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Dispensary and Availability of Right Medicines in Haryana

20th September 2014

Naya Haryana
Healthcare infrastructure and facilities in Haryana is in an extremely poor state with little investment and high degree of mismanagement of existing facilities. Receiving healthcare is the fundamental right of every citizen and its the governments role to provide adequate and timely care to those who need it. In Haryana, especially in the last 10 years, providing for Healthcare has been a low priority agenda with the state government, with greater emphasis being laid on property development. The Hooda government has been claiming aloud that it is a government that cares for its people, so lets take a good look at how much it really cares! Poor infrastructure According to the figures published for 2012-2013, by the Department of Health, Government of Haryana, the total population of Haryana is2.53 crore(2011 Census). The total number of Government hospitals to cater to this size is only56, with the total number of beds available at5,306! So this government that has served two terms in office, is taking care of its 2.53 crore citizens by providing for just 5,306 beds! Is this a government that really cares? To support the 56 hospitals, there are 109 community health centres and 357 primary health centres. However, another surprising fact is that there are only63dispensaries/polyclinics/urban health centres in the state. So how can any government possibly hope to provide its 2.53 crore citizens any semblance of quality healthcare? So if you have been told by the government that this is adequate, then take a look at the number of children that were examined to check the state of their health.27 lakhchildren were examined out of which14.90 lakhchildren were found to be ailing. So we in Haryana have 14.90 lakh children who are ailing and many of whom have needed hospitalisation but the government has only5,306 bedsfor its entire population! This certainly is a government that cares! If for some reason you still believe that the Hooda government has healthcare for its citizens as a top priority, then take a look at the per capita expenditure the state government has incurred each year. Low per capita expenditure In FY09-10, per capita expenditure was justRs 399.85. This is the average amount spent by the government on each person, every year. One would expect that the government would significantly raise the per capita expenditure every year by a significant amount. Any caring government would. So lets see the figures in FY10-11, per capita expenditure was Rs 442.08, an increase of10.56% onlyover FY09-10. In FY11-12, it was Rs 490.28, an increase of10.90%. In FY12-13, it was Rs 642, an increase of 30.94%. In FY13-14, it was Rs 734, an increase of14.33%. So one can see that other than FY12-13, all the other years had onlytoken increaseeach year. This goes on to show how much of a priority the government attaches to peoples health. The sports budget has been increasing at a faster rate. Now we all know that each year the population in Haryana has been increasing and therefore it is only natural to assume that the number of people that require medical treatment would keep increasing every year. Lets draw our attention to the year 2010. We see that the number of in-patients treated were18.01 lakh. But strangely in 2011, the number dropped significantly to13.90 lakhand13.96 lakhin 2012. So how does the number of patients treated, drop so significantly in 2011 & 2012, especially since the population is increasing each year? Its amazing to see how we can provide only5,306 bedsto 2.53 crore citizens and still hope for a vote in the coming elections! Availability, affordability and distribution of medicine In 2012, a detailed study was carried out in Delhi, to study the procurement process, pricing, availability and affordability of medicines. The study covered tertiary, secondary and primary hospitals, and the format of research was as per guidelines laid out by WHO/HAI norms. It was found that80%of the health financing came from out of pocket expenses of the patient. Around70%of the costs went towards purchasing medicines. This meant that the cost of medicines was very important in determining the cost of health care to the individual. In Haryana, the sheer number of dispensaries is extremely low, thereby restricting the network of affordable channels of medicine distribution. The problem is further compounded by the fact that the number of essential medicines available at any given point in time, in any dispensary, is very low. In Delhi itself it was found that the availability of medicines depended on whether they were original brands or generics (same molecules but different manufacturer). The availability ranged from28%to60%of the total medicines that were researched. If this is the situation in Delhi, we can well imagine the situation in the dispensaries of Haryana. In fact a similar study should be initiated in Haryana to study the procurement process of medicines by the state and a comparative analysis made with procurement prices in Delhi which could give a good idea of the price differential between the two states. Given the volume involved, even a small percentage saved through better negotiation can ensure more funds are available to be deployed in other areas of healthcare. Most people complain that essential medicines are not usually available at government dispensaries. Yet these medicines are available in private chemist shops located in the vicinity. It is suspected that the corrupt officials are deliberately causing the scarcity to ensure that the same medicines are sold at a higher cost to the consumer through private chemist shops. It will not be surprising if a detailed investigation reveals yet another scam. It is very important for the state government to substantially increase the number of dispensaries in the state and ensure that every village has one and is fully stocked with all the medicines in the essential and general category. Unless these are widely distributed and at a much lower cost than the market, the patient will continue to suffer very high cost of medicine, which ultimately make the total healthcare unaffordable. The Hooda administration has completely failed to provide the minimum necessary healthcare infrastructure that the people so desperately need. Shortfall in recruitment of medical staff This casual approach is also seen in the recruitment of doctors and related staff. Against a sanctioned staff strength of 478 for Senior Medical Officer and above, only413were recruited. Against 2,509 sanctioned Medical Officer (Class 1&2) the actual recruitment has been2,025. The same is true for staff nurses, against the sanctioned 1,985, the actual recruitment was1,504. So with5,306 beds, an average annual per capita increase in expenditure at10%and under recruitment of medical staff, can this administration face its citizens and honestly say, yes we care for you? Sorry Sir, your pseudo policy on healthcare stands completely exposed. Its now for the people of Haryana to decide if they want to continue to have you leading Haryana yet again or to relegate you to the failed pages of history. The time has come for aNaya Haryanathat will implement aNayi Soch.

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