FAISALABAD: Punjab Rural Support Programme (PRSP) staff tasked with treatment of people at various levels from basic health units to district council dispensaries have been allegedly found involved in bogus entries of patients, issuance of fake slips, remaining absent from duty and non-issuance of medicine.

The irregularities were detected during a special inspection of 168 basic health units (BHUs), 59 district council dispensaries (DCDs), three each GRDs, Unani and Tibbi dispensaries and six MCH centres. The PRSP had taken up these establishments on Sept 1, 2004, and Rs450 million were being spent annually.

Following inspection reports, District Coordination Officer (DCO) Noorul Amin Mengal through a letter – a copy of which is available with Dawn -- informed the PRSP chief executive officer about it. He said the district government had been closely monitoring functions and assignments of assigned BHUs, DCDs and other healthcare facilities entitled to the PRSP. He said during various visits by designated officers of the district government, including the executive district officer (health), the district monitoring officer and others, a number of anomalies had been detected.

The DCO said: “A number game is being played just to show efficiency/performance with regard to the OPD count but the prime/major components of primary healthcare -- EPI services/anti-dengue activities/polio campaigns and other field activities -- are being ignored.”

He said targets for making entries at each health facility had been fixed, such as the OPD target was more than 2,200. He said bogus entries had been made in the OPD, maternal health, family planning and obstetric registers just to meet targets.

“Contrary to the government policy, a new OPD slip is issued to each patient everyday just to increase the number. To meet the given target of OPD patients, so-called medical camps and school visits are being shown; 300 to 400 schoolchildren are entered as patients whether sick or not. Medicines are not provided to them but maximum consumption of medicines is shown,” the letter read.

It also reads that special instructions have been given not to issue medicines that are almost out of stock and retain them to show their presence. For example, five to six ampicillin injections were stored at BHUs for the last one year just to show their availability, but they were not being provided to the patients.

The DCO also said some life-saving medicines were not available at BHUs for a long time. Injection syntocinon was out of stock at about 80pc units, a basic medicine for induction of labour in delivery cases, but bogus entries had been made in records. Only a few deliveries had been conducted at the BHUs and most of those entered were fictitious. Delivery kits were not available at most BHUs, he added.

DCO Mengal said medicines such as injection B Complex, Vitamin A, antitussives syrup, anti-rabies vaccine and anti-snake vaccine were not available at most of the BHUs. In rural areas, there was a dire need for anti-rabies vaccine and anti-snake venom but they were not available at BHUs.

Medical officers of all BHUs had been deputed as focal persons for preventive programmes in their catchments like routine EPI, polio and dengue but they were not doing their jobs. They were not even aware of the EPI schedule. Medical officers never visited the EPI room to monitor activities and cold chain at the static centre. No effort had been made to make the BHUs dengue-free. Cleanliness at all BHUs was deplorable. Most of the BHU buildings needed major repair and maintenance for a long time, the officer said.

Telephone numbers of patients recorded in the delivery register proved fake on verification. Most staff of BHUs did not reside at the units. Residential buildings were also in a dilapidated condition.

The DCO said it was clear that primary healthcare at the BHU level had been neglected because the emphasis of PRSP was patients’ number game in OPDs putting at stake all preventive measures and achievements of millennium development goals.

“This state of affair was alarming as proper health services are not being provided at the BHUs causing financial losses to the national exchequer. The PRSP has failed to perform mandatory functions assigned to it,” he added.

DCO Mengal has asked the PRSP head to explain his position within four weeks otherwise the agreement between the district government and the PRSP could be terminated.

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