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James Debono
The Government Pharmaceutical Services has registered a 63 per cent increase in the issue of medicines and foods to state hospitals and health centres in the four years between 200 and 2004.
The Health Department informed MaltaToday that during 2005 the “percentage of the Ministry of Health’s recurrent budget allocated for the procurement of medicines and medical devices accounts to 22 per cent of the total recurrent vote.”
The statement has raised doubts on the sustainability of this expenditure in the free medicine scheme especially due to a rise in the price of branded medicines in international markets.
While it is a “normal procurement procedure” for the government to issue calls for generic medicines, there are however specific instances wherein the GPS is obliged to procure branded products for specific patients in view of particular clinical conditions.
Inefficiencies and abuse in the current system of free medicine distribution have exacerbated the problems in the field. Back in 1997 the PN had described the 50c charge introduced by the MLP government on the issue of free medicines as an “anti-social measure”.
Upon being elected the PN removed this charge. Eight years later the government is not excluding a system of payment in this sector.
MaltaToday asked the Health Department whether it is considering any reform in the distribution of free medicines to curtail abuse and whether any system of payment is being contemplated. The department said discussions on possible reforms in the distribution of free medicines “are taking place with the relevant stakeholders. Since discussions have not yet been finalised it is not pertinent to comment on this issue.”
This newspaper is informed that problems in this sector are attributed to a very bureaucratic system.
“Due to an overabundance of procedures, pharmacists are trapped in administrative and bureaucratic work instead of engaging in patient care,” sources said. “The system is understaffed as many pharmacists are finding more attractive jobs in the private sector. This means longer queues and less time for patient care.”
MaltaToday has learned that the current card system officially known as Schedule V based on the issue of yellow and pink cards is very time wasting and is far from foolproof.
During the past years there were a substantial number of cases in which patients were found to be abusing the system by having two cards.
Some patients claim that they have lost the original and pay 50c for an affidavit for a new one to be issued. A pharmacist who used to work in this sector informed MaltaToday that “it would be much better to introduce an electronic smart card system which would be much better to process, waste less time, and cut down the chances of abuse. However one would have to invest some capital into this. However such a modern system would be much more efficient, much faster, more reliable and can also be used to check prescribing patterns and derive important statistical information.”
Patients who have contacted MaltaToday have also complained that they are often told that medicines are often out of stock. Persons working in the field said that due to financial restrictions the government is buying stocks of medicines that last for a shorter amount of time. “This results is resulting in shortages.”
Another reason is that the authorities are trying to avoid having medicines in stock, which end up expiring before being used. “If one wants to be 100 percent sure something does not end up out of stock one will inevitably end up with a lot of waste.”
A pharmacist working in the private sector has told MaltaToday that a more efficient alternative would be one in which free medicines are distributed from private pharmacies.
Back in 1998, the MLP proposed in its electoral manifesto that after discussions with interested associations and unions, it would “introduce measures for patients entitled to free medicines to collect them from a private pharmacy of their choice. This will enable patients to collect their medicines in a time convenient to them.”
Back than the PN had also proposed to enter into discussions with the Chamber of Pharmacists, to devise a scheme for the distribution of medicines to registered patients where patients could collect their medicines from their local pharmacy.
Despite the 63 per cent increase the announced reforms have still to materialise.
jdebono@newsworksltd.com
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