Medicine Monitoring National Citizens’ Movement for Free Elections (Namfrel) volunteers are tasked to monitor the procurement, delivery, and inventory of medicines in 72 Department of Health (DOH) retained hospitals and 16 centers for health development (CHDs) nationwide. The project’s goal is to prevent “ghost” deliveries, fake deliveries, and overpricing, as well as ensure proper dispatch of priority medicines to improve the delivery of health services. Namfrel and DOH signed a Commitment of Support and Cooperation Agreement on 21 September 2004. Former Health Secretary Manuel Dayrit sent out a circular on 1 February 2005 and directed all DOH agencies and personnel to include Namfrel as one of the two observers from the non-government sector to monitor the agency’s procurement and distribution of pharmaceutical products. Volunteers were issued IDs signed by new Health Secretary Francisco Duque. Namfrel was also included in the DOH’s Integrity Development Committee (IDC), an anti-corruption unit in the department’s Central Office (Department Personnel Order No. 2005-1810). Namfrel volunteer leaders at the local areas may also sit as members of the regional IDC of the CHDs. About 123 volunteers were trained and deployed to the DOH-managed hospital nearest where they live. Out of the 72 RHs and 16 CHDs, Namfrel was able to send observers in 50 RHs and 14 CHDs. Observers monitored an initial P62.82 million worth of medicines in 8 RHs and P3.47 million worth of delivered items in 2 CHDs. Observers expressed concern on the need to train new members of Bids and Awards Committees on RA 9184 in hospitals. There were occasional reports of violations of the procurement law due to lack of proper training. In comparing awarded prices of similar medicines among nearby hospitals, initial analysis seems to suggest “possible” overpricing of items sold by suppliers. While these reports are being verified, officials of the DOH have been informed so that precautionary measures can be established. The project team also recommended the proper use of stock cards in the inventory system and to automate supply management at the national and regional hospitals. In a consultation meeting, the DOH said that hospitals are required to follow the New Government Accounting System (NGAS). Part of it is the prescribed use of stock cards in the inventory system. Volunteers, however, observed that a number of hospitals are using logbooks instead of stock cards. In a stock card system, inventory of one kind of medicine/drug is logged in one card. The common excuse of supply officers in the hospitals is that it is easier to use a logbook than stock cards and they don’t have enough people to maintain the stock cards. Hospital Procurement Initial reports came from eight retained hospitals – Philippine Orthopedic Center in Quezon City, Margosatubig Regional Hospital in Zamboanga del Sur, Dr. Paulino Garcia Memorial Research and Medical Center in Cabanatuan, Nueva Ecija, Zamboanga City Medical Center, Research Institute for Tropical Medicine in Muntinlupa, Western Visayas Medical Center in Iloilo, National Children’s Hospital in Quezon City, and Gov. Celestino Gallares Memorial Hospital in Bohol. Medicines monitored in these hospitals amounted to P62,822,729.35. Of the eight hospitals, two (Margosatubig Regional Hospital and Zamboanga City Medical Center) have submitted diagnostic and procurement reports after the projects were awarded to bidders. Reports from the other hospitals are pending for submission either because the bid is not yet awarded or volunteers are still accomplishing the reports. Table 1 shows a sample comparison of identical medicines procured by the two hospitals including the unit cost of each. The project team detected 22 out of 47 medicines in the two hospitals which seemed to contradict the normal trend in procurement. First, bulk purchases did not result in cheaper unit costs. Second, the same supplier offered a different unit price for the same drug in the two hospitals. Third, a hospital within a city was given a higher unit cost compared to a remote hospital. Medicines procured must be in the Philippine National Drug Formulary (PNDF) based on Executive Order No. 49 issued by former President Fidel Ramos. The PNDF is an essential drugs list which is the basis for the procurement of the DOH and other government agencies concerned. It is also a basic component of the national drug policy to ensure the availability of safe, efficacious, and quality drugs at affordable cost. DOH-managed hospitals may procure drugs and medicines not in the PNDF, provided that they have a written request with a corresponding justification addressed to the head of the National Drug Policy Staff (Administrative Order No. 163 of 2002). So far, no report has been received in violation of this. Aside from the PNDF as basis for procurement, all medicines procured by DOH-managed hospitals must be in their Annual Procurement Plans (APPs). A hospital may actually purchase less than what is stipulated in the APP, but not more than what is planned (except during emergencies). Program drugs for National Immunization, Tuberculosis Control, and the “Ligtas Tigdas” campaigns were procured at the DOH Central Office and delivered to CHDs through Fast Pak, DOH’s main forwarder. Most of these drugs were kept at the Quirino Warehouse in Cubao, Quezon City. Vaccines are kept at the Research Institute for Tropical Medicines warehouse; contraceptives are kept at the Population Commission warehouse; and syringes and hospital equipment are kept at the DOH Central warehouse. Other concerns of volunteers (but immediately addressed by DOH) were as follows: 1) Annual Procurement Plans of some hospitals were not easily given to volunteers; 2) A couple of volunteers were not immediately recognized by the hospitals’ head despite a Circular Order from DOH Central; and 3) A few volunteers were not invited to the public bidding despite their coordination with the hospital being monitored. Medicine Delivery A total of 15,740 cartons of Program Drugs amounting to P150,801,471.52, which were procured at the DOH Central Office, have been delivered to 12 CHDs.
|