Govt hospitals running without graduate pharmacists

A physician diagnoses and treats the illness of patients and a nurse takes care of the patients. But what exactly does a pharmacist in hospitals do? 

The pharmacist's job is to monitor and follow up on the patient's prescription, prevent drug misuse, and safely store the drug in hospitals, which is imperative for comprehensive healthcare services. That is why physicians and pharmacists work together to treat patients in almost all countries of the world. 

Although there are graduate pharmacists in some Grade A private hospitals in our country, there are none in government hospitals so far.

The Ministry of Health has issued several directives regarding the appointment of graduate pharmacists in government hospitals, but the directives have not yet been implemented. 

The Directorate General of Health Services (DGHS), however, said graduate pharmacists will be appointed in government hospitals in a short period of time.

Health experts have been calling for the appointment of graduate pharmacists in every hospital for a long time.

Professor Dr Md Shah Amran, chairman of the Department of Pharmaceutical Chemistry at Dhaka University, told The Business Standard (TBS), "A graduate pharmacist can determine whether the dosage of medicine given to a patient is correct and whether an alternative, cheaper medicine can be given to the patient." 

"Currently, specialisation has come into all jobs, meaning the job descriptions of physicians, surgeons, pharmacists and nurses are specified. But if the doctors do the work of pharmacists, as they do in Bangladesh, then patients will be deprived of proper services," he said.

"Graduate pharmacists are needed in hospitals to prevent unnecessary use of medicines. Doctors, pharmacists, nurses and medical technologists are needed in the healthcare system. The absence of hospital pharmacists in health services is one of the reasons for the poor healthcare system," said Professor Shah Amran.

"Pharmacy should be included as a cadre subject and graduate pharmacists should be recruited in hospitals through the Public Service Commission. They will get into jobs as 9th grade employees by taking the Bangladesh Civil Service (BCS) examinations. Then the quality of healthcare will improve. Otherwise, patients who have the minimal financial ability will go abroad for treatment," he said.

At present, 41 public and private universities in the country offer the Bachelor of Pharmacy (B Pharm) programme and about 4,000 graduate pharmacists pass out from there every year. A large number of them work in the pharmaceutical industry, while the rest go into other professions or remain unemployed. 

According to health experts, if graduate pharmacists are employed in hospital pharmacy services, clinical pharmacy services and retail pharmacy services, the overall healthcare system will improve significantly.

Md Fariduddin Kawsar Khan, managing director of NOVO Healthcare and Pharma Ltd, told TBS, "We have a misconception about pharmacists. In our country, we think pharmacists are those who have Diploma degrees and who buy medicines and maintain drug stock. But graduate pharmacists are actual pharmacists as they obtain Grade A certificates from the Bangladesh Pharmacy Council." 

"However, no Grade A pharmacist post is available in our government hospitals. In 1993, an initiative was taken to appoint 10 graduate pharmacists in government hospitals, but it has not been implemented," he said.

Fariduddin Kawsar said, "Hospital pharmacists do not only work with medicines. They will monitor every prescription of the patients, do follow-ups, see if there is any side-effect of any drug, if any specific drug is being modified, etc."

"A doctor is not aware of medicine-related complications. The pharmacist can adjust the patient's prescription if the dose is lower or higher. Government hospitals' not having graduate pharmacists has resulted in both financial and physical loss to patients," he added.

Some private hospitals in Bangladesh like Evercare and Square Hospital have pharmacists. In these hospitals, pharmacists can give suggestions during doctor-patient visits or on prescriptions.

The Ministry of Health issued two notifications in 2020 regarding the appointment of one graduate pharmacist for outdoor and one for indoor (50-bed) services in government hospitals, with instructions for setting up individual pharmacy service directorates/departments, determining the scope of work and appointing pharmacists.

Muhammad Mahbubul Haq, secretary of the Pharmacy Council of Bangladesh, told TBS, "Aside from appointing graduate pharmacists in public and private hospitals to ensure proper use of medicines, people will get full service if graduate pharmacists are appointed in community-based model pharmacies. The government has agreed to it in principle. The DGHS needs to be more sincere on this matter."

Professor Dr Samiul Islam Sadi, director (Administration) of DGHS, has submitted applications to the Ministry of Public Administration and the Ministry of Health for the appointment of pharmacists. 

The appointments will begin in a short time after completing all procedures. Around 600 pharmacists will be employed initially. After that, more appointments will be made based on vacant posts, he said.

25 September is World Pharmacists Day. This year's theme is "Pharmacy united in action for a healthier world". The objective is to showcase how pharmacy professionals are shaping people's health and well-being around the world. ***