By Nigam Gupta
Health and Education are the foundation for human development. But regrettably; in Jammu & Kashmir, we have been watching the big talks and claims of the politicians, bureaucrats and the officials of Health Department regarding various advancements, announcements near allocation of big budgets, launching of schemes and policies then, awards and so on but in reality hospitals still been found running overly short of basic amenities, even drugs and medicines, and allied facilities else staff and so on forcing people to move outside the state for better treatments there-for.
The same kind of impressively ambitious slogans been sounded by these concerned seats regarding the need of having a centralised procurement system for medicines and other hospital supplies, through a corporation, as it is being done in many other states. Everything remained in papers till 2013. Finally, we heard that a corporation had been constituted and then incorporated and an IAS officer and his team put in place by the Government. The Journey of J&K Medical Supplies Corporation had begun, but at a very slow pace.
Since then, there have been many ups and downs in functioning of corporation and I ,being very closely associated with hospital supplies, watching the role of each stake holder closely thought of writing my experiences, which could make the people understand the process of procurement by the corporation and related challenges. Unlike other purchases, the purchase of medicines and other hospital supplies are more critical, as it deals with human life and has to be 100% safe for human consumption.
In my opinion, the stake holders in the entire purchase process are the ‘Corporation, Hospital Administrators and HODs, followed by Suppliers / Manufacturers and of course , the ailing communities , that is patients _being existent consumers. Then and there, the procurement process is initiated by the corporation on the requisition of the hospitals.
Here; I would like to briefly dwell on the interests of various people who want Corporation to be a success or failure.
As all of us rightly remember that the corporation was established by the government to relieve the HODs and other hospital Administrators of the procurement related works, as otherwise, the Administrators remained busy in procurement related works and other important patient related issues actually suffered.
But the million dollar question is whether the HODs and others wanted to leave this important job?Like many; my answer also is a big “No”. As this basic assignment gave them lot of importance and other perks (I hope you understand), that is why it was always Corporation versus HODs and others. If not all but surely few of them questioned the reasonable system and even if not actually sabotaged but, in fact, surely denigrated and offended the functioning of corporation at every stage.
Anyhow; still many rate contracts were issued by the JKMSCL, vested interests spread all sorts of rumours like the medicines supplied by the corporation were substandard, not available and caused reactions and so on. The accusatory fingers raised now on the working of JKMSCL is really not as innocent as it appears.
As the procurement directly made by officials of H&ME Department, from the open market or as temporary arrangements hardly prefer to adopt this quality testingsystem. Whereby; for the first time in the history of Health & Medical Education Department, each batch of medicine procured by JKMSCL (even after the proper examination of analytical reports) again quality tested by certified labs, before issuing it to the hospitals. The financial burden of quality testing was also borne by the manufacturers / suppliers who were paying 1.5 % extra for quality testing of medicines.
By all said and done, the progress made in the last two years by the corporation was phenomenal. The way it started becoming functional, was really appreciated by all including some of our colleagues who were dead set against this corporation’s concept. The rate contracts were issued in a most transparent manner and deserving people got business. The transparent process of e-tendering and then implementation of e-aushadhi was appreciated by all. I have been working with other Corporations in the country, what the other corporations could achieved in ten years, was achieved by JKMSCL in two years, despite real challenges of shortage of manpower, non- availability of Drug Ware Houses and shortage of corpus funds and payment delays and so on.
Being suppliers, many among us were quite happy with the past system of procurement, where per medicines been accepted and distributed to patients, just on the basis of an analytical report duly received from the supplying manufacturer. Now; the question arising in every liable mind is why are Untested, substandard quality medicines and so on in the name of sufferings of patient care being purchased from open market well through encouragement of back door purchases; despite of availability of standard quality medicines on very cheaper rates with corporation?
About 50-80 % budget was spend by hospitals directly, despite of clear instructions from the Government that only 25% budget of Medicine is to be spent by HODs and rest to be passed on to the JKMSCL.
Another blame game started and resulted from side to side, when the requisitions by the HODs were never made available to JKMSCL in time. Even the medicines purchased on their requirements were never lifted from the Regional Drug ware Houses, which I believe are still under the Administrative control of Directorates. So, in a nutshell, few doctors (HODs/ Hospital Administrators) would never allow this corporation to be a success and would like to make purchases of their own.
Here, I don’t hesitate in blaming the second group in procurement process is of manufacturers /suppliers else liaison agents etc. They are a divided lot, some of them who are interested in doing clean business others knowingly or unknowingly might be in search of temporary arrangements then, few are in favour of corporation where as others are against. Let’s accept a bitter truth that no one actually seems interested in leaving personal interests aside and wants to encourage and support the common cause otherwise.
JKMSCL , despite being the first corporation to arrange the training on e-aushadhi software for all stake holders including the suppliers, in a point of fact, could also not come out from the rusted system of delaying tactics which is actually due to the unholy corruption oriented and lethargic practices of some officials there in the JKMSCL as-well. But, still we were getting the purchase orders on our desktop and were able to track the supplies from our manufacturers to the drug ware houses. All sort of reports required by us were made available online. This e-aushadhi software and its practical use in JKMSCL was worth appreciation and in my opinion one of the best practices of the state.
Height of senselessness by few officials also demonstrated; when, parallel tenders for procurements were floated by few including prestigious NHM and that too for PM’s dream projects duly sponsored by GOI for implementation of ‘National Dialysis Program’ and so on. This is something which is otherwise not in the larger interest of state administration as-well. When, we have a dedicated agency for ensuring quality procurement appropriately meant for the purpose to free the ‘Administrators & Doctors’ from procurement related works and not to let suffer the other important patient related issues as such. Then, why? Such deliberate attempts been made by initiating by these cheap-skating exercises and situations which otherwise turn out to be so difficult to digest the competencies, calibres and qualification-eligibilities else basis of appointments of such officials as well.
Yes, there were delays in making payments, verification of the bills by Drug Ware Houses and finalization of some tenders but all these important issues were overlooked by the reasonable suppliers and manufacturers for the reason that the head of the corporation was making sincere efforts by working day and night to ensure that JKMSCL becomes functional. Though, I personally didn’t find time to attend but many meetings were held with the stake holders to seek their support. So, we also looked forward for a transparent system, which was being appreciated by other corporations also.
Challenges are many; including new trends of double-dealings by displaying big hoarding of 10% to 50% discounts by another group which is also against JKMSCL. There is an unholy nexus between the chemists in and around the hospitals, who manage the prescriptions from the doctors for their shops and the doctors get the cut or commission on the sale of medicines. But, in terms of quality, no one bothers. Accordingly , everything is being done by this unholy nexus of chemists and the hospital staff, as JKMSCL is being perceived as threat by them.
And, day by day, the situation is coming close to a plea that if the Government doesn’t intervene, the corporation shall be closed and the vested interests, who were against the corporation and in favour of corruption; shall succeed.
“We must admit that the corporation is in the interest of poor people of the state and if it closed the MOHFW, GOI will not provide the funds under “Free Drug Policy” and for other purchases out of the funds provided by them as it is mandatory for the state to have corporation, for use of funds provided by GOI”.
I feel relieved of the burden on my conscience, by writing few lines, which I thought the people of J&K had a right to know.
—The author can be reached at: firstname.lastname@example.org