Medicine procurement procedures at Mater Dei Hospital made it difficult for clinicians to carry out their job in a way that fully benefitted patients, a government-appointed inquiry board found.
It concluded that the procurement process, which has been used for many years, needed to be remapped and re-engineered to ensure reliability, accuracy, timeliness, real-time visibility, process tracking and stock position and replenishing requirements.
The report was tabled in Parliament by Health Minister Chris Fearne on Wednesday. Mr Fearne had ordered the inquiry after this newspaper reported in mid-November that expired Tamiflu medicine was being used at Mater Dei’s intensive care unit.
The scientific tests carried out by independent laboratories as part of the inquiry found that the batch used had an efficacy of 96.52 per cent and impurities of 0.29 per cent.
For any medicine to be considered good for use, the minister pointed out, its efficacy could not be below 90 per cent and it could not have more than three per cent impurities.
The four-member board of inquiry found that, while the doctors were right to use the medicine in question, procurement procedures needed to be updated.
The procedures impeded clinicians from acting in an environment which benefits patients
Untimely and ineffective medicine procurement procedures “impeded the clinicians from exercising their profession in an environment which benefits the patients fully,” the board reported.
Mr Fearne told this newspaper last month the hospital’s pharmacy had a large stock of Tamiflu from 2009, when fears of a swine flu epidemic were high. The stock was worth about €600,000. When patients needed Tamiflu, they would be administered medicine from the 2009 stock.
The decision to administer the medicine to patients in critical condition despite it being past its use-by date followed talks with the clinicians and the competent hospital authorities, health authorities had said.
The inquiry board concluded that the hospital authorities had made the right move, since the efficacy of the medicine had not been affected.
It pointed out that the medicine did not form part of the government procurement list and that continuity between the administrators of this list and the central procurement and supplies unit was lacking. “There was no active coordination and state of preparedness to avoid this incident a priori,” the board concluded.
The report also chastised the Directorate for Pharmaceutical Affairs, noting “lack of visibility, active coordination and communication” between the directorate and the central procurement and supplies unit.
The system used was too heavy in its bureaucracy, which was another reason why the clinicians had to make use of the expired batch, the board said.
On the fact that neither patients nor their relatives were informed of the decision to administer expired medicine, the board said it was believed that doing so would have caused “undue anxiety”.
The board also called for the introduction of a robust information management system.
Mr Fearne said the board’s recommendations would be adopted.