BMC cracks whip, asks its hospitals to ensure medicine supply

Mumbai: The BMC deputy municipal commissioner (public health), in a meeting on May 10, directed health officials, including hospital deans, to ensure that there was no shortfall of medicines and medical supplies in civic hospitals. Hindustan Times had reported on the artificial shortage of these and other items created by the delays of the BMC’s CPD (Central Purchase Department) in ordering them.

A senior health official from a civic-run medical college told HT that at the meeting, they had been instructed to increase local purchase and see to it that patients or their relatives were not made to buy medicines and other hospital essentials. “This is, however, a temporary solution,” he said. “We hope the civic body resolves the CPD (Central Purchase Department) issues soon.”

On May 10, HT had reported on the artificial shortage of medicines and medical supplies in civic hospitals, which was forcing patients to buy basic medicines like multivitamins and paracetamol themselves. They were also asked to purchase IV sets, IV fluids, gloves and surgical and suturing materials, all of which should come free of cost in BMC hospitals.

₹6,308.38 crore is the total estimated health budget of BMC for this financial year. These are divided into twelve schedules, each schedule having different types of medical supplies: for instance, Schedule I is for injections and sera vaccines and Schedule II is for tablets and capsules.

When the schedules are in place, the medicines are supplied from the CPD to BMC hospitals. Hospitals are not allowed to prescribe these medicines to be purchased from outside because they are supposed to be provided free of cost by the civic body. “A few years ago, the municipal commissioner sent out a circular, forbidding us to prescribe medicines that were part of the schedule,” said another senior official of the BMC-run medical college. “With the current short supply, we are now forced to do so.”

Meanwhile, an audit report titled ‘Public Health Infrastructure of Health Services in Maharashtra’ for the years 2019-20 to 2021-22 states that there was a delay in finalisation of the Rate Contract (RC) for different schedules of medicines for a period ranging from four months to 35 months.

Civic hospitals put out their requirement for supplies every two years. The CPD then floats tenders. After tenders are awarded, the rates of all medical items, including medicines, are finalised and locked for a selected period, also called the Rate Contract (RC). All future purchases, including those made by a hospital, during that schedule’s tenure are based on the RC.

The report states that there was a 35-month delay by the CPD department in finalising the RC for laboratory, chemical stents and reagents; 29-month delay for surgical items; 24-month delay for blood bags and rubber goods; 18 months for disinfectants; and 17 months for needles and syringes among others. The report also stated that “due to the expired RCs, the hospitals had to resort to local purchase to cater to their requirements”.

A CPD official offered a justification. “We usually take out an RC for two years,” he said. “If the RC has expired, we give an NOC for local purchase. Once the NOC is given, the hospital can procure medicines via competitive bidding at the local level. Competitive bidding is the essence of the bidding system. Since the hospitals have purchased medicines at the competitive bidding, the AG audit is not correct.”

The official added that it was necessary to keep in mind that the points raised in the audit were from the Covid pandemic period when there were no tenders floated and everyone made local purchases with competitive bidding. “Hence, the purchases done locally were with due procedure,” he concluded.