BMC increases spending capacity of civic-run hospitals

The Brihanmumbai Municipal Corporation (BMC) has increased the spending capacity of the heads of civic-run hospitals to ₹25 lakh for non-Covid ailments and separately, ₹50 lakh for Covid-treatment, which involves purchase of medicines and other material.

The current spending capacity for civic hospitals is ₹3 lakh at a time.

A BMC health official said that a separate, higher allocation was made for Covid-related treatment as the past two years have shown the unpredictability of the virus which has led to rapid modifications in the treatment protocol.

“Covid-19 treatment has been costly because of the injections and drugs involved in the treatment. Therefore, the budget Covid-19 treatment procurement has been kept at ₹50 lakh,” the official said on the condition of anonymity.

There are 13 categories or “schedules” — not to be confused with scheduled drugs which are categorised based on approvals by the Food and Drugs Authority —that include close to 2,000 items such as injections, tablets and capsules, surgical dressing, laboratory chemicals, drugs, and disinfectants among other things.

The decision was taken at a meeting held by the civic body’s central purchasing department (CPD) conducted last week with hospital deans, medical superintendents and heads of the departments in attendance and held at the Parel-based civic-run KEM Hospital.

An official circular will be sent this week to all four medical college-hospitals (KEM, LTMG Sion, BYL Nair and RN Cooper), the Nair dental college as well as the 16 municipal general hospitals (such as Rajawadi, VN Desai, Bharatratna Dr Babasaheb Ambedkar municipal hospital), six specialty hospitals (including Kasturba), and 29 maternity homes in the city.

“To tackle the delay in regular schedule supply, we have given financial power to the dean/medical superintendent of the hospitals for local purchase of the medicine via a quotation,” said Ramakant Biradar, deputy municipal commissioner, who is also in-charge of CPD.

“We have received permission from the municipal commissioner on simplification of local purchase procedures. In addition to increasing the financial purchase budget from ₹3 lakh to ₹25 lakh for regular medicines and ₹50 lakh for Covid-19 treatment-related purchases at a time, we have also reduced the vendor deposit amount so that when the deans/medical superintendents put out the tenders, they get more vendor participation,” Biradar added.

Each hospital annually sends a list to the CPD of what medicines need to be procured. The CPD invites tenders and presents the finalised tender to the BMC’s standing committee for its go-ahead. The hospital is then allowed to proceed with the purchase. In case of a shortfall, hospital deans/ medical superintendents can also procure what is needed by putting out a tender, for which they were able to spend ₹3 lakh at a time. With the new decision in place, they can now spend up to ₹25 lakh at a time for non-Covid treatments, and ₹50 lakh at a time for Covid-related treatments.

This decision comes at a time when civic-run hospitals have been facing a shortage of medicines which has forced hospitals to ask patients to purchase these medicines directly from chemists.

Earlier this year, KEM hospital faced a shortage of medicines including tetanus injections, as well as dressing material like gloves etc., LTMG Sion hospital — one of the four major civic-run hospitals — has been facing an acute shortage of antibiotics and intravenous (IV) fluids for the last two months.

Sion hospital, which annually treats 15-16 lakh patients in its outdoor patient department and records 80,000 hospitalisations annually, is facing a shortage of intravenous fluids and antibiotics.

Arjuna Olimathi, a resident of Dharavi, whose father was admitted in the hospital on Friday night after he fell unconscious due to an underlying condition, said the hospital staff asked to procure him saline bottles and other medicines from a local chemist. “They say it is not available. We have no option but to go to the nearest chemist shop and get the medicines,” he said.

“My mother, Bimal (62), is admitted for jaundice. We admitted her on Wednesday and since then, almost every day, the staff tells us to purchase medicines and saline bottles,” her daughter Sita Gupta, who purchased 10 Dextrose and Sodium Chloride injections on Saturday.

A senior doctor from the surgery department said the hospital has been facing a shortage of medications, dressing materials, anaesthesia tube among other things for some time now, but in the past two months in particular, the shortage of antibiotics and IV fluids has been acute. “Apart from Augmentine, the hospital doesn’t have the other commonly used antibiotics. We also do not have the IV fluids,” he said.

Dr Mohan Joshi, dean of LTMG Sion Hospital said he raised the issue in the meeting with CPD last week. “We have been trying to meet the demands with a local purchase option. We are facing certain difficulties in getting some medicines via local purchase and we have raised our concerns in the meeting. Our constant effort remains to serve the poor patients coming to the hospital.”

Biradar said while the changes in local purchases will be sent to the concerned people this week, communication between heads of departments and deans will play a crucial role. “The heads of departments, pharmacists have to inform the dean/medical superintendent on the requirement and alert well before the stock gets over. It is observed that many a times, there is communication issue leading to temporary shortage,” he said.

In the BMC budget for 2022-23 announced in February, ₹6,933 crore was earmarked for the health department ( ₹2,660 crore of this was for capital expenditure). While increasing the spending capacity of hospitals was not specified in the budget — the decision to do so is an administrative decision — this year saw one of the highest allocation of funds to the civic health department in recent years. It was 4.7% more than the funds allotted in the previous financial year.

While this is the first time that the BMC will increase the purchasing power of deans of civic-run hospitals, the state government had increased the financial power of deans of government-run medical colleges to from ₹3 lakh to ₹20 lakh in 2012. Hindustan Times