Procurement, funds double in 3 yrs, but govt hospitals still face shortage of drugs

Authorities from Tamil Nadu Medical Services Corporation (TNMSC) claimed that there has been a two-fold increase in the funds that government hospitals have spending on medicines and procurement of medical equipment in the past three years. But, despite this, hospitals often face shortage of essential drugs such as analgesics and antibiotics. Hospital authorities said that this is owing to the lack of response for the tenders they invite to buy the medicines and the equipment.

Government hospitals in Trichy, Chennai and Dharmapuri have often run out of essential drugs such as insulin, metformin, dopamine and IV fluids. Hospital authorities have to depend on private drug sellers and private clinics to meet the needs of required drugs using the funds collected under CMCHIS scheme or dean’s daily allowance.

“The amount of drugs and medical equipment is dependent on the funds available with the TNMSC. Sometimes we are able to procure the required amount of the drugs and equipment, otherwise we use the funds available under Chief Minister’s Comprehensive Health Insurance Scheme to buy the medicines and equipment. In case of unavailability, the hospitals have to buy it from the local druggists and chemists,” said Dr Narayana Swami, the medical superintendent at Rajiv Gandhi Government General Hospital.

Among the most needed medicines at the government hospitals, analgesics and antibiotics are the most procured drugs from TNMSC. Paracetamol remains the most procured drug among the analgesics. With bacterial infections being extremely common at the government hospitals and hospital-acquired infections keeps antibiotics amongst the highest procured drugs.

With an increased prevalence of diabetes and hypertension in the state, anti-hypertensive drugs and anti-diabetics have been in high demand for the past few years. Doctors at government hospitals say that hypertension and diabetes are chronic diseases and patients with Type 2 diabetes follow upon the medications to keep the blood sugar level in control. IV fluids are also among the most procured drugs at the government hospitals.

“The essential drugs such as antibiotics, analgesics and IV fluid are the basic requirements in the government hospitals, however, there is often a scarcity of even the basic drugs and this leads to a strained relationship between government hospital authorities and the procurement authorities. Despite an increase in the fund over the years, districts like Pudukottai, Sivagangai, Dharmapuri and Tiruvannamalai had a scarcity of antibiotics earlier this year,” said Dr Arvind Santhosh, a doctor from Coimbatore Medical College and Hospital.

The value of drugs purchased in the last three years has increased subsequently from Rs 571 crore in 2016-17, to Rs 602 crore in 2017-18 and Rs 692 crore in 2018-19.

The screening devices are amongst the most procured equipment at the government hospitals with CT scan and MRI scans.

“There are at least 200 CT scans and 50 MRIs done at a district headquartered government hospital every day. To improve the screening facilities, more number of MRI scan units has been set up at government hospitals. With ultrasound screening availableat the government Taluk hospitals and non-district headquartered government hospitals, the requirement has increased,”said Dr Ravi, professor and director of Barnard Institute of Radiology.

The value of equipment purchased in the last three years has almost doubled from Rs 270 crore in 2016-17 to Rs 534 crore in 2018-19. In 2017-18, Rs. 555 crore were spent on medical equipment after a large number of advanced equipment was installed at the government hospitals.

The TNMSC officials state that bids are issued for the drugs as per the requirements, however, sometimes there are no bidders and government hospitals have to be instructed to buy the drugs from the local drug providers.

Senior TNMSC officials said that they invited bids for more than 10 essential drugs earlier this year, but did not receive any response. The tenders have been floated again and they are awaitng response.

“Though drugs can be bought from the local providers, the problem intensifies in case of medical equipment and TNMSC has to make provisions for the availability of the medical equipment,” managing director of TNMSC Dr P Umanath.