Parliament of Fiji
Friday, May 18, 2018
By NFP MP Hon Parmod Chand
Madam Speaker, I rise to present my End of Week Statement on the Review of Free Medicine Scheme. This Statement will highlight the shortfalls as well as the need to review the Free Medicine Scheme.
Madam Speaker the Free Medicine Program was announced in the 2015 National Budget that was announced on 21st November 2014, to take effect from 1st January 2015. “Turning promises into deeds” was the Budget theme. One of the promises of Fiji First was the provision of providing all price control prescribed medicine that would be prescribed by doctors, even for Non-Communicable Diseases, for those earning less than $20,000 per annum.
Later when the scheme was rolled out, a Ministry of Health circular clearly stated that those who qualify for the scheme are adults over 18 years of age earning less than $20,000 per annum and individuals less than 18 years old if their combined parental income is less than $20,000 per annum.
But Madam Speaker, firstly when the scheme was implemented only 70 price control medicines were listed as free medicine, which was eventually increased to 142 prescribed price control medicine from 2016.
Secondly the contradiction in those eligible for the scheme is abundantly clear. For example if both parents in a home earn $19,000 per annum each, both qualify for free medicine. However their children under the age of 18 years will not qualify even if they don’t earn a cent or are students because the combined parental income is $38,000 per annum or more than $20,000 stipulated as a qualifying criteria.
So the parents will get free medicine for whatever its worth, while their children will not. This is totally unfair and discriminatory.
Just like the Fiji First promise to continue maintaining zero VAT on seven basic food items and medicines, the free medicine scheme has seen a promise turn into a mis-deed. At the last count that I am aware of, around 25,000 people were benefitting from free medicine.
This is similar to the Fiji Electricity Authority subsidy or free electricity as it was called, or even free water when it is subsidy. Of course this number may have increased but certainly not proportionate to the segment of our population living in poverty by government’s own statistics.
Madam Speaker while more than 28 percent of our population live in poverty and thousands of others earn less than $20,000 annually, one wonders why the numbers are not significantly higher if the scheme is so highly beneficial as it is made out to be by Government?
The answer is bureaucracy Madam Speaker. Just as one spends an average of $30 running around to get his or her documentation in order to qualify for the water subsidy or Electricity subsidy, so does an individual eligible for the scheme.
Electricity subsidy, when it was initially announced would have resulted in a saving of $19.08 in one year. This subsidy may have increased but is still far less than what people thought.
The water subsidy of 91.25 units will save you $13.96 in one year. Free prescribed basic medicine will save you a maximum of $400 in one year if you are sick for most days in a year and need prescribed price controlled generic medicine for more than 150 days in one year. That is indeed far-fetched because any worker has a maximum of either 18 or at the most 21 days sick leave each year.
Therefore, the bureaucracy and inability to get all prescribed medicine for free is a huge hinderance.
Madam Speaker, the retail pharmacies have been forced to participate in the free medicine scheme because if they don’t, they are liable to be slapped with a $100,000 fine. This is again unjust.
Retail pharmacies have to provide space to store free medicine or whatever stock is supplied. Then their staff have to manually record recipient’s details and also that of the prescription. All this is done manually.
They don’t have direct access to the Ministry of Health servers to electronically ascertain the eligibility of the recipient but manually record details of his or her card. The electronic link to MOH database was promised by Government almost four years ago but has not been fulfilled.
Worse still, pharmaceutical staff have to tolerate abuse when told medication prescribed by the doctors is either not available or is not listed as a free medicine. We have established that in many retail pharmacies the full list of 142 medicines is not available because they weren’t supplied in the first place despite being generic medicine.
Madam Speaker one pharmacy in Suva, which is one of the busiest and strategically located, had only 50 of the 142 listed medicines.
Furthermore, our investigation has established that there is only one designated staff at Fiji Pharmaceutical Service who looks after the stocks at 52 retail pharmacies. That is why stocks get either depleted or expire when not used.
Recently there was a case of $15,000 worth of insulin under free medicine scheme expiring in retail pharmacies when actual fact, stocks had run out in hospitals and patients told there was no insulin in stock.
Madam Speaker, simply the free medicine scheme is in a shambolic state and needs to be reviewed urgently to bring about efficiency and to ensure it is fully maximised by all those eligible recipients.
We therefore urge Government to: –
Change the eligibility criteria so that individuals under 18 years of age, who are mostly students, are able to access this scheme, irrespective of their parents’ joint income reaching the maximum threshold of $40,000, if they earn $20,000 and themselves individually qualify for the scheme.
Equip pharmacies with computers or if not link one of their computers to the Ministry’s database of eligible recipients.
Remove list of 142 free medicines and implement a truly genuine free medicine scheme where those eligible can access any medicine as prescribed by the doctor, thus removing the risk of medicine being either overstocked, under-supplied or expiring.
This will remove the need to supply pharmacies with a list of generic medicines, who in turn can dispense medication from their own stock and send bills monthly to Ministry of Health for payment, eradicating both patient and pharmacy frustration and giving true meaning to free medicine.
Madam Speaker, we sincerely hope Government takes on board our suggestions for the delivery of a genuine free medicine scheme.