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In Kashmir, government hospitals are the initial and usually sole hope for poor patients. Each year, the government provides astronomical amounts of medicines to these hospitals, purchased with public money, intended to be provided free of cost to the poor who are unable to afford treatment. But in practice, numerous patients leave hospitals with prescriptions that lead them to private pharmacies. The drugs that are supposed to be free are usually “out of stock”. This is not a trivial matter. It is a severe failure that warrants total responsibility from hospitals.
From districts such as Srinagar, Baramulla, Anantnag, Kupwara, and Pulwama, patients often complain that they are told to purchase medicines from outside. Some of the hospitals attribute it to shortage of supply, others say it is the system’s fault. The reality is in poor management and no monitoring. Drugs for poor patients are diverted, misused, or left to expire in store rooms. The actual sufferers are those poor who cannot even afford a strip of tablets.
The government is spending crores annually on free medicine distribution under multiple health schemes. But in the absence of an open mechanism within hospitals, the gain never reaches the people to the fullest. The system needs to be made transparent, traceable, and accountable. Every hospital needs to put up, for public knowledge, the list of medicines provided by the government and their stock. This list must be updated on a daily basis, both within the hospital and online. Patients should know exactly what is available for them free of cost.
Technology can correct much of this issue. Computer-based inventory systems must be employed to track each medicine’s intake and dispensing. The patient for whom it is being dispensed needs to be noted, making the record traceable. This would minimize manipulation and leakage. Most hospitals in Kashmir have computers, yet their information is never kept up to date or audited. Accountability cannot be left to paperwork. It requires action.
Hospital administrators, such as medical superintendents, should be held directly accountable for the administration of medicines provided by the government. When a hospital reports shortage, and the records indicate availability, there should be a prompt audit. Surprise inspections and random checks can go a long way in preventing abuse. If irregularities occur, stern action should be taken. Accountability should go beyond files and press releases.
This problem is also associated with the role of private chemists and firms. Numerous doctors prescribe drugs that are not stocked by hospital shops, and therefore, patients are made to purchase from elsewhere. This practice secretly profits private vendors at the cost of public trust. Periodic checking of prescriptions can make such trends known. An open system must not encourage doctors to push patients towards private purchase if government stock is available.
Patients too should have a voice. Every district hospital must have a functional grievance counter or helpline where patients can report medicine shortages or overcharging. Complaints must be recorded and resolved quickly. No patient should leave without medicine because of someone’s negligence or greed.
Simultaneously, hospitals also have to receive proper and timely supply. Delayed tenders and transport problems occasionally lead to actual shortages. The government will have to address these supply chain gaps. But after the medicines arrive at the hospitals, the onus of ensuring equitable distribution lies squarely on hospital administration.
There are some encouraging beginnings in Kashmir as well. Jan Aushadhi centers and district drug stores have enhanced availability at many locations. But the issue at the last link—the hospital counter—remains. That is where the weakest oversight is, and that lacks accountability.
Public health is a trust. Each vial, tablet, and syringe dispatched to a hospital is owned by the people. Abuse or mismanagement of the same is a violation of that trust. Open visibility of stock, electronic monitoring, rigorous audits, and actual penalties can restore that trust.
No poor patient in Kashmir should be informed that “the medicine is not available.” That line is system failure. When hospitals are held accountable, that failure will stop. Medicines for the poor are not favors. They are rights. Hospitals need to honor those rights and save every pill that belongs to people.
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