In an endeavour to improve overall delivery of patient care, Bihar Medical Services and Infrastructure Corporation Limited (BMSICL) is making resolute step. From transparent procurement policy of equipment and drugs to development of required infrastructure in various health facilities across Bihar, BMSICL is going out of way to ensure quality delivery of care to masses, says Sanjaya Kumar Singh, Managing Director, Bihar Medical Services and Infrastructure Corporation Limited, in conversation with Elets News Network(ENN).

Q Around a decade ago, BMSICL was established under the aegis of Health Ministry, Bihar with the objective to streamline things. What are its key role & responsibilities?

In an endeavour to expedite whole process of development of healthcare infrastructures across the State, the Government of Bihar established Bihar Medical Services & Infrastructure Corporation (BMSICL) in 2010. It plays a pivotal role in quality improvement in delivery of overall care process. The Corporation is the sole procurement and distribution agency of drugs and equipment i.e. autonomous centralised procurement agency for all healthcare facilities of Government of Bihar.

Key role & responsibilities of BMSICL include:

• To promote value for money services in a transparent and equitable manner.

• Procurement, storage & distribution of quality drugs & surgical items.

• Procurement, distribution, installation and maintenance of medical equipment/instruments required in different hospital/ institution of Bihar and maintenance of comprehensive maintenance contract (CMC) with the supplier.

• Development of infrastructure for establishment of certain medical equipment.

• Construction & maintenance of entire healthcare facilities and health-related infrastructure/ buildings across State.

• Ensuring an efficient supply chain network for timely distribution of drug/medical devices, medical/ non-medical equipment/instruments to all healthcare facilities of the Government of Bihar.

• Streamlining the procurement process in order to ensure that all healthcare facilities of the State get free of cost service at one point.

• To establish warehouses, storage rooms and cold storage facilities in different districts for providing safe, secure and convenient places for storage of medicines, surgical products and other medical products of all kinds. • To enter into contracts necessary or desirable, for the conduct of the Company’s affairs.

Q Shed some light on procurement processes on fronts of drug and equipment.

In order to support drug procurement processes and medical equipment procurement processes, a procurement manual- ‘a comprehensive policy for procurement of drugs/surgical items and medical equipment’ has been formulated and documented. It was finally approved in September, 2018 by Health Department, Government of Bihar after legal and financial vetting from the Law & Finance Departments.

The procurement manual as the procurement policy document provides a detailed guideline and a legal coverage to the entire procurement processes of BMSICL.

Empanelment of five NABL accredited QC (quality check) labs for drug testing has been done to ensure that testing of medicine samples for every procured batch is undertaken on time. This would help in timely distribution of quality medicines to the various stores across districts and to entire health facilities in the State.

EDL (essential drug list) review and updation for more comprehensiveness in medicine procurement- EDL review process was started in 2015. The technical core committee earlier formed for the purpose of review of the EDL was also restructured for more inclusiveness from the peripheral health facilities and development partners.

The main idea of the EDL review was to have facility-wise EDL with more number of drugs for more comprehensiveness and a wider disease coverage including the non- communicable diseases as well.

The latest version of EDL launched in March 2018 comprises 310 products as compared to 180 products of the earlier EDL of 2011.

Periodical and structured procurement review meetings are being conducted from 2016 onwards with an objective to monitor the progress in the procurement process. Vendor Partnership platform has been established and active interaction with existing and prospective vendors has also been started by BMSICL.

For many years, BMSICL faced a major challenge of distrust among the vendors/bidders and within the market due to issues like delayed and pending payments, improper response etc. In addition, the manufacturers were not directly participating in the bidding process and there were local representatives who acted as business mediators in the entire bidding and contracting process.

In order to remove these barriers and to create a positive image of BMSICL, all pending payments of the previous suppliers were released except those pertaining to legal matters.

To do away with the business mediators, BMSICL in association with CAREIndia organised first large scale state level ‘PartnersConclave’ in April 2018 in which more than 200 manufacturers and their authorized suppliers participated. The conclave laid strong foundation of mutual trust among various stakeholders as a result BMSICL is now getting a greater number of bids for its tenders. In addition, BMSICL has invited expert officials from Government (Central/State) and Semi Government organisations so that they could provide an insight about the technical aspects to various partners.

Q Govt facilities at times lack required equipment and other necessary logistics pertaining to care. What steps have been undertaken to improve infrastructure?

With the aim to ensure ample availability of necessary equipment in different medical colleges/ hospitals of Bihar, BMSICL has entered into rate contract for 60 most important equipment.

Construction of new medical colleges and hospitals has been taken up on a large scale to improve healthcare infrastructure across State.

Under the State Government’s ambitious 7 Nischay Scheme many institutes including one ANM training institute in every sub-division of the State, one GNM and paramedical institute in every district of the State, and one BSc nursing institute in every medical college of the State are being developed.

A Center of Excellence (COE) building has been set up at Nalanda Medical College and Hospital (NMCH) for providing high-end diagnostic tests.

For maternal and neonatal care, 100-bed MCH hospital is being set up in six medical colleges & hospitals, and two district hospitals at Muzaffarpur and Sitamarhi.

In addition, following infrastructure related development work is also being carried out by BMSICL:

• Development of PMCH with a total expense of Rs 5540 cr.

• Upgradation of nine district hospitals with a total cost of around Rs 160 crores.

• Development of 272-bed capacity Mental Healthcare Hospital at Koilwarand and Ara.

• Development of medical college and hospital at Madhepura, Bettiah, Purnia & Chapra.

• Development of dental medical college & hospital at Rahui (Nalanda).

• Construction of 106 bedded superspeciality eye hospital at Rajendra Nagar, Patna.

• Development of superspeciality 106-bed eye hospital & 400-bed orthopaedic hospital at Rajwanshi Nagar, Patna.

Q PPP is being perceived as the best model to improve infrastructure. How is it being leveraged across to streamline things?

Public-Private-Partnership (PPP) provides an opportunity for private sector participation in financing, designing, construction, and operation & maintenance of public sector programmes and projects. It’s high time to forge a greater interface between the public and the private sector in a wide range of activities especially in the area of healthcare delivery services where shortage of trained / skilled manpower is a big challenge.

Leveraging PPP model, BMSICL has established CT scan and MRI machines in PPP mode in all working Medical College & Hospitals of the State.

Besides this, x-ray services on PPP mode through State Health Society, Bihar, is also in line at the district level and below.

These services require huge investment as well as trained manpower and we have better experience running these services on PPP mode across health facilities in Bihar.

We are also gearing up to operate the Centre of Excellence at NMCH Patna under PPP-mode. It will enable masses to avail high-end diagnostic tests.

Q What steps have been taken by the agency to ensure quality and regular drug supply to masses & to avoid any malpractices on this front?

BMSICL ensures timely procurement and regular supply of quality drugs, surgical and suture items every year by getting the requirements from various Government health facilities across the State by means of online indenting by the concerned authorities. The indenting of drugs/medical devices is done as per the EDL. Some of the measures which have been undertaken on this front include e-tendering process, technical evaluation of bids, and inspection of the respective manufacturing units. Supply of quality drugs is done in accordance with the indent received from different medical institutions and the health facilities. The monitoring of the entire process is done through C-DAC owned DVDMS (Drug and Vaccine Distribution Management System) at the district level and below.

Q India needs indigenous medical equipment to contain costly medical facilities. How do you read the statement in context of Bihar?

I do agree that India needs indigenous medical equipment to combat costly medical facilities. At the same time, BMSICL is ensuring quality and safety standard of the medical equipment by adopting prevalent safety and quality standard like USFDA/ European CE/ BIS at the time of designing their technical specifications.

Being nodal procurement agency for the Health Department of Government of Bihar, we ensure procurement of quality equipment so that people of all strata get quality care.

BMSICL undertakes following procedures for quality assurance:-

• Technical evaluation of bid document submitted by the bidder is done by verifying the quality certificate as well as technical data sheet of the quoted medical equipment.

• Demonstration of quoted medical equipment by the bidder in presence of specialist (doctor) who ultimately will be using it.

• The consent of OEM (Original Equipment Manufacturer) to ensure uninterrupted service of the supplied equipment for three years during the warranty period, and during the consecutive seven years under the AMC/ CMC (Annual/Comprehensive Maintenance Contract) period is essentially obtained.

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