How hospital pharmacies work

2011-09-15 00:00

I APPRECIATE the effort made by Lawrence J. Sakarai in The Witness (August 23) titled "Hospital hell". The article mentions various concerns and challenges, but it shows a lack of knowledge and understanding of the policies that govern the health system. It doesn't take into account the situation on the ground in both the public and private-sector health system. I suspect he has no experience of a private health-care facility on which to benchmark his frustrations.

His submission portrays an ideal picture of a person entering a hospital and leaving after an hour with medicines in hand. We are far from this in South Africa, both in public and private-sector health. In a country dogged by a shortage of hospitals and health-care professionals, it is somewhat ignorant of Sakarai to expect the ideal. He mentions that strange and unknown ailments defeat time which really highlights his lack of appreciation of the services offered and the health system as a whole. In reality an increasing number of people are accessing health care, while the human resources in the sector have remained at the same level. In a hospital pharmacy the following duties are carried out:

• manufacturing of extemporaneous medicines;

• procurement, storage and distribution of pharmaceuticals for wards and clinics;

• pre-packing of pharmaceuticals for patient ready packs;

• dispensing to in-patients and out-patients; and

• maintaining appropriate records and statistics.

The above-mentioned is just an overview of the main functions of the department for the benefit of the public.

A pharmacy has never and will never operate like a spaza shop or your favourite supermarket. Dispensing is defined in terms of the Pharmacy Act as "the interpretation and evaluation of a prescription, the selection, manipulation or compounding of the medicine, the labelling and supply of the medicine in an appropriate container according to the Medicines Act and the provision of information and instructions by a pharmacist to ensure the safe and effective use of medicines by the patient".

This means that all prescriptions must be monitored. The aim of which is to ensure that patients receive drug treatment as intended by the prescriber and as required for optimal care. The pharmacist must identify problems and/or opportunities for optimising treatment to safeguard the patient.

This must be undertaken for each and every prescription that comes to the pharmacy. It therefore cannot be done in the absence of a pharmacist, hence one window may operate although three are available. The availability of personnel at a work place can never be 100%, whatever race (as per the pernicious race question raised). The writer must know that individuals working in the pharmacy must be registered with the South African Pharmacy Council. It is therefore not a matter of race but of the qualification obtained and registration status. The pharmacy department is the last stop for most patients who come to the hospital and therefore becomes the venting department for all patients if they have encountered problems along the way of treatment.

All complaints must be directed to the public relations officer who then forwards them to the relevant department head. Sakarai seems to think that matrons run hospitals. They are managers of the nursing component, therefore he directed his questions to the wrong person. I am not surprised he was still in the hospital at 4 pm as he was conducting a walkabout in the hospital corridors, embarking on an "opinion-formulating mission". Next time I hope you will also visit the wards and compliment the hospital on the neatly kept grounds.

Hospitals are care facilities and are composed of personnel who fully understand the Batho Pele principles. I would like to encourage Sakarai to engage himself in a fact-finding mission in private hospitals to compare waiting times.

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