Prescription Audit Norms Oversight Leaves Healthcare System Vulnerable in Kashmir Valley
Srinagar: In a concerning revelation, it has been found that the Health Department in Kashmir has failed to effectively govern Prescription Audit Committees (PACs) in hospitals across the valley. Despite the Health and Medical Education (H&ME) Department's directive in February 2020, ordering the establishment of prescription audit committees at Government Medical Colleges, and district and sub-district level hospitals across the Union Territory, there appears to be a lack of monitoring and enforcement.
The prescription audit committees were expected to play a crucial role in evaluating prescriptions to prevent malpractices that could compromise patient safety or lead to unethical conduct by healthcare professionals. However, patients and those accompanying them to hospitals have complained that medical staff members' continued use of unethical tactics is impairing patient care. Showkat Ahmad, a resident of Magam told Rising Kashmir, "The situation is very bad. There is a lot of difference between the prescription of one doctor and another. A common man doesn’t know what the doctor writes on the prescription. This must be stopped and strict action should be taken against doctors violating the orders."
On February 02, 2023, the Directorate of Health Services Kashmir (DHDK) issued an order warning the CMOs and Medical Superintendents against disregarding the prescription audit norms. “Unnecessary diagnostic tests/procedures are prescribed and patients are referred to private clinics/specialists without requirement. Drugs are prescribed in contravention to the provision of the Drugs & Cosmetic Act & Regulations,” the order stated.
One of the major concerns raised by the affected individuals is the prescription of unnecessary drugs and medicines. This has not only raised questions about the quality of healthcare but has also amplified the financial strain on patients who are forced to purchase medications that may not be essential for their treatment. Moreover, the situation worsens as additional diagnostic tests are being prescribed without proper justification. The financial burden of these tests is proving to be unaffordable for many patients, particularly those belonging to economically disadvantaged backgrounds. The absence of a robust prescription audit mechanism has allowed this practice to persist, leaving patients grappling with the dual challenges of health and financial instability.
“Recently, I was suffering from stomach pain and visited a hospital. I was asked to undergo some diagnostic tests which were later rejected by another doctor," Dr Showkat further added. According to a top expert at J&K Health Department, placing medical officers and hospital managers in PACs is not a strategic step towards the improvement of medical services in the statement. Commenting on the issue, Dr Ahmad further added," It is absolutely a wrong decision as they have not put consultants, specialists or those senior doctors (in PACs) who really prescribe medicines to patients in hospitals. I have seen many doctors prescribing unnecessary medicines. It is important to write a good company or brand and whatever is relevant.”
Two years ago, the government took proactive measures by establishing divisional and district-level PACs. Directives were issued to Chief Medical Officers (CMOs) and Medical Superintendents, instructing them to appoint Nodal Officers responsible for collecting photocopies of one percent of prescriptions on a random daily basis. This initiative was specifically aimed at scrutinizing prescriptions issued by government doctors in Outpatient Departments (OPDs). However, officials have disclosed that, despite the passage of two years, the prescribed order has not been adhered to and this is giving an unethical free pass to the pharmaceutical distribution of medicines to medical shops outside the hospital premises.
Previously it was the responsibility of the divisional Prescription Audit Committee to compile their suggestions into a thorough monthly report. Nonetheless, Dr. Mir Mushtaq, the Directorate of Health Services Kashmir Spokesperson, stated that all Chief Medical Officers, Medical Superintendents, and Block Medical Officers have received instructions to guarantee that routine audits and inspections will take place. “Prescriptions are done on a regular basis and if somebody is found not following the orders, we will take strict action against the erring officials. We have also advised the doctors to write the prescriptions clearly and properly so that everyone whether a patient or pharmacist is able to read it,” he said.
