Rajasthan: The Medicine of Life
The free medicine project in government hospitals, including life-saving drugs, has arrived as a life-giving miracle for the people of Rajasthan, especially the poor, who were hitherto devastated by the huge cost of healthcare
Sadiq Naqvi and Akash Bisht Baran/Jaipur
“Nobody comes to us now. We have lost all business since the government launched this free medicine scheme for all,” said Ramesh Jain, owner of Arogya Medicine, a private pharmacy outside Gangori Hospital, a multi-specialty government facility in Jaipur. Similarly, scores of other pharmacies are waiting for that elusive customer. Not long back, this used to be a buzzing market, with a throng of patients or their relatives.
Inside the hospital, the staffer manning the free medicine kiosk is having a hard time dealing with the rush. “Every day, more than 500 patients come to me. This excludes the number of patients admitted in the hospital who are also entitled to free medicine,” he says. Under the Mukhyamantri Nishulk Dawa Yojana, people in Rajasthan are now getting more than 400 drugs free in all government hospitals and dispensaries.
“The inflow of patients in the hospital too has increased by a good 50 per cent,” says the Chief Medical Superintendent, Dr Ajay Mathur. With patients from across the social strata thronging the government facility, quite visibly the trust in the State’s health apparatus is growing. “Now, the people who would never consider going to a doctor for paucity of money, choose to come to the hospital without worrying about money,” says Dr Rajesh Rajawat, Chief Doctor at the Community Health Centre at Kelawada village in Baran. “Earlier, a doctor was not sure if the patient would even buy the medicines which had been prescribed. Now, we are confident that the patient is taking the medicines without worrying about the cost.”
“It’s a boon. My husband is suffering from cancer. The entire treatment would have cost thousands of rupees. Instead, I have spent a few hundred rupees on medicines and travel costs,” said Sundari Devi of Jaipur.
The scheme is already being hailed as a gamechanger of sorts for the beleaguered Ashok Gehlot-led Congress government in Rajasthan. So much so, even the opposition accepts that the scheme is working wonders. “It’s a good scheme. It’s very helpful to the poor. However, there are problems with monitoring and implementation of several other schemes,” Arun Chaturvedi, chief of the state unit of the BJP, told Hardnews.
Meanwhile, inside Swasthya Bhawan, the headquarters of the state health ministry, Dr Samit Sharma, chairman of the Rajasthan State Health Corporation, is on the job. In his office, a man from Jodhpur hands over a prescription slip and narrates how some government doctors are still prescribing costly medicines
Dr Sharma, a doctor before he joined the administrative services, takes a good look at the slip and straightaway tells his personal assistant to connect him to the principal of the medical college. “Cefixime 500 does not exist. How can a doctor make this mistake,” he exclaims.
“We should strive to make the Jodhpur Medical College an example for others to follow,” the principal is told. “Please look into the matter and tell the doctors to stop engaging in such practices,” he adds, before hanging up.
“Monitoring is not really within the ambit of my job. People who feel strongly about issues keep coming to my office with such complaints. In turn, I keep apprising the senior doctors since I am constantly in touch with them,” he explains.
‘Every day, more than 500 patients come to me. And this excludes the number of patients who are admitted in the hospital who are also entitled to free medicine’
Sensitising the doctors to switch to generic medicines has been a protracted campaign which Dr Sharma has been spearheading in the state since his first appointment. He is a part of the global campaign to ensure that drugs are made available to all at a nominal price and there is no barrier of cost when it comes to the well-being of people.
“As a probationer in 2003, I was posted in Jhalawar in Rajasthan. This is where I started this experiment and ensured that 45 essential drugs were procured directly from the companies and given at a nominal cost to patients,” he narrates. The experiment continued in subsequent postings in Jodhpur, Chittorgarh, Nagaur and Alwar where Dr Sharma served as the district collector.
Drug manufacturing is a lucrative business with windfall profits. “This is one industry where profit margins range from 50 per cent to even 2,000 per cent. This is crazy when you are dealing with life-saving drugs and you know that thousands die for want of proper medication,” says Dr Sharma, even as he pulls out some top brands from his attaché case which the government is procuring directly from multinationals at different price bands, some even at one-fifth or less of their printed prices.
“The manufacturers who engage in propaganda and don’t match up to the quality must be suffering. The rest of the manufacturers are making up for their sales deficit by going for bulk supply to the government,” says Dr Sharma. “It’s a direct loss of Rs 1,500 crore in terms of the amount of medicines which have been distributed through government facilities. And if you include the amount of useless medicines which the doctors are in a habit of prescribing, the loss is even more,” he says, explaining that drugs like Becosules or other multivitamins prescribed by the doctors are not always useful.