Time to Regulate Health Administrators & Pharmaceuticals like Doctors #CBI- arrests-Joint-Drugs-Controller


  CBI has arrested Joint Drugs Controller for allegedly taking a ₹4 lakh bribe to clear injections made by  Biocon Biologics .The CBI has arrested Joint Drugs Controller S Eswara Reddy for allegedly receiving a Rs 4 lakh bribe from a conduit to waive the Phase 3 clinical trial of the ‘Insulin Aspart’ injection, an under development Biocon Biologics product to manage Type 1 and Type 2 diabetes, officials said on Tuesday.

        The incident may be just a tip of the iceberg, to indicate collusion between administrators and various industries. It is the time to regulate all important components of health industry including health administrators as doctors are regulated – to achieve real cost effective health care.

          In last few decades, as doctor-patient relationship has been getting more complex and medical industry has controlled the financial interaction, the medical costs have become expensive. Hence the health insurance industry is gradually becoming indispensable. As doctors are at the front and remain the visible component, they are blamed for the expensive medical treatments.  The tremendous rise in health care expenses is usually borne by the government, taxpayer, insurance or patient himself.  Therefore there has been an increasing dependence on investors in health care, along the lines of an industry to ensure its financial viability. 25 factors- why health care is expensive

      Complex interplay of various industries  like pharmaceutical, consumable industry and other businesses associated with  health care  remain invisible to patients. Various important components for example pharma industry, suppliers, biomedical, equipment, consumables remain unregulated.  There is large number of administrators involved in such processes.  Although doctors are strictly regulated and kind of over-regulated but such administrators and financial controllers who play important part in medicine, cost, sale and purchase, remain largely unregulated. Because of such undeserved criticism, doctors have actually been alienated from financial aspect but still they are often perceived as culprits for cost escalation.

CBI has arrested Joint Drugs Controller for allegedly taking a ₹4 lakh bribe to clear injections

       The CBI has arrested Joint Drugs Controller S Eswara Reddy for allegedly receiving a ₹4 lakh bribe to waive the phase three clinical trial of the Insulin Aspart injection, a product of Biocon Biologics under development to manage Type 1 and Type 2 diabetes, officials said on Tuesday.

CBI has arrested Joint Drugs Controller for allegedly taking a ₹4 lakh bribe to clear injections made by  Biocon Biologics

Biocon Biologics is a subsidiary of the  Biocon. The company has denied allegations.The agency has also arrested  director at Synergy Network India Private Limited, who was allegedly giving Reddy a bribe, they said.

After completing the necessary paperwork, the CBI has arrested Reddy and Dua, nabbed during a trap operation on Monday while the alleged bribe exchange was going on, the officials said.

The CBI has also booked Associate Vice President and Head-National Regulatory Affairs (NRA), Biocon Biologics Limited, Bangalore, L Praveen Kumar, as well as Director, Bioinnovat Research Services Private Limited, Delhi, Guljit Sethi in the case under IPC sections of criminal conspiracy and corruption. 

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Facilitators turn administrators: Biggest tragedy to medical profession in present era


14 Doctors in rural Unnao resign alleging mental harassment and misbehaviour by administrative officers over COVID-19 work.

       Administrators, who have never treated  a patient in their lifetimes, but control treatment of thousands of patients. The  biggest tragedy to the medical profession in present era, causing discouragement and demoralization of medical profession.
         Their role should not have been more than facilitators, but they have become medical  administrators. They are so distant from the ground reality.  To control the health system, administrators have a tendency to pretend that shortcomings in the patient care can be rectified by punishing the doctors and nurses.
The vulnerability that is  intrinsic to the  doctors’ working makes them sitting ducks, an easy target for harassment and punishments and  is exploited by everyone to  their advantage. Administrators use this vulnerability to  suppress them. It is used by  media and   celebrities who projected  themselves as Messiah for the cause of patients, and  sell their news and shows by labeling the whole community of doctors as dystopian community based on just one stray incident.

     The blame for deficiencies of inept system, powerful industry, inadequate infrastructure and poor outcomes of serious diseases is shifted conveniently to doctors, who were unable to retaliate to the powerful administrative machinery.   

        The demonstration of the cleft that separated doctors from the actual overpowering controlling medical industry  and administrators is  not given, in order to maintain the prejudice  with its dangerous bias towards doctors, who are in forefront and are visible to public. Clearly separating the role of health workers and the hidden administrators would not only settle the matter, but is actually essential to project the reality. The correct perception of two fundamentally different components would reveal a real gulf and would help to address the core issues.

    A wish to govern, regulate and punish the medical professional by administrators is not new. Hammurabi 4000 years back had initiated to write the cruel rules of the game, which possibly initiated a change in the global perception and regulatory system and formed the basis for cruel regulation in radical and unprecedented ways.

      In  a quest to control  this difficult area,  which encompasses life and death, deals with extremes of poverty and riches, mortality and morbidity, pain and relief, sadness and happiness, smiles and sorrows and uncountable emotions, intertwines with financial aspects and  the  amalgamation of intricacies of science with legal complexity, doctors are burdened with over-regulation and administrative pressures.

               Consequently the  doctors are the sufferers, as they feel enslaved and suffocated. But ultimately who would be the sufferer, does not need an Einstein brain to guess.

14 doctors resigned, alleging harassment and misbehaviour by administrative officials.

More than a dozen doctors posted in rural hospitals in Unnao district of Uttar Pradesh collectively resigned, alleging harassment and misbehaviour by administrative officials.

The doctors, numbering 14, posted at community health centres and primary health centres submitted their resignation letters to the chief medical officer (CMO) of the district on Wednesday. Speaking to the media, one them said that while their teams would work on the field from noon to 4-5 p.m., isolating COVID-19 positive cases in their home, distributing medicine and carrying out sampling, the local SDM would summon them after that seeking a report of their work. The doctors would have to drive back several km to the tehsil from their place of work just to “prove that they are working,” said the doctor. “Despite continuously working, it has been made to appear like we are not working and that due to this, the COVID-19 situation is going out of control,” he said. The doctors also alleged that they were not provided sufficient drug supply from the government and often faced verbal harassment at the hands of the CMO and the CMS. If the field teams were unable to trace down patients because of submission of wrong phone numbers and addresses, they should not be held responsible for it, said the doctors.

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Medical Regulation:Is it time to regulate medical business/ administrators of healthcare? “Oxygen cut, 30 children die in Gorakhpur hospital” who is responsible?


The inconsolable   catastrophic calamity in Gorakhpur Hospital is a mishap, which should be  preventable by good medical governance.   This is a real life example of negligence by poorly managed system, which has resulted in loss of multiple lives. Poor competence of administrators is more damaging, less containable, more damaging institutionally than smaller unintentional human errors by doctors. More than sadness, it is a painful surprise that such things can happen in present era of mammoth advancements! Until now, discussion on every such incidence stopped with blame on doctors in the end. No body will even try to look beyond doctor’s faults as it is easier to find some mistake or the other by retrospective analysis in doctor’s work or documents. That helps in cover up of system faults. Since ultimately it is only the doctor who is visible with the patient, doctor has to bear onus of each medical or non medical problems of health system. In routine circumstances, after the unanticipated death, one or two doctors  are made scapegoat, thrashed or harassed, unless proved innocent few years on, that also if they are lucky enough to have impartial investigation. Doctors carry the burden of universal expectations, thanklessness, threats and vandalism for bad outcomes, even in absence of proper health facilities. That is how, rest of medical industry, administrator  and non doctors associated with the health care,  mainly responsible for the problems,  enjoy   strange kind of immunity. But since now problems are overflowing  and big enough to unmask the real hidden people responsible for poor health care system in case an impartial inquiry is done.  Is it time to regulate all people including non doctors and medical businesses who are associated with health sector, in the manner doctors are regulated?

Oxygen cut, 30 children die in Gorakhpur hospital. Criminal negligence, row over unpaid bills hit encephalitis, neonatal wards.( Hindustan times)

 

Foremost admission is that we do not have a proper foolproof health care system. Strangely, the perpetual inadequacy of state healthcare infrastructure is never questioned.  Problems of electricity, oxygen, quality of drugs, medicine, quality of consumables, heath insurance implants and stents have very important role to play in treatment of the patient and cost associated with it. Doctors need essential items and can not work without  drugs and equipment , which are supplied by industry and procured by administrators.  Marketing, sales, pricing, insurance, quality  and all business deals  of these items are  beyond doctors preview. Therefore the  actual number of  non doctors  involved in health sector are beyond any imagination and these people  are not regulated in any manner. Ultimate blame is wrapped up by incriminating whole community of doctors, resulting  in misguided  conclusions. All these complex issues ends up with society inflicting a mode of self harm by mistrusting their savior.  In fact, there has been an article feeling a need for regulation of NHS managers, in a way same as doctors.

NHS Managers should face same regulation as doctors, says Francis

https://doi.org/10.1136/bmj.j2055 ( 25 April 2017)

Possibly it is time to unmask   and unveil the whole mammoth industry and regulate each and every person associated with health, in a manner same as doctors.  Role of non doctors , touts, different streams of medicine, administrators,  sales and marketing , medical  finance,  electricity, oxygen, cost and  quality medicine, drugs, consumables, implants and stents has very important   role to play and doctors should not be   burdened  with criticism for  all the mess created by all other people. Good health care system should be designed to prevent tragedies. Strict action after the event is just finding scapegoats.

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