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By Prajith
Access to modern medicine and services of qualified medical practitioners are denied to the majority of the people living in rural settings in India today despite commendable growth achieved by the pharmaceutical industry over the years. The basic reason for this state of affairs is the non-availability of medical practitioners in Primary Health Centres and the reluctance of doctors to set up clinics in these less developed regions. If the doctors refuse to move to rural areas, the medicine shops also cannot come up in these locations as the sales of medicines largely dependent on prescriptions by doctors. In fact, non-availability of adequate number of MBBS doctors is posing a major challenge in the implementation of various national and state level health schemes in the country. The government has been taking steps to address this issue for some time with not much success. Medical students have a statutory obligation to serve at a Primary Health Centre at least for two years when they pass out with the MBBS degree. But, very few of the medical graduates abide by this obligation and they somehow manage to circumvent this provision causing perpetual shortage of doctors in rural areas. Most of the health departments of state governments have been increasingly facing this dilemma with no workable solution.

The Union health ministry’s recent move to allow pharmacists to prescribe medicines in PHCs for treating minor ailments in the rural areas is the latest initiative to address this problem. Indian Pharmacists Association has been suggesting to the ministry to bring this reform in the health care sector for the welfare of the patient community for some time now. In states like Punjab, Uttarakhand and Himachal Pradesh the local governments have already allowed pharmacists to prescribe medicines for minor ailments. Early this year, the Union health ministry has been considering the suggestion to allow Ayush doctors to practice allopathy and use modern medical technology for treating patients in rural areas. In fact, Maharashtra government allowed qualified homoeopathic doctors to practice modern medicine in the villages last year so as to provide some medical help to its rural population in case of an emergency. The permission is being granted on the condition that they should pass a one-year course in pharmacology conducted by the State Medical Education Board. Such localized actions by the state governments cannot solve this issue on a national level. For that the health ministry has to take a policy decision on the proposal to allow qualified pharmacists to prescribe medicines for minor ailments in rural areas without much delay. Competent pharmacists with qualifications of Pharm D and B Pharm are available in the country with the knowledge of pharmacology of drugs and their uses, side effects and drug interactions. The health ministry’s initiative of allowing pharmacists and medical practitioners of other systems to prescribe medicines is, however, being strongly opposed by the allopathy doctors and their associations. Their argument is that by allowing professionals other than allopathy doctors can dilute the modern medical practice in the country ultimately resulting in a sharp rise in the number of quacks in the country. That possibility cannot be ruled out totally but medical needs of the rural folk cannot be ignored too.
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