Two - month buffer stock mandatory:

No more drug shortages - Health Secretary

by Shanika SRIYANANDA

Health Ministry Secretary Dr. Ravindra Ruberu assured that there would not be a shortage of essential drugs in future as the Ministry has instructed the relevant authorities to maintain a two month buffer stock.

Dr. Ruberu, an ENT specialist, in an interview with the Sunday Observer said the situation is gradually improving.

He said one of the main concerns of the Ministry was the eradication of dengue and insisted on better public coordination to keep the menace at bay.

Following are excerpts of the interview:

Q: Sri Lanka’s health sector is being criticised very often for grave irregularities. How do you assess the country’s current health service?

A: We should be proud of our health service as we have achieved higher standards in many areas of the sector. As evidenced from international statistics, we have topped some of the Asian countries. The country has a good health service.

Q: Don’t you think that the health sector is facing a serious crisis?

A: Yes, the important issue at the moment is the drug issue. But it is gradually improving. There are some trade union issues not settled yet.

Our main concern is dengue control. This is a very important issue that we are getting ready to tackle. We are monitoring the situation and conducting several campaigns to keep the disease at bay.

The Health Ministry and other relevant authorities can do very little to control dengue in the absence of active public co-operation. If each household does its part controlling dengue would be easier. People should clean their environs at least weekly.

The Ministry is to introduce BTI but I don’t think we can control the menace completely. We need public support.

Q: Is there any restriction by the Treasury on the purchase of drugs?

A: Yes, it happened earlier and we did not receive the funds on time. Now the situation is improving and as a result the expenditure went up. There were other factors such as lack of coordination among the relevant authorities and poor cash flow which had its impact on tenders.

Q: Does the Ministry implement any short and long term plans to prevent shortage of drugs in future?

A: We have streamlined the system for then placing orders. We have instructed the State Pharmaceutical Corporation and Medical Supplies Department (MSD) to hold a buffer stock of essential drugs for at least two months.

Now we order in drugs while maintaining a buffer stock.

Q: Does this mean that there would not be a shortage of drugs in future?

A: We try our best to prevent shortages but there are unpredictable things like tenders being cancelled or the drug failing to conform to the required standard. Such situations are beyond our control, though there would be a temporary shortage in certain essential drugs.

Q: The health sector is always affected by trade union action. How do you ensure better coordination for smooth administration.

A: The Ministry coordinates well with the trade unions now. They have extended their cooperation to the Ministry. They also need to understand that some of the issues are very complicated. We are trying our best to negotiate with them to settle these problems.

Q: There are allegations that some of the patients admitted to State hospitals including Colombo National Hospital were asked to buy the necessary drugs from outside in the middle of the night. If so how can the Ministry say that there is no shortage of drugs in State hospitals?

A: I reject these allegations and I can assure you that there is no shortage of drugs now in State hospitals. If it recurs then the director of the respective hospital is answerable. Otherwise, there can’t be a shortage of drugs in any of the State hospitals as all necessary drugs have been supplied without delay.

Q: But, it was reported that a patient admitted to the Accident Ward of the Colombo South Teaching Hospital was asked to purchase drugs from outside. How could patients take action against such situations?

A: We shall take action if such complaints are addressed to the ministry. So far we have not received any such complaints. There will be temporary shortages of some drugs as we have to handle over 6,000 varieties of drugs.

There would be problems relating to distribution of drugs. I have found myself that the drugs available in the hospital pharmacy have not been supplied to the wards. There will be communication problems and the hospital director needs to solve them. They can be rectified at primary level.

These problems occurred due to the shortage of drugs in the central drug stores, which supplies drugs to all State hospitals. If there is a shortage of drugs the hospital authorities should inform the MSD. Lack of financial allocation, should be brought to the notice of the Ministry.

Q: The average man is not aware of these procedures. Do you agree that drug shortages will reflect badly on the Ministry of Health.

A: Yes, complaints on drug shortages should be made to the Director or the superintendent of the hospital without directing them to the Ministry. They will look into the non-availability of these particular drugs. If they are not available in the hospital pharmacy, he will hold an inquiry. There is however a system to solve these issues.

Q: If the system works properly as you explained, patients would not have to face the problem of buying drugs from outside in the middle of the night!

A: If it is not working well we have to act on the complaints we received. On the other hand, if people continued to complain to the Ministry about each and every shortcoming, the Ministry would not have time to attend to its duties. Therefore these issues need to be solved at hospital level.

Yes, I understand the feeling of the patient when he is asked to buy the drugs from outside. But the issue is a part of the big picture.

Q: Patients, who come to government hospitals complaint that they were asked to have their tests done at the private laboratories, in the hospital vicinity. The State hospitals have the best laboratory facilities. How do you explain this?

A: I just cannot give an answer off-hand. I need to see the reason for this situation. I agree that the State hospitals have the best laboratory facilities.

But sometimes it happens that the particular testing facility is not available at the hospital.

I don’t think all tests are done in private laboratories but there could be necessity for certain tests to be done outside. Sometimes the hospital authorities are not investing in some of the expensive tests.

Other than these I don’t see any reason to justify patients being asked to have the testing done outside. All the tests should be done at the hospital laboratory. In the major hospitals like the Colombo National hospital all the routine tests should be done at the hospital laboratory itself.