A lot of hue and cry is going around on various social media plateforms wherein medical assistants are demanding pharmacist registration by denting &diluting the Central Pharmacy Act 1948 further, even if one time relaxations was already given to those registered with the State Pharmacy Council Register under Section 32C in the central Pharmacy Act 1948 for according special provisions regarding persons registered under the repealed JK Pharmacy Act, which read as “Notwithstanding anything contained in the Section 32, any person whose name has been entered in the register of Pharmacists maintained under Jammu And Kashmir Pharmacy Act 2011 and possesses qualification prescribed under the said Act, shall be deemed to have been entered in the register of Pharmacists prepared and maintained under Chapter IV of this Act.” Any such further dilution will have grave effects on the public health. Before we address the issue, everyone around should know who Pharmacists are and what actually they do in a healthcare system.
Pharmacists are health professionals who specialize in the use of medicines, as they undergo university or graduate-level education to understand the biochemical mechanisms and actions of drugs, drug uses, therapeutic roles, side effects, potential drug interactions, and monitoring parameters. This is mated to anatomy, physiology, and pathophysiology. Pharmacists interpret and communicate this specialized knowledge to patients, physicians, and other health care providers. Using knowledge of the mechanism of action of drugs, the Pharmacist understands how they should be used to achieve maximum benefit, minimal side effects and to avoid drug interactions.
Pharmacists are taking on expanded roles and are increasingly being recognized as the medication management experts of the health care team including clinical services, reviewing medications for safety and efficacy, and providing drug information. Pharmacists, therefore, are the experts on drug therapy and are the primary health professionals who optimize medication use to provide patients with positive health outcomes. Can a person become a doctor just by assisting a doctor for some years, but unfortunately, a person can become a Pharmacist just after getting a certificate that he assisted in a pharmacy shop for some years, or simply doing Medical Assistant course without realizing the importance of this noble profession.A person without knowledge of pharmacology cannot understand the rationale use of drugs or pharmaco-vigilance keeping aside in assisting in implementation of these to the healthcare providers.
One such unhealthy practice related to enrolment of Medical Assistants as Pharmacists under the State Pharmacy Act of 1956. Medical Assistants are health care professionals trained for job requirements of assisting doctors as general duty assistants for medical and surgical procedures such minor surgical procedures, dressings, giving injections, applying plasters etc. in the same manner as other health care assistants such as Ophthalmic Assistants, Medical Laboratory Assistants, Sanitary Asstt, OT Assistants are trained to perform specific clinical jobs. Accordingly, Medical Assistant health care professionals happen to be in a cadre different from Pharmacist category in the health care delivery system in terms of training and job requirements with separate provision of posts for the two categories in government service.
In the rest of the country, the Pharmacy Council of India (PCI) regulates education as well as profession of pharmacy, but in Jammu & Kashmir due to the erstwhile special status of the state, drug laws were regulated by the JK Pharmacy Council, which never bothered to incorporate educational regulations as a result under qualified medical assistants were employed by H&ME to work in place of Pharmacists. Qualified Pharmacists possessing graduate or postgraduate degrees were labelled as overqualified. Due to identity crisis, qualified Pharmacists moved from pillar to post for recognition and lost precious time in going around courts and administrative offices.
Such under qualified practitioners were caught by a storm when Article 370 was abrogated. Now central pharmacy laws would apply to the union territories of Jammu and Kashmir and Ladakh and no one can enter the profession of pharmacy without valid credentials. Under Section 12 of the central Pharmacy Act 1948, only the qualifications of diploma in pharmacy (D Pharma), bachelor in pharmacy (B Pharma) and doctor of pharmacy (Pharm D) are approved for the purpose of registration as Pharmacists.
Those expounding this unjustified cause of Medical Asst’s for registering as Pharmacists are probably unaware of the fact, that the doctors who plans the drug treatment of patients and very well versed with pharmacological sciences are not eligible to be registered as Pharmacist as per the Pharmacy Act 1948. In terms of argument advanced in favor of Medical Assts, Medical professionals therefore should have a superior claim to be registered as Pharmacists.
Anyone championing for this unjustified cause paramounts to negating the benefits of a more rational and scientific pharmacy practice in the UT. A saying in Kashmiri language ‘kar-e-gilkarbazari-ye-najar’ best describes the approach adopted while endorsing the claim of Medical Assistants. Modern drugs are highly effective medical tools that need to be used with care for their potential harmful side effects; thus these medications demand to be handled by professionals specifically trained for the purpose and not by ‘Me-too Clinical Assistants’. Pharmacy qualified personnel need to come forward and negate the Goebbels type of misinformation campaign unleashed by protagonists of Medical Assistant Lobby so that the God sent opportunity of advantages of being integrated with the mainstream pharmacy profession does not get compromised by those with vested interests and for whom political and commercial interests override patient safety.
The question arises that why the healthcare system in Jammu and Kashmir is reluctant to incorporate professional pharmacy services? Why the patients in this part of the globe are left at the mercy of under qualified and untrained persons? This system has given birth to many problems, like development of antimicrobial resistance due to irrational use of antimicrobial agents, growing concerns of kidney diseases due to indiscriminate use of painkillers, rise of counterfeit medicines, illegal sale of drugs with abuse potential, indiscriminate use of steroids and other narrow therapeutic drugs that put the lives of patients at risk. By calling medical assistants “Pharmacists” is injustice to the profession of pharmacy because neither their curriculum nor their expertise in any form reflects the work of Pharmacists. One fails to understand why when the mess in the valley was cleared after the abrogation of Article 370, its corrupted roots are being nurtured again. It is well said, “poison in safe hands becomes medicine and medicine in the wrong hands becomes poison”. Why are the people at the helm of affairs encouraging malpractice?
It is pertinent to mention it here that Department of Pharmaceutical Sciences, University of Kashmir is one of institution in the entire o Jammu and Kashmir offering the graduate-level programme in Pharmacy for the past thirty four years& as on date thousands of Pharmacy graduates have passed from the department.
We at Jammu and Kashmir Pharmacy Graduates Association even took the opportunity to suggested Pharmacy Council of India (PCI), the apex body regulating Pharmacy Profession in the country to come forward with a Bridge Course in Pharmacy (BCP) for the Medical Assistant Course (MAC) passed out people in the whole areas of the two Union territories of J&K and Ladakh in the light of extension of jurisdiction of Central Pharmacy Act to the UTs, so as to bring them at par with other pharmacy professionals in the state and elsewhere in the country without any technical impediments.
Any such move without a Bridge Course in Pharmacy (BCP) surely will collapse the Pharmacy Sector in J&K. As the pharmacy professional organization the PCI’s primary responsibility is to safeguard the interest of the pharmacists, and not to compromise with general public health.
As per the official records pharmacy division in the health department is occupied by medical assistants and the retail pharmacy sector is occupied by matriculates who were granted drug licences on the basis of experience. People with B Pharm and M Pharm qualifications are not allowed to work as Pharmacist in hospitals and are disqualified on grounds of being highly qualified. This situation has been going on in the state for the last 20 years.
Since the extension of central pharmacy act 1948 to the jurisdiction of the two Union territories of J&K and Ladakh, it is the prime responsibility of the PCI and MoHFW to protect the rights of the Pharmacists in J&K.
Moreover, we would also like to impress that Health& Medical Education in J&K should give suitable opportunities to pharmacy graduates by utilizing their expertise,/offering their services to the patients as Hospital Pharmacists. Every major hospital in J&K needs to have a full-fledged Department of Pharmacy with adequate infrastructure, manpower, equipment, and funding towards establishing Clinical pharmacy practice departments. Since this requirement is already well stipulated in the approved drug policy of J&K, the government needs to start working in this direction in its right earnest.
Some of the key job description regarding the Pharmacist includes, Drug selection, quantification, procurement, storage, distribution and dispensing along with necessary counseling, monitoring, and drug information services to the patients. Such a service is highly sophisticated and professional activity that can only be performed by skilled, well-trained and qualified pharmacyprofessionals. However, in all major and minor hospitals of the state, there are either unqualified (matriculates) or under-qualified (Medical Assistants) people managing these affairs leading to frequent failures of the system besides dissatisfaction among patients. Therefore, in tune with Drug Policy provisions, the state government must create an adequate number of vacancies for pharmacy graduates in all hospitals of the state. This is highly required for an efficient supply chain management and scientific medicines management within government hospitals.
(Author is a Member, J&K Pharmacy Graduates Association)