPA is to be given for increasing the income then it should also be given to other government employees who are not allowed to work privately after office hours.
So, it will be too late if those who are milking the distress of the patients are not checked by the government right now.
(Daya Sagar is a Sr Journalist and a social activist can be reached at firstname.lastname@example.org)