Thursday, October 07, 2010

TCMC Re-registration & Sample letter

TCMC Re-registration & Sample letter

Also visit http://www.qpmpa.org/news-and-events/15-general/57-tcmc-re-registration-a-sample-letter.html


Dear Members,

TCMC re-registration


As directed by the High Court the TCMC is out again demanding Rs. 500 for the high security registration certificate costing less than Rs. 6. Though the case number is shown, they have taken care not to mention QPMPA.

For details of the judgment visit – http://www.qpmpa.org/news-and-events/16-j-u-d-g-e-m-e-n-t-s/53-tcmc-re-registration-2010.html and – http://www.qpmpa.org/images/stories/qpmpa/journal/6_JMS_Feb_2010.pdf to see that shown in their Counter affidavit published in our Feb 2010 issue of the Journal.

It is said that they are acting as directed by the High Court. However, the High Court has not asked them to violate the TCMP Act 1953.

The NOTICE No. E. 2639/10/MC Date: 20-9-2010 by the TCMC is a clear violation of the Act and no-where in the Act, especially in the one quoted – Section 20 (3) & (4) it says that we pay Rs. 500 for updating the Register. See http://www.medicalcouncil.kerala.gov.in/index.php?option=com_content&view=article&id=8

Section 20 of the Act is on Duties of the Registrars. His main duty is to keep the Registers in order.

S. 20 (3) says that the Registrar shall keep the registers correct by timely removal of the names of those dead.

S. 20 (4) says that to keep the register updated, the Registrar may write by registered post to the registered practitioners to find out the details and if no reply in six months delete the name from the register. Para 9 of the Counter in page 21 of the QPMPA Journal cited will be interesting.

Should the RMPs be penalised for the irresponsible attitude of the Council all these years. As the first step we can exercise Section 21 (3) of the Act to correct the Council. Should we pay Rs. 500 for a certificate costing less than Rs. 6? The fees permitted for Registration is only Rs. 20 as per the Act. (Section 24.) Then why Rs. 500 for the topnotch certificate with photo. Nowadays everyone is having many photo ID cards and certificates. The cost hardly is less than Rs. 10.

The most irresponsible directive in the Instructions in the Application form is the demand for a self-addressed envelop (30x26 cms).

The Registrar is innocent and it is our colleagues who decided all these on 22.4.2010 to plunder more than 39,000 RMPs in Kerala. As the details of the Members is blank in the TCMC website, the majority of us do not know who these great ones are. They want to make the TC Medical Council rich and Rs. 500 from 40,000 RMPs will bring in around Rs. 2 crores (200 lakhs) for an investment of less than Rs. 3 lakhs for the certificates.

If they want to make the TCMC rich, they are free to sponsor something produced by Pepsi or others as done by the National IMA! Many of our colleagues still believe that IMA and IMC are the same!

Why should the TCMC issue a certificate the size of 30x26 cms? That can be as small as a PAN, or an ATM card. If a small one, the ID can be with the RMP always and will help him out at many places.

I have the following suggestions to update the Register of Modern Medicine Doctors by TCMC:-

1. Reduce the fees to Rs. 100/- for the new high security certificate. Accept Postal Orders, cheques or arrange online money transfer. Give the bank Account number of the TCMC and the fees can be transferred without much problem. Proof of fees transfer to be attached with the application for the great certificate.



Note: A photo ID Certificate cannot be a permanent one. It must be updated every 5 or 10 years as the countenance / physiognomy change with aging. Also note that there is nothing that is tamper-proof and this new certificate will not solve quackery as found out by our super brains in the Council.

2. No fees for Senior Citizens (those above 60 years).

3. The safety of the original registration certificate cannot be assured by the TC Medical Council. So demand only an attested copy and on getting the new certificate the RMPs can surrender the old one. No one will be accountable for the loss in transit.

4. No self-addressed envelope. The Council must have their printed envelopes.
My request to QPMPA Members:-


Kindly send the above suggestions to TCMC, the address given below.

THE TRAVANCORE–COCHIN COUNCIL OF MODERN MEDICINE,
COMBINED COUNCIL BUILDING, RED CROSS ROAD,
THIRUVANANTHAPURAM – 695035



If the TCMC is not to fall in line, we will first approach the Government and then the Hon'ble High Court with a request to remove all those concerned for violating the TCMP Act repeatedly that they are entrusted to enforce, under Section 22 of TCMP Act, 1953.

Note: The Email ID shown in "Contact" page of TCMC site will not work. So send your complaint by India Post.

Details in http://www.medicalcouncil.kerala.gov.in/index.php?option=com_content&view=article&id=8





Kishore Kumar

Sunday, September 26, 2010

Kayamkulam Calling: Expressway Kerala Style

Kayamkulam Calling: Expressway Kerala Style:

Expressway Kerala Style


Expressway Kerala

The great visionaries & missionaries of Kerala

We must be proud of our planners building better roads all over Kerala now.

In June 1990, one Ms Subhadramma wrote an article in the Indian Express and that opened the eyes of our great masters and planners at the Centre.

After 20 years, the masters and think-tanks in Kerala found out that we must have better roads and the struggle is on to save Malayalees.

As the planners failed to act, in 1993 the following article appeared in Mathrubhoomi daily.



The proposals in the above article were—

(1) Length - Kasargod to Trivandrum 600+ kms.,
(2) Width - 150 m.,
(3) 10 m. wide footpaths on either side,
(4) Four tracks of 15 m. each,
(5)Two 15 m. wide shoulders between two tracks on either side and,

(6) 40 m. wide median in the middle.

The tracks on either side are the primary roads, in which two-way traffic is permitted and next to that is the Expressway, having 4-lanes and one-way traffic in each direction.

That is 10-15-15-15-40-15-15-15-10 = 150 m. The 40 m. wide median can be developed in future as required.


The other important points were:

  • (1) Hand over the ownership of this road to private sector and they can build, operate, own and maintain it. In other words, that can be called BOOM.
  • (2) The toll proposed was Two paise per tonne per kilometre (2x1x1). That is, a vehicle weighing 1 tonne (1000 kg.) can travel from Kasargod to Trivandrum by paying a toll of Rs. 12 and can cover the distance in less than 6 hours. Rs. 120 for 10 tonnes,
  • (3) No periodical increase in toll, and if possible reduce it in future.
  • (4) Those giving land can be made shareholders of the company owning the Freeway.
  • (5) The public and Govt. can invest money for the road building and can be shareholders and earn dividends and sell it to raise money in future.
  • (6) Link roads to be built towards east and west to connect all towns to the Expressway.
  • (7) By going for a new road an area 600 kms. long will develop and the land value in that area will increase.
  • (8) The people can be relocated to other places and thus can decongest the present towns and cities and thus make life easier.
  • (9) By widening the present roads, we can never attain the high speed of the future.
  • (10) All the land developments in Kerala are confined to either sides of all the roads and destroying them is not the answer to improve facilities.
  • (11) By demarcating a 150 or 200 m. wide stretch as the main north-south corridor transportation problems for the next 2 or 3 centuries can be addressed.
  • (12) If that is done now, that can be achieved with the least destruction of man-made structures.
  • (13) The only one disadvantage, when a new modern road is designed, will be the crash in the land price on either side of the present roads for the wealthy and powerful ones. However, that will be a temporary phenomenon, and will spring back to the present levels in a few years.

The missionaries and visionaries of Kerala

We must be very proud of our politicians, their followers and the planners of Kerala whose only mission is plunder and vision very parochial. They just cannot think of anything beyond five years.

30 m. wide land was acquired for NH 47 & 17 about 40-years ago. Originally, they were bullock-cart tracks hardly five ft. wide connecting nearby towns. In forty years that has reached the present width and it is said that people who donated the land 4 decades back have not received the land price fully yet.

Straightening it was a herculean task for our great engineers and even after four attempts in 40 years, most of the curves are still there.

After publishing the articles cited, there was a national awakening in road building and in the 1990s, the Central PWD Minister was a hero. Unfortunately, the leaders from Kerala never thought of it and our state was no-where in the picture in national road plans. Ignoring the idea of BOOM cited, the BOT — Build, Operate & Transfer — idea surfaced during this period from the bureaucracy. This is a short cut to bleed the people by all concerned. Our planners are very intelligent and the poor Indians are honouring them with pay and pension every month.

After killing thousands of innocent ones on the roads the politicians in Kerala finally decided to improve our roads around 2003 and the great Kerala PWD Minister Dr. Muneer came out with the proposal of the most idiotic plan that can ever be imagined in the whole world. The design once available in the website of Roads and Bridges Corporation of Kerala is copied.

The Dr Muneeraway



The UDF Ministry and their followers then and even now wanted to implement this proposal. Yes, on a 100 m wide stretch of land from Kasaragod to Thiruvananthapuram, the highly paid Road Architects of Kerala designed the cited Expressway (Muneeraway). A railroad on the left, a tar road next, a power-way next and a waterway on the right end. This award winning design disappeared from the Roads & Bridges Website soon after the coming of the LDF Ministry, for the simple reason, that some idiots with brainpower opposed it.

The way out

By the year 2050, Kerala will become the biggest city in the world 600 km long and all the roadsides will be full of buildings and people. There will be no rural-urban differentiation.

The present roads in Kerala are not designed or built in a scientific way and they can never accommodate the volume or speed of vehicles of the next generation or century. The best alternative is to design and build a new road parallel to NH 17 & 47 say 3 to 10 kms. toward the east and that must have a design speed of say 300 to 500 km/hr. Next to that, we must also plan a six-track railroad for bullet trains and by the next century, they will attain a speed of over 600 kms/hr. The width for the road must be at least 150 to 200 m. as said above to make it 8 or 16 lanes as required.

It is estimated that the cost of building the new road by widening will cost around Rs. 17 crore for each kilometre and we have more than 1500 kms. to be rebuilt. The total will be Rs. 25,500 crores and the builders will recover it as toll in 30 years with 10, 15 or 20% interest. The cost for the roads will be around Rs. 7 cr. per km and the rest is compensation for the structures. to be destroyed. This is criminal waste of public money.

For repaying the principle alone in 30 years, we have to shell out Rs. 850 cr. every year. If the builders are charging only 10% interest that will be Rs. 2,550 cr. every year. That means every year the owners will drain more than Rs. 3,400 cr. from us for the next 30 years. That will be more than Rs. 1,00,000 crores! By the 30th year, we will start thinking of widening it again to reduce the road death rate in Kerala. The only way out for our planners then will be destruction of all that built during the next 50 years and widen it to 60 m.

The Cost Factor

It is estimated that the widening exercise of the present highways with a length of 1550 kms. will cost around Rs. 25,000 crores at the rate of Rs. 17 crore per kilometer. Out of this Rs. 7 crores is for building the road and Rs. 10 crore for land purchase. There will be a service road on both sides and the speed tracks – 2-lanes – in the middle. To complete the rebuilding it will take another 5 years. By that time, the vehicle density will double and in another 20 years, the 2-lane track will become insufficient.

With the money invested for a two-lane road, we can have a geometrically designed brand new road having three times its width. This will permit to accommodate more vehicles and higher speed.

Kasargod to Thiruvananthapuram is 600 kms.

If we acquire a strip 150 m. wide, the total area purchased is 90 sq.kms.

One square kilometre = 247.11 acre.

That means 90 sq.kms. = 22,240 acres.

At an average rate of Rs. 50,000 per cent, in an area 5 to 10 kms towards the east of present NH 47 & 17, an acre will cost Rs. 50 lakhs. (Rs. 50,000 x 100 cents = Rs. 50,00,000). The present land price in this area is not more than Rs. 10,000 to 25,000 for each cent.

At the rate of Rs. 50 lakhs per acre, 22,240 or say 25,000 acres will cost Rs. 1250000 lakhs or Rs. 12,500 crores. (Rs. 12,500,00,00,000). The excess land purchased is to rehabilitate those who lose all their land in this process.

That means, with just 50% of the proposed expenditure we can purchase a strip 150 m. wide instead of the 45 m. wide one. This will open up a new corridor also and more land on either sides of the 600 km long strip will start developing.

Next major expenditure is roads and bridges in this 600 km long strip. As proposed, there will be four roads of 15 m. width, two footpaths 10 m. wide on each side. There will be two shoulders 15 m. wide and the middle partition 40 m. wide.

That means, out of a width of 150 m we need develop only 80 m. They are 60 m. roads and 20 m. footpaths and drainage.

So to have a perfect expressway we must develop 48 sqkms. (600x1000x80). As said 1 sqkm. = 247.11 acres. So 48 sqkms. = 11,862 acres.

One acre = 43,560 sqft. Then 11,862 acres = 51,66,67,700 sqft.

At Rs. 500 per sqft. for a heavy traffic road the total construction cost for 51,66,67,700 sqft. will be Rs. 25,833,38,50,000 or say Rs. 26,000 crores.

So land + construction cost = 12,500 + 26,000 = Rs. 38,500 crores.

The additional cost is - 38500-25000 = Rs. 13,500 crores.

In turn, we get a north-south super highway in which we can travel at more than 150 kms/hr non-stop for 600 kms. In future, this road as envisaged by Ms. Subhadramma will go up to Ahmadabad in the north and Kanyakumari in the south. In Us one travel from one end to the other, 6,000 kms. non-stop. That is also true in all developed countries. The facilities so developed is not only for the rich, as projected some among us to torpedo all developments. The new road will not divide Kerala into two areas as feared by some.

Similarly, we must have a separate 6-lane railroad system for bullet trains that can travel at 300 to 400 kms/hr. This railroad can be built two or three kms. away and parallel to Expressway on similar terms as we build the Expressway.

All that we require is a unanimous political will, an Act of the State Govt. to make it a BOOM road, form a company or a cooperative society to own the same and transparency. Funds will come from all over the world from Malayalees and others and it will be oversubscribed in no time. The Central PWD contribution can be accepted as share capital and they can cash it when the share price increases. This can be taken up on a war footing and all types of labour unrest and bundhs shall not be applicable to this master project of the State.

Simultaneously we must develop the exisiting highways and other roads within the width available. If funds are not available from the Central Govt., the same shall be entrusted to the firm coming up for the BOOM Road.

Those who donate land for the project shall be paid the market price and shares depending on the area donated. Example: For One Cent two shares and for an acre 200 shares. These shares can be separated and be called "Land Share" and will have a higher value. To start with the share for the public can be issued at 200% the share value of Rs. 10 or more.

Kindly think of the future and stop the irresponsible projects of the selfish and parochial ones ruling us now. They just cannot think beyond the next 5 years.

If this proposal is taken up seriously, then Keralites will pool the Rs. 50,000 crores or more required for a new road and they will be the owners of the new Freeway of the future Kerala. If implemented with the shareholders money, all that the Govt. has to insist is toll rate. The toll need not be more than that proposed 20 years ago.

I am ready to take it up, if Keralites agree and promise to stand united. We can ignore the alms from the Central Govt. We can build a Kerala worth the name — GODS OWN COUNTRY!

May God save this Gods' Own Country by making the masses here wiser.

Dr. K. Kishore Kumar,
Askoka Bhavan, Near MSM College,
Kayamkulam 690502

Ph. 9447485532

Visit http://www.qpmpa.org/news-and-events/15-general/48-development-kerala-style.html

Thursday, May 13, 2010

Drug License for Hospitals in Kerala only


To,

The Chief Minister, Health Minister & important Officials of Kerala:

Dear Sirs,

Non-availability of Drugs --
All Private Hospitals in Kerala to close in a few days –
want of medicines –
Act immediately!

I request the Chief Minister, Health Minister of Kerala, and all those conerned to step in and help bring back the Drugs Controller back to sense. If not thousands of patients will suffer all over Kerala.


The Drugs Control Department of Kerala has once again won the 20-year-old battle with the Private Hospitals in the state to impose Drug License on all private Hospitals/Clinics/Nursing Homes, etc. However, the non-availability of medicines will force the closure of many private hospitals in the state and the Drugs Department will be solely responsible for the consequences.

The case – known as Drug License case – WP (C) No. 38494 of 2003 (Y) – was dismissed by the Hon’ble Kerala High Court on 25 March 2010 paving the way for the Drugs Controller of Kerala to implement his directives dated 17 March 1995.


However, the Drugs Department is in a dilemma and are helpless. They won the case by misinterpreting one sentence in the Drugs & Cosmetics Act, 1940, a 671-page document. That is-

Schedule K - 5.A Drugs supplied by a hospital or dispensary maintained or supported by Government or local body. (See page 168 of the Act.)

The Drugs Controller of Kerala after seeing the item cited – Schedule K – 5A. – found out that it means that Govt. Hospitals are exempted and Private hospitals are not exempted and so must take drug license, way back in 1990, and issued orders to that effect. Having won the case they are now trying to implement the High Court verdict through Drug stores by telling them not to supply medicines to hospitals without a license.

The news that appeared in Pharmabiz is copied hereunder – (Kindly note the Para marked blue)

DrugsControl.org

Drugs News

Kerala Drugs Control Dept orders private hospitals to obtain licences for pharmacies from May 1

(3/5/10)

Chennai, 3 May: Following the verdict of March 26, 2010 by the High Court of Kerala, the Drugs Control Department of the state has started giving instructions to all the private hospitals operating own pharmacies to obtain drug licences after April 30.

However, the department has not issued any written circulars in this regard to the hospitals but instead directives were given orally, said the drugs controller in-charge M Geetha. She said there are some technical problems in giving written orders, but it will be done in future if necessary.

According to sources in the department, officials in the rank of assistant drug controllers have passed on the direction to the respective hospital managements directly and over telephone in their jurisdiction. The sources said that the new order puts the hospital managements as well as the enforcement officers in a dilemma as to how many licences the super speciality hospitals should obtain since many of them are having more than one pharmacy in their hospitals.

"The ward pharmacies attached to all the specialities in a super speciality hospital are centralized with a general pharmacy store and medicines from each of the subordinate pharmacies are dispensed by pharmacists only. So each ward pharmacy has to be reckoned as a retail outlet. If so, the hospital management has to apply for drug licences depending up on the number of ward pharmacies," an ADC told Pharmabiz. But he said so far no concrete decision on this aspect was taken by the department and the discussion is going on at the higher level.

Revi S Menon, the ADC of Eranakulam said within days of the court order, the hospitals started applying for licences. He said the narcotic permit order given to certain hospitals previously have been now stopped in the cases of those hospitals which have not taken drug licenses or applied for fresh ones. The offices of ADCs in Kerala are giving the order of allotment of narcotic drugs, ND 3, to hospitals for Morphine, Pethidine and Fentanyl Citrate for the purpose of pre-anaesthetic medication. Revi said his office received more than hundred applications with in one week of the announcement.

According to K E Mohanan, ADC Kozhikodu, instructions for fresh drugs licenses have been given to all the major and minor hospitals operating pharmacies to apply for license afresh.

When contacted M R Pradip, ADC of Thiruvananthapuram, said that he already instructed all the hospitals in his zone which need order for narcotic allotment to get the drug licence beforehand. Regarding new applications only for hospital pharmacies, he said he has not started instructing private hospitals for fresh licenses as he has not received any order from the higher authority.

The officials said the major problem the hospitals have to encounter is with regard to the appointment of qualified pharmacists in the stores as there is a severe shortage of Diploma or B Pharm holders in Kerala.

According to drugs controller Geetha, for a retail pharmacy a hospital management must remit Rs 3000 to the government treasury and the space must be of 10 square meters. For an outlet a refrigerator and inverter are made mandatory for getting licence.

About 3000 private hospitals in the state have to apply for fresh licences as per the court order or they have to close down their pharmacies after the deadline.

Pharmabiz

Qualified Private Medical Practitioners’ Association (QPMPA) -- the organisation of private sector doctors in Kerala was fighting this issue for the last 20 years. The QPMPA is moving the Supreme Court once again, and we never want it to be a battle royal. We expect an honourable retreat by the Drugs Controller, though late.


The motives of the Drugs department are many and the hospitals do not want to include one more department to their unaccounted pay rolls. Nearly 50 departments are plundering the hospitals regularly and adding one more is not the issue involved.


The most important reason is that the Drug Licenses are issued in the name of registered Pharmacists and not in the name of the doctor or the hospital. Whenever the services of a pharmacist are terminated, the Drug License of that institution will vanish or disappear with the Pharmacist concerned. If that pharmacist is close to the Drugs Department officials, they usually are, then the hospital is forced to oblige to the demands of the department.


Therefore, to be on the safe side and run a hospital peacefully, the doctor or the hospital owner must have a pharmacist as spouse!


Most of the Drug manufacturers in Kerala are retired Drugs Control Department officials or are very close to them. The major hurdle of these small drug manufacturers is marketing. No one can compete with the multinational drug companies in marketing.


With the ill-gotten right to impose Drug License on hospitals, the department is getting additional control over more than 5,000 drug outlets in Kerala. The Kerala Drug Manufacturers’ Association is having close rapport with the department. Majority of the private hospitals do not patronise drugs from small manufacturers. They all go for branded items.


Therefore, a Drug License is a well-planned trap, noose or snare for hospitals and with that, the Department can manipulate medicine purchase by Private Hospitals and help their friends prosper in the business. (Having learned the tricks of the trade from the North Indian lobby, we do not want to brand all of them as producers of spurious drugs.) More than 30% of the medicines coming to Kerala are dispensed through hospitals.


For the kind information of the Drugs Department of Kerala, there are thousands of one-man show clinics managed by Homeopaths and others buying the cheapest drugs available in the market from licensed Drug Stores and selling it at the cost of branded drugs. Hope that the Pharmacy Council will quote this information in the Impleadment Petition we expect them to file in the Apex Court!


Unfortunately, the QPMPA and the IMA (Indian Medical Association) who is also a party in this case or their advocates failed to read the Drugs & Cosmetics Act, 1940, and Rules, 1945, above or below Schedule K – 5A, and fight it on the other grounds readily available and so the case dragged on for 20 long years.


I, Dr. K. Kishore Kumar, aged 62 years, S/o. Late Mr. Kumara Pillai, of Ashoka Bhavan, Kayamkulam 690502, the State Secretary of the QPMPA, which is now a National Organisation of Private Hospitals, humbly request the Drugs Controller of Kerala to have a rethinking on this Drug License issue, though legally on the right side, with the blessings of the Hon’ble High Court of Kerala.


Ms. M. Geetha, the Drugs Controller now, having read the Drugs & Cosmetics Act & Rules in full, and having assimilated the true position and having expressed that to Pharmabiz, (cited), I, Dr. Kishore Kumar, on behalf of the QPMPA, as its State Secretary, request you to withdraw the Letter No. L-17323/94/DC from the Office of the Drugs Controller, Thiruvananthapuram – 37, dated 17.3.1995.


If the department is not prepared to back out, we (QPMPA) will be forced to prove that the Drugs Controllers or Pharmacists in Kerala are not smarter than all others in India.

Let us be on a collusion and not collision course! I, once again, request the Chief Minister, Health Minister of Kerala, and all those conerned to step in and help bring back the Drugs Controller back to sense. If not thousands of patients will suffer all over Kerala.

Dr. K. Kishore Kumar,

State Secretary, QPMPA,

Ashoka Bhavan, Near MSM College,

Kayamkulam 690502

Ph. 0479 2445532

Mob. 9447485532

Dear Sirs,


Kindly go through the following points given below to substantiate my views cited above:

Copied below, are the views of senior doctors on Drug Licence. Kindly go through the points.

Views from a well-wisher-- (1)

Dear Dr. Kishore,

There are several valid points to be contested.

One is that the treatment of a patient to a given illness cannot differ according to the owner of the Hospital / Clinic or whose fund is being used.

The MCI Act refers to ‘A’ Registered Medical Practitioner and his privileges. It does not give any distinction between doctor employed by private management or Govt., or self - employed practitioner or who funds him.

This issue was there in 1980s in connection with a G.O. issued while Vaylar Ravi was the Home Minister of Kerala, saying that private practitioners cannot treat injuries and accident cases. Later on, the Govt. withdrew the G.O. Now every doctor must attend Traffic Accident patients, and report the case to the Police.

The contention that "a" doctor giving drugs to his patients need not take licence was in the context of 1940, when there were no antibiotics and 90% of medical procedures, diagnostic/therapeutic were not known.

Medical sciences were passing from the pathophysiology of organ changes like fatty degeneration of liver, to studying the cellular changes. By 1970s, doctors started to learn more about the intracellular and molecular changes. Twenty years later medical sciences are learning about the sub-molecular changes and genes influence on disease.

In short, in 60 years time since the original Act was passed the total knowledge of human ailments, its causes and possible remedies including prevention has quadrupled and it is almost doubling itself in each decade. No one doctor alone can treat any disease or give adequate health care to anyone.

A physiological phenomenon like pregnancy in woman needs more than one doctor to have adequate care. Obstetrician can initially examine. Then, her blood group including ‘Rh’ factor has to be determined by a laboratory supervised by a Clinical Pathologist, and then it is necessary to have an Ultrasound Radiologist to diagnose any foetal anomalies. If there is history of certain inherited or familial diseases, then amniotic fluid has to be withdrawn and studied by Immunologist or Geneticist.

If all goes well, at the time of delivery apart from the Obstetrician, it is necessary to have an Anaesthetist available to resuscitate the baby if needed and a Paediatrician to examine the baby to determine any anomalies, which should be corrected. In 1940, this might have been taken care of by a midwife or a family doctor. For better care or less damage to both brain and other vital organs of the infant and the mother about half a dozen doctors are needed at present. Hence, "a" doctor should be substituted for team of doctors and hospitals.

More over singular often can mean entire humanity like a man has certain fundamental rights in a democracy means men, women and children, in fact all citizens.

As illustrated above when an emergency occurs like postpartum bleeding the doctors have only few minutes before the woman bleeds to death. When they are busy, the Drug Inspector happens to be inspecting and demands the doctors to give certain explanation. Here the choice allows the patient to bleed to death or face criminal charges from the Drug Inspector in not helping him to properly carryout his duties.

Under such an environment, most human beings will take the least harmful course by asking the clerical staff to give drug inspector Rs. 500/-, which he will readily accept and go way. This is what is happening in practice.

It is worth recalling that hardly a decade ago to get a telephone connection one has to wait years. Once you have it, for that to function properly, the services of telephone lineman’s regular visit is an absolute necessity. In a City like Cochin, having in 1990s about two lakhs telephone connections, on an average requires two monthly visits by the telephone linesman to give life to the dead phone, which happen frequently. Nobody can refute that one has to pay at least Rs.50/- per visit if it is a minor problem. That is the Telephone linemen were collecting Rs. Two crores every year from a City like Cochin. Since that licence / permit raj has ceased to exist the use of telephone has increased 100 fold with no corruption. Now every other Indian is having a telephone. The total number of phones in India now is 59 crores and the share of our License Rajas is less than four crores.

It is worth remembering that since Sir Thomas Babington MacAulay drafted the Indian Penal Code in 1834, not much happened to improve the law enforcement system. In these 170 years, literally, our Parliament and State Legislatures have passed thousands of enactments and number of Court Cases has accumulated in millions. In order to get civil suit properly adjudicated it will take the lifetime of two generations for ordinary citizens of India.

Under these circumstances if the Indian Parliament in their finite wisdom passes an Act saying that most of the problems are due to the use of incorrect language, with bad grammatical and idiomatic construction of sentences leading to enormous appeals going to Superior Judicial Forums, therefore it is enacted that all judgements in all Courts in India must be first reviewed by the Govt. High School English teacher and certified before it can be pronounced by the Hon. Judicial Officer.

What will be the reaction of the Judiciary in India!

In the above case of delivery, the doctors caring for the young woman have a combined medical education and training of more than 60 years and a drug inspector who is not even a registered medical practitioner should oversee his use of proper drugs of proper potency is to say the least is ridiculously absurd. It is also worth remembering that in the last 100 years the medical profession has eradicated scourges like smallpox, contained polio, malaria, plague, cholera, etc. Have the legal system anywhere in this world has been able to prevent one crime!

Another point to add is the quality control of the drug must be done before it is sending for the manufacture. The Drug Controller of India has totally failed to assure good quality drugs in India. Let them give a report of how many qualitative analyses have taken place in a year. How many Atomic Spectrometers the department have to analyse the entire elements and quantities in a given drug.

In order to follow the transit and ultimate utilisation of these drugs it is better to use the computer digital technology for which India is well known on this Earth. They can create a barcode for every drug pack or foil and follow by computer-aided scan at every stage. It will be 100% accurate, corruption free and cost effective.

Our solution is political decision at the level of Govt. of India.

With best regards.

XXX

Views from Dr Sushama Anil -- (2)

Dear Kishore

I am sending you the details of laws regarding the manufacture, distribution and sale of medicines in India. In my opinion, if we argue that the doctors need not take any drug license may be rejected by the court. Because for the handling of any dangerous article the Govt. expects a control over it, hence the judiciary will always support the license and this.

We have to argue that we are ready to take the drug license in the name of the doctor in charge of a hospital but without the need of a pharmacist. Isn’t it? That means that the Drugs and Cosmetic Act must be amended. That argument may stand in the court. Am I correct? Pls Think...

Regards

Sushama Anil

Views from Sushama Anil (3)

Second Letter from Dr. Sushama --

Dear Kishore

Pls see the attached file. In addition, you may follow the link mentioned in the file. A few lines from the file are quoted below.

From the file attached:

Advisory Tasks
Since pharmacists posses maximum knowledge about the complexity and potential side effects of various drugs, they are very often employed to advise medical practitioners on the selection and side effects of the drugs.

They also perform a number of administrative duties in hospitals and other medical establishments.

Now a days the advisory job mainly carried out by medical representatives from the medical companies. Therefore, if the govt wants to strengthen the advisory job, then the medical representatives should have pharmacy qualification. At first govt should make a rule to eliminate unqualified advisors, i.e., the usual medical representatives from the medical manufacturers. I believe the govt does not have any rule to regulate the appointment of medical representative, who are delivering a very responsible function, i.e., introducing the medicines and providing information about it to the doctors. That means, as mentioned above, it is the role of a pharmacist to do it. The medical representatives must have a pharmacy qualification. Isn’t it?

Still, in the modern medical store in a hospital there is no need of a pharmacist. Many of the hospital medical stores are computerised now a days. Hence, the billing and stock keeping is also computerised and precise.

In addition, another important - - very important -- aspect of your letter: - you rightly mentioned about the unity among doctors. Actually, my slogan is “THINK, UNITE AND REACT” which I have mentioned in many of our local IMA (Balussery Branch) meetings. In addition, the success behind other professional communities is none other than their UNITY. So…. at least in the present situation pls ask our comrades to UNITE and REACT and for them I give my wholehearted support.

Regards,

Sushama Anil

Views of Dr. Kishore

Hereunder, I am giving my views after studying the Drugs Act & Rules (617 pages available at http://cdsco.nic.in/html/Copy%20of%201.%20D&CAct121.pdf) and the important points are copied hereunder and has given my comment in boxes. The page numbers quoted are as in the above pdf file.

Drugs & Cosmetics Act, 1940

http://cdsco.nic.in/html/Copy%20of%201.%20D&CAct121.pdf

Page 21

CHAPTER IV

MANUFACTURE, SALE AND DISTRIBUTION OF DRUGS 1[AND COSMETICS]

16. Standards of quality. —3[(1) For the purposes of this Chapter, the expression “standard

quality” means—

(a) in relation to a drug, that the drug complies with the standard set out in 4[the

Second Schedule], and

XXXXXX

Page 23

18. Prohibition of manufacture and sale of certain drugs and cosmetics.From such 1date as may be fixed by the State Government by notification in the Official Gazette in this behalf ,no person shall himself or by any other person on his behalf—

(a) manufacture for sale 2[or for distribution], or sell, or stock or exhibit 2[or

offer for sale]—

2[(i) any drug which is not of a standard quality, or is misbranded,

adulterated or spurious;

XXX

(vi) any drug or cosmetic in contravention of any of the provisions of this

Chapter or any rule made there under;]

(b) sell, or stock or exhibit 2[or offer] for sale, or distribute any drug 3[or cosmetic] which has been imported or manufactured in contravention of any of the provisions of this Act or any rule made there under;

(c) manufacture for sale 2[or for distribution], or sell, or stock or exhibit 2[or offer] for sale, or distribute any drug 4[or cosmetic], except under, and in accordance with the conditions of, a licence issued for such purpose under this Chapter :

Provided that nothing in this section shall apply to the manufacture, subject to prescribed condition of small quantities of any drug for the purpose of examination, test or analysis:

Provided further that the 5[Central Government] may, after consultation with the Board, by notification in the Official Gazette, permit, subject to any conditions specified in the notification, the 2[manufacture for sale, or for distribution, sale, stocking or exhibiting or offering for sale or distribution] of any drug or class of drugs not being of standard quality.

Page 24

7[18A. Disclosure of the name of the manufacturer, etc.—Every person, not being the manufacturer of a drug or cosmetic or his agent for the distribution thereof, shall, if so required, disclose to the Inspector the name, address and other particulars of the person from whom he acquired the drug or cosmetic.]

My comments on the above Section 18A:

Kindly note the lines highlighted. Hospitals do not manufacture any of the drugs dispensed or sold in the hospitals and are not the AGENTS for DISTRIBUTION thereof. All that is required from hospitals or persons keeping drugs, if required, shall disclose the details. The next Rule 18B is for those holding license. This section clearly says that any person can store medicines and must obey the Inspector.

8[18B. Maintenance of records and furnishing of information. —Every person holding a licence under clause (c) of section 18 shall keep and maintain such records, registers and other documents as may be prescribed and shall furnish to any officer or authority exercising any power or discharging any function under this Act such information as is required by such officer or authority for carrying out the purposes of this Act.]

19.Pleas. — (1) Save as hereinafter provided in this section, it shall be no defence in a prosecution under this Chapter to prove merely that the accused was ignorant of the nature, substance or quality of drug 7[or cosmetic] in respect of which the offence has been committed or of the circumstances of its manufacture or import, or that a purchaser, having bought only for the purpose of test or analysis, has not been prejudiced by the sale.

Page 25

(2) 1[For the purposes of section 18 a drug shall not be deemed to be misbranded or

adulterated 2[or spurious] or to be below standard quality nor shall a cosmetic be deemed to

be misbranded or to be below standard quality] only by reason of the fact that—

(a) there has been added thereto some innocuous substance or ingredient because the

same is required for manufacture or preparation of the drug 3[or cosmetic] as an article of

commerce in a state fit for carriage or consumption, and not to increase the bulk, weight

or measure of the drug 3[or cosmetic]or to conceal its inferior quality or other defects; or

4* * * * * *

(b) in the process of manufacture, preparation or conveyance some extraneous

substance has unavoidably become intermixed with it: Provided that this clause shall not

apply in relation to any sale or distribution of the drug 3[or cosmetic] occurring after the

vendor or distributor became aware of such intermixture.

5[(3) A person, not being the manufacturer of a drug or cosmetic or his agent for the distribution thereof, shall not be liable for a contravention of section 18 if he proves—

(a) that he acquired the drug or cosmetic from a duly licensed manufacturer, distributor or dealer thereof;

(b) that he did not know and could not ,with reasonable diligence, have ascertained that the drug or cosmetic in any way contravened the provisions of that section ; and

(c) that the drug or cosmetic, while in his possession, was properly stored and remained in the same state as when he acquired it .]

My comments:

S 19(5) clearly says that anyone can store drugs and do whatever he wants.

6[20.Government Analysts. — (1) The State Government may, by notification in the

Official Gazette, appoint such persons as it thinks fit, having the prescribed qualifications, to

be Government Analysts for such areas in the state and in respect of such drugs or 7[classes

of drug or such cosmetics or classes of cosmetics] as may specified in the notification.

XXX

(2) of this section.]

Page 26

21. Inspectors. —(1) The Central Government or a State Government may, by notificationin the Official Gazette, appoint such person as it thinks fit, having the prescribed

qualification, to be Inspectors for such areas as may be assigned to them by the Central

Government or State Government, as the case may be.

(2) The powers which

XXX

6[22. Powers of Inspectors(1) Subject to the provisions of section 23 and of any rules made by the Central Government in this behalf, an Inspector may, within the local limits of the area for which he is appointed, —

5[(a) inspect, --

XXX

(i) any premises wherein any drug or cosmetic is being manufactured and the means employed for standardizing and

2[(2A) Every record, register or other document seized under clause (cc) or producedunder clause (cca) shall be returned to the person, from whom they were seized or who produce the same, within a period of twenty days of the date of such seizure or production, as the case may be, after copies thereof or extracts there from certified by that person, in such

manner as may be prescribed, have been taken.]

My comments:

Drug Inspectors are given vast powers and a license is not mandatory for him to check a place where drugs are stored as per the above Section.

1Ins.by Act 35 of 1960, s. 5(w.e.f. 16-3-1961)

2Amended by Act 68 of 1982 (w.e.f. 01-02-1983)

28

(3) If any person willfully obstructs an Inspector in the exercise of the powers conferred

upon him by or under this Chapter 1[or refuses to produce any record, register or other

document when so required under clause (cca) of sub-section (1)], he shall be punishable

with imprisonment which may extend to three years, or with fine, or with both.]

Page 28

23. Procedure of Inspectors.

33.3[Power of Central Government to make rules. —(1) The Central Government may after consultation with, 1[or on the recommendation of,] the Board and after previous publication by notification in the Official Gazette, make rules for the purposes of giving effect to the provisions of this chapter:

XXXX

(q) provide for the exemption, conditionally or otherwise, from all or any of the provisions of this Chapter or the rules made thereunder, of any specified drug or class of drugs 2[or cosmetic or class of cosmetics];

[CHAPTER V

MISCELLANEOUS

2[333P.] Power to give directions. The Central Government may give such

directions to any State Government as may appear to the Central Government to be necessary for carrying into execution in the State any of the provisions of this Act or of any rule or order made thereunder.]

My Comments:

The Central Government has not taken any action during the last 20 years, though they were a party in this case. Silence was their Hallmark.

Page 53

DEPARTMENT OF HEALTH NOTIFICATION

New Delhi, the 21st December 1945

No. F. 28-10/45-H (1). __In exercise of the powers conferred by Sections 6(2), 1[12, 33 and

33N] of the Drugs and Cosmetics Act, 1940 (XXIII of 1940), the Central Government is pleased to make the following Rules: __

RULES

PART I__PRELIMINARY

1. Short title, extent and commencement. ___(1) These Rules may be called the Drugs and

Cosmetics Rules, 1945.

2(2) They extend to the whole of India.

2. Definitions.___ In these Rules, unless there is anything repugnant in the subject or context___

(a)“the Act” means

XXXX

Page 54

2[(ee) “Registered medical practitioner” means a person__

(i)holding a qualification granted by an authority specified or notified under

Section 3 of the Indian Medical Degrees Act, 1916 (7 of 1916), or specified In

the Schedules to the Indian Medical Council Act, 1956 (102 of 1956); or

(ii) registered or eligible for registration in a medical register of a State meant for the

registration of persons practicing the modern scientific system of medicine

3excluding the Homoeopathic system of medicine; or

(iii) registered in a medical register, 3other than a register for the registration of

Homoeopathic practitioner, of a State, who although not falling within subclause

(i) or sub-clause (ii) declared by a general or special order made by the

State Government in this behalf as a person practicing the modern scientific

system of medicine for the purposes of this Act; or

(iv) registered or eligible for registration in the register of dentists for a State under

the Dentists Act, 1948 (16 of 1948); or

(v) who is engaged in the practice of veterinary medicine and who possesses

qualification approved by the State Government.

Page 81

PART VI -- SALE OF DRUGS OTHER THAN HOMOEOPATHIC

MEDICINES

59. (1) The State Government shall appoint Licensing Authorities for the purpose of this Part

for such areas as may be specified.

1(2) Applications for the grant or renewal of a licence 2[to sell, stock, exhibit or offer for sale

or distribute] drugs, other than those included in Schedule X, 3[shall be made in Form 19

accompanied by a fee of rupees one thousand and five hundred or Form 19-A. accompanied by a

fee of rupees five hundred, as the case may be, or in the case of drugs included in Schedule X

shall be made in Form 19-C accompanied by a fee of rupees five hundred, to the licensing

authority:]

Page 87

65. Condition of licences. __ Licences in 1[Form 20, 20-A, 20-B, 20-F, 20-C, 21, and 21-B] shall be subject to the conditions stated therein and to the following general conditions___

1[(1) Any drug shall, if compounded or made on the licensee’s premises be compounded or

made under the direct and personal supervision of a 2[registered Pharmacist]

(2)The supply, otherwise than by way of wholesale dealing, 3[* * *] of any drug supplied on the prescription of a Registered Medical Practitioner shall be effected only by or under the personal supervision of a 2[registered Pharmacist].

4(3) (1) The supply of any drug 1[other than those specified in Schedule X] on a prescription

of a Registered Medical Practitioner shall be recorded at the time of supply in a prescription

register specially maintained for the purpose and the serial number of the entry in the register

shall be entered on the prescription. The following particulars shall be entered in the register: _

(a) serial number of the entry,

(b) the date of supply,

(c) the name and address of the prescriber,

5(d) the name and address of the patient, or the name and address of the owner of

the animal if the drug supplied is for veterinary use.

(e) the name of the drug or preparation and the quantity or in the case of a

medicine made up by the licensee, the ingredients and quantities thereof,

(f) in the case of a drug specified in 1[Schedule C or Schedule H] the name of the

manufacturer of the drug, its batch number and the date of expiry of potency,

if any,

(g) the signature of the 2[registered Pharmacist] by or under whose supervision the

medicine was made up or supplied.

________________________________________________________________

Page 90

2(5)(1) Subject to the other provisions of these rules the supply of a drug by wholesale shall

be made against a cash or credit memo bearing the name and address of the licensee and his

licence number under the Drugs and Cosmetics Act in which the following particulars shall be entered____

(a) the date of sale.

(b) the name, address of the licensee to whom sold and his sale licence number. In case

of sale to an authority purchasing on behalf of Government, or to a hospital, medical,

educational or research institution or to a Registered Medical Practitioner for the

purpose of supply to his patients the name and address of the authority, institution or

the Registered Medical Practitioner as the case may be,

My comments:

Rule 65. Condition of licenses. - Subsection (5) (1) (b) shown above says that it is the duty of a licensee to give the drugs to all hospitals and registered medical practitioners. The Drug stores or the licensing authority has no business to go after the fate of such drugs purchased from such licensed Drug stores by a doctor or hospital – they may sell or swallow it! All that the drug stores are expected to maintain are the records of the purchaser and the Drugs Department has no legal right to demand a hospital or registered medical practioner to take a license to do this purchase from a licensed drug store!

The law makers in 1940/45 were not irresponsible like those manning this democracy now and never wanted RMPs running hospitals to supply drugs to their patients free of cost.

At odd hours hospitals being the only place open, they used to give the required drugs on demand and that cannot be condemned or construed as sales over the counter as found out in 1990 by the masters in Kerala and insist for a Drug License for hospitals. That sale is done purely on humanitarian grounds.

Unfortunately, the lawmakers never anticipated such a twist to what they wrote in 1940 and they be pardoned after 70 years. In 1940 they never expected that criminals will take over the reins of this holy country, especially in God’s own land.

Refusing to give drugs to hospitals is violation of the conditions cited and it is the duty of the Drugs Department to see to that.

The most quoted and irresponsible letter from the Drugs Controller of Kerala to his friends running Drug Stores. It is unfortunate to note that the Drugs Controller of Kerala in 1990s took over the right vested with the Supreme Court of India – Interpret Laws of this Country!

Letter from the Drugs Controller, Kerala dated 17.3.1995
Annexured in the SLP as Annexure P - 3
attached as Schedule B in the Stay Order

No. L-17323/94/DC Office of the Drugs Controller,
Thiruvananthapuram - 37
dated: 17/3/1995
From
The Drugs Controller.

To
The Secretary,
All Kerala Chemists & Druggists Association,
Chemist Bhavan, Ernakulam (South),
Ernakulam.

Sir,

Sub: Drugs and Cosmetics Act 1940 and Rules thereunder
Sale/supply of drugs by private Hospitals --
Requirement to take out Drugs Licence --

As you are aware, the Drugs and Cosmetics Act, 1940 and Rules prescribe Drugs Licences for stocking for sale, selling and Distribution of drugs by any person. Exemption to this are provided in Schedule K of the Drugs and Cosmetics Rules, 1945. Item 5 of the Schedule exempts all Registered Medical Practitioners and Items '5A' exempts hospitals or dispensaries maintained or supported by Government or local bodies. No exemption is provided to private hospitals from taking out Drugs licences and the exemption formerly given to hospitals and dispensaries run by Charity or Voluntary subscription has also been withdrawn by the Amendment to the schedule made by Government of India as per G.S.R. No. 812 (6) dated 14/11/94. Though steps were taken to require private hospitals to take out Drugs licence in 1990, the actions were challenged in the High Court and the Hon' High Court directed the Government to take a decision in the matter. Government in August, 1994, decided that Hospitals which were not exempted, were to take out Drugs Licences. Time till 31/3/1995 for making applications and granting Drugs licences had been fixed earlier by this Department. The time is now extended till 30/4/1995. My object in writing this letter is to advise the members of your Association to quote Drugs license Numbers of Hospitals in the invoice/Bills issued for supply of drugs as prescribed in rule 65 (5) (i) for supply of any drugs after 30/4/1995.

Yours faithfully,
Sd/-
for Drugs Controller.
sn/18-3

The most interesting part is that the Kerala Govt. and the Drugs department never bothered to read Rule 65 (5) (1) (b) (shown above) in 1995.

Unfortunately the present Drugs Controller Ms. Geetha is in a dilemma having read & understood(!) Rule 65(5)(1)(b) & Rule 65(9)(b) (given below) and so cannot issue any written orders. That is the what we read in Pharmabiz.

http://www.drugscontrol.org/newsprint.asp?id=5293

(Page 91 of Act )

2[(9) (a) Substances specified in Schedule H or Schedule X shall not be sold by retail except on and in accordance with the prescription of a Registered Medical Practitioner and in the case of substances specified in schedule X, the prescriptions shall be in duplicate,one copy of which shall be retained by the licensee for a period of two years.

(b)The supply of drugs specified in Schedule H or Schedule X to Registered Medical Practitioners, Hospitals, Dispensaries and Nursing Homes shall be made only against the signed order in writing which shall be preserved by the licensee for a period of two years;]

My Comments on the above:

In short the Licensed Drug stores are there to dispense drugs to the public as directed by a Registered Medical Practioner as per Rule 65 (9)(a). The records for Schedule X drugs must be maintained for two years.

The above Rule 65 (9)(b) is clear in all ways as far as RMPs and Hospitals are concerned. They have the right to buy and stock, dispense or sell any drug available in the market from a licensed shop. The Drug Store must maintain the records for two years.

The move to impose Drug License for hospitals is to take away the record keeping job of Drug Store Pharmacists the friends of Drug Inspectors.

Page 168)

PART XI-EXEMPTION

123. The drugs specified in schedule K shall be exempted from the provisions of

Chapter IV of the Act and the Rules made thereunder to the extent and subject to the

conditions specified in that Schedule.

(Page 446)

SCHEDULE K

[ See Rule 123]

Class of Drugs Extent and Conditions of Exemption

4[5. Drugs supplied by a registered

medical practitioner to his own

patient or any drug specified in

Schedule C supplied by a

registered medical practitioner at

the request of another such

practitioner if it is specially

prepared with reference to the

condition and for the use of an

individual patient provided the

registered medical practitioner is

not (a) keeping an open shop or

(b) selling across the counter or

(c) engaged in the importation,

manufacture, distribution or sale

of drugs in the provision of

Chapter IV of the Act and the

rules thereunder.

(Honouring the prescription of a colleague

is not a crime, but permitted.)

Extent and Conditions of Exemption

All the provisions of Chapter IV of the Act

and the Rules made thereunder, subject to the

following conditions:

5[(1)The drugs shall be purchased only from a

dealer or a manufacturer licenced under these

rules and records of such purchases showing

the names and quantities of such drugs together

with their batch numbers and the names and

addresses of the manufacturers shall be

maintained. Such records shall be open to

inspection by an Inspector appointed under the

Act, who may, if necessary, make enquiries

about purchases of the drugs and may also take

samples for test.

Page 447 of the Act

(2) In the case of medicine containing a

substance specified in 1[Schedule G, H or X]

the following additional conditions shall be

complied with]

(a) the medicine shall be labelled with the name

and address of the registered medical

practitioner by whom it is supplied

(b) if the medicine is for external application, it

shall be labeled with the words 2[* * * ]

“For external use only” or if it is for internal

use with the dose

(c) the name of the medicine or ingredients of

the preparation and the quantities thereof,

the dose prescribed, the name of the patient

and the date of supply and the name of the

person who gave the prescription shall be

entered at the time of supply in register to be

maintained for the purpose

(d) the entry in the register shall be given a

number and that number shall be entered on

the label of the container;

(e) the register and the prescription if any on

which the medicines are issued shall be

preserved for not less than two years from

the date of the last entry in the register or the

date of the prescrip tion as the case may be.

3[(3) The drug will be stored under proper storage

conditions as directed on the label.]

(The question of a qualified person do not appear Anywhere in the conditions cited above in Item 5.

On the other hand “the supervison of a Qualified Person is the first requirement in Item 5A.)

5.A Drugs supplied by a hospital or

dispensary maintained or

supported by Government or

local body 4 [* * *]

The provisions of Chapter IV of the Act and

the Rules thereunder which require them to

be covered by a sale licence, subject to the

following conditions :

448

(1) the dispensing and supply of drugs shall be

carried out by or under the supervision of a

qualified person;

(2) the premises where drugs are supplied or

stocked shall be open to inspection by an

Inspector appointed under the Drugs &

Cosmetics Act who can, if necessary, take

samples

(3) the drugs shall be stored under the proper

storage conditions.

1[(4) The drugs shall be purchased from a

manufacturer or a dealer licensed under these

rules or received as transferred stocks from

hospital stores for distribution. Records of

such purchases or receipts shall be

maintained.]

2[5.B Whole Human Blood I.P.

and/or its components stored for

transfusion by a First referral

Unit Community Health Centre,

Primary Health Centre and

Hospital

The provisions of Chapter IV of the Act and

the rules made thereunder which require

obtaining of a licence for operation of a blood

bank or processing Whole Human Blood and,

or its components subject to the following

conditions, namely.

(1) The First Referral Unit, Community Health

Centre, Primary Health Centre and/or any

Hospital shall be approved by the State/Union

Territory Licensing Authority after satisfying

the conditions and facilities through

inspection.

(2) The captive consumption of Whole Human

Blood I.P or its components in the First

Referral Unit, Community Health Centre,

Primary Health Centre and/or any Hospital

shall not be more than 2000 units annually.

1 Ins. as per G.O.I. Notification No. GSR 648(E) dt 16.9.2002 w.e.f.01.10.2002.

2 Ins. as per G.O.I. Notification No. GSR 909(E) dt 20.11.2001

Page 449

Class of Drugs Extent and Conditions of Exemption

(3) The Whole Human Blood and/or its

components shall be procured only from

Government Blood Bank and/or Indian Red

Cross Society Blood Bank and/or Regional

Blood Transfuion Centre duly licenced.

(4) The approval shall be valid for a period of two

years from the date of issue unless sooner

suspended or cancelled and First Referral Unit,

Community Health Centre, Primary Healthy

Centre or the Hospital shall apply for renewal to

the State Licensing Authority three months

prior to the date of expiry of the approval.

(5) The First Referral Unit, Community Health

Centre, Primary Health Centre and/or any

Hospital shall have the following technical staff

for storage of blood or its components:-

(a) A trained Medical Officer for proper

procurement, storage and cross matching

of blood and/or its components. He/she

shall also be responsible for identifying

haemolysed blood and ensure non-supply

of date expired blood or its components.

(b) A blood bank Technician with the

qualification and experience as specified

in Part XII B of Schedule F or an

experienced laboratory technician trained

in blood grouping and cross matching.

(6) The First Referral Unit, Community Health

Centre, Primary Health Centre and Hospital

shall have an area of 10 sq metres. It shall be

well lighted, clean and preferably airconditioned.

Blood bank refrigerator of

approximate capacity fitted with alarm device

and temperature indicator with regular

temperature monitoring shall be provided to

store blood units between 2oC to 8oC and if the

components are proposed to be stored,

specialized equipments as specified in Part XII

B of Schedule F shall also be provided.

450

Class of Drugs Extent and Conditions of Exemption

(7) The First Referral Unit, Community Health

Centre, Primary Health Centre and Hospital

shall maintain records and registers including

details of procurements of Whole Human Blood

I.P and/or blood components, as required under

Part XII B of Schedule F.

(8) The First Referral Unit, Community Health

Centre, Primary Health Centre and Hospital shall

store samples of donors blood as well as patients

sera for a period of seven days after transfusion.]

(In total 32 items are exempted under Schdule K)

(Read pages 446 to 450 in Schedule K in the Drugs Act & Rules cited.)

My Comments:

The Item 5A was included in 1945 to protect the Govt. Institutions as there were no doctors in most of such Institutions. On the other hand a private hospital is always blessed with a qualified hand. A reading of all the Items in Schedule K will make the position of private hospitals clear. In fact it is said at many places that “Any Hospital” is exempted. The most important Extent and Conditions of Exemption seen in 5A is that the drugs must be handled by a qualified person in a public institution. This point or condition is not mentioned in Item 5 in Schedule K.

Central Drugs Standard Control Organization
Dte.GHS, Ministry of Health and Family Welfare, Government of India

3. The Drugs and Magic Remedies (Objectionable Advertisements) Act 1954

This Act is meant to control the Advertisements regarding drugs; it prohibits the advertising of remedies alleged to possess magic qualities and to provide for matters connected therewith.

The Drugs and Magic Remedies Act prohibits a person from taking part in publication of any advertisement referring to any drug which suggests use of the drug for:
a) the procurement of miscarriage in women or prevention of conception in women; and

b) the maintenance or improvement of the capacity of the human being for sexual pleasure;
c) the correction of menstrual disorders in women;

Factories Act

d) the diagnosis, cure, mitigation, treatment or prevention of any venereal disease. It is prohibited to directly or indirectly give a false impression regarding the true character of a drug or make false claim for it or to convey any false or misleading information in any material particular about it. No person shall import into or export from India any document containing advertisement of this nature.

Whoever contravenes the provisions of this Act shall, on conviction, be punishable with imprisonment which may extend to six months, with or without fine. In case of subsequent convictions the imprisonment can be extended to one year. The document, article or thing which contains the offending advertisement can be seized and confiscated.

If the person contravening any of the provisions of the Act is a company, every person who at the time the offence was committed was in charge of the business of the company shall be deemed guilty.

The prohibition under this Act does not apply to: a) any signboard or notice displayed by a registered medical practitioner including the treatment for any of the disease, b) any treaties or book dealing with any of the matters from a
bona fide scientific standpoint, c) any advertisement related to any drug sent confidentially to any registered medical practitioners or to chemists for distribution among registered medical practitioners or to a hospital or laboratory, and d) Government advertisements.

(RMPs are exempted in this issue also!) Hope the Drugs Controller will have a rethinking in this issue at least after 20 years.

K. Kishore Kumar, State Secretary, QPMPA