J&K's prescription guidelines struggle with compliance

Srinagar, Feb 6: The J&K Health Department has issued yet another circular urging government healthcare doctors to adhere to long-standing prescription guidelines, underscoring persistent non-compliance attributed to lax oversight and a lack of accountability.

Earlier this week, the Directorate of Health Services, Kashmir, re-emphasised protocols originally introduced in 2016, including the use of legible capital letters for prescriptions, mandatory inclusion of a doctor’s name, designation, and signature, and prioritisation of generic medicines from government-supplied stocks. Despite reminders, most recently in January 2022, observance remains sporadic, raising concerns about transparency and patient safety.

To address these gaps, the latest directive mandates Chief Medical Officers (CMOs) to appoint a “Nodal Officer” responsible for scrutinizing prescriptions. However, skepticism lingers over whether this measure will yield tangible improvements, given the systemic failure to enforce prior orders.

Critics link the non-compliance to broader ethical lapses in government healthcare. Stakeholders have long demanded stricter adherence to curb prescription errors, irrational drug combinations, and unnecessary referrals to private facilities, a practice explicitly criticised in a 2023 DHSK order. The order also flagged inappropriate diagnostic tests and violations of drug regulations, highlighting dysfunction within Prescription Audit Committees (PACs) tasked with oversight.

While the J&K government has intensified efforts to shutter illegal clinics and unqualified practitioners, experts argue the threat also lies in prescriptions from qualified doctors. Irrational prescribing, driven by alleged doctor-pharma collusion, risks patient health and inflates out-of-pocket expenses, a stark contradiction to the J&K's 2016 free drug policy.

Despite the policy, most patients still bear 'unnecessary medication' costs, exposing flaws in implementation. Proposed solutions, like a 2017 Audit Regulatory Panel and legibility mandates, have stalled, fueling accusations of institutional apathy. Healthcare advocates stress that without stringent penalties, monitoring, and cultural shifts to prioritise ethical practice, J&K’s prescription reform efforts will remain symbolic, leaving patients vulnerable to financial strain and preventable harm.