EXPLORING THE INTERPLAY BETWEEN
BUSINESS REGULATION & CORPORATE
CONDUCT IN INDIA (BRCC)
MEETING AND PARTNERS WORKSHOP
26.06.12, New Delhi
Center for Climate Change
Engineering Staff College of India (ESCI)
Andhra Pradesh State Partner for BRCC
Project
A Learning Center for Practising Engineers, Scientists and Managers
OVERVIEW
A Learning Center for Practising Engineers, Scientists and Managers
OVERVIEW
PHARMACEUTICAL SECTOR
Total Pharma Companies (Registered Units) in
AP – 727
- Small & Medium Scale companies - 670
- Large scale companies - Approx. 57
A Learning Center for Practising Engineers, Scientists and Managers
OVERVIEW
HEALTH CARE SECTOR
Approx. 7000 Private Hospitals in AP
• 5400 are below 25 beds
• 1050 hospitals are above 25 beds
• 200 are 35 bedded hospitals
• 350 are above 100 beds
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A Learning Center for Practising Engineers, Scientists and Managers
METHODOLOGY
Field Work
A Learning Center for Practising Engineers, Scientists and Managers
SURVEY FOR BRCC PROJECT
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•
•
•
•
•
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Kakinada
Vishakhapatnam Zone - I
Vijayawada
Zone - II
Guntur
Hyderabad
Medak
Zone - III
Ranga Reddy
Mahaboob Nagar
A Learning Center for Practising Engineers, Scientists and Managers
FIELD-WORK
(PRIMARY RESEARCH)
The details of surveyors Zone wise
Sri M. Kameswara Rao (Visakhapatnam)
Sri R. Gopalakrishna (Kakinada)
– Zone – I
Sri R. Sambasiva Rao (Vijayawada)
Sri C. Narayana Rao (Guntur) were allotted to do the survey at
respective places as the response was not effective so the surveyors
were changed.
Sri V. Venugopal and his Team Members (Vijayawada) and Sri K.
Sasidhar Reddy (Guntur)
– Zone – II
Center for Climate Change, ESCI members
-- Zone - III
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A Learning Center for Practising Engineers, Scientists and Managers
DETAILS OF SURVEY COMPLETED
Zone - I
Zone - II
Sectors
Number of samples
collected
Sectors
Number of samples
collected
Pharmaceutical
Companies
--
Pharmaceutical
Companies
10
Private Hospitals
34
Private Hospitals
31
Medical
Representatives
20
Medical
Representatives
30
Prescriptions
19
Prescriptions
33
Sectors
Number of samples
collected
Pharmaceutical
Companies
30
Private Hospitals
09
Medical
Representatives
13
Prescriptions
31
Zone - III
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A Learning Center for Practising Engineers, Scientists and Managers
FINDINGS
Pharma and Health Care Sector
A Learning Center for Practising Engineers, Scientists and Managers
PHARMA COMPANIES STATED
• Environmental law should be implemented nation wide; one state one law
is unfair.
• Medicine should be affordable. This will happen when we encourage the
local Pharma industries rather than going for imported medicine.
• To encourage local industries Government has to provide infrastructure.
There is lot of gap between the present infrastructure facilities and the
required facilities.
• NO isolated cluster for polluting industries. If all the Pharma industries
are at one place then it is easy to mitigate pollution in cost effective
manner. Solutions are there for pollution mitigation.
• Entrepreneurship in this sector had done very good job so that INDIAN
PHARMA industry became world leader in 30 years. India started with 0
now world leaders.
• Entrepreneurs done their part it is the responsibility of the government to
provide necessary infrastructure and other things. Government failed in all
aspects that not even provide infrastructure and not even working along
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with companies.
A Learning Center for Practising Engineers, Scientists and Managers
INITIAL FINDINGS / SUGGESTIONS
PHARMACEUTICAL SECTOR
• Pharmaceutical companies should give the 25 - 40% of
production to the generic medicine shop, so that the medicine
should be available at people at low cost
• Frequent auditing/third party inspection for the production
and hazardous waste management should be mandatory and
under the control of regulatory bodies.
• Non-licensed companies should be shut down as and when
encountered.
• Strict rules for quality management and quality inspection
should be prepared and controlled by government.
• Government has not deeply analyzed the cost of medicine/
inputs in pharma sector. This need to be done.
• Regulatory body should fix the cost of medicine.
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A Learning Center for Practising Engineers, Scientists and Managers
INITIAL FINDINGS / SUGGESTIONS
HEALTHCARE SECTOR
• President, AP Nursing Home Association agreed that 90% of Doctors
do NOT follow ethical practices.
• Also, that there is no Codes followed for diagnostics, prescription
of medicines.
• No Corporate Hospital have any kind of CSR policy in place.
• Only 5% of hospitals are aware of NVG and Bio-Medical Waste
Regulations.
• No hospital have defined charges for Diagnostics etc. They charge
on the basis of opinion/ mood of doctor at the given time.
• Schemes like Arogyasri are more used for doing wrong diagnostics
and non-required surgeries to get money from Govt. Moreover
involvement of businessmen (as Hospital owner/ Chairman) make it
more easy to extract money from Govt. due to network with
politicians and higher officials.
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A Learning Center for Practising Engineers, Scientists and Managers
Suggestions
Healthcare Sector
• Universal Health Care plan’ is the best for country like India. In
this CUBOID model, 100% population is covered, with 100%
financial coverage and payment is do e in advance i.e. prior to
incidence of disease.
• Eg. In Europe that is Society based model where people pay
the part of salary as tax, which is used for providing health
care services. But its easy there as, their people work in
organized sector.
Whereas in India only 40% population work in organized
sector, rest 60% approx.. live in rural area and work in
unorganized sector.
A Learning Center for Practising Engineers, Scientists and Managers
For India, Eg. NAREGA- part payment can be cut and put into
the pooled fund for health care of BPL / rural population.
As OP is generally required by everyone once every year, 9% cases
go for secondary treatment and only 1% go for tertiary treatment ,
this money can be used there, for achieving aim of “Providing
Health Services to All”.
• National Level Committee need to work to establish the model for
long term benefit of GOVT. HOSPITAL & society. This will lead to
reduction into “Diversion of funds to Private Hospitals” and will
“Improve Facilities, Infra and Work Environment of Govt Hospitals”.
• Generally politicians come for 5 years and they see vote bank so
they decide policies to give short term benefits. This is the reason
that Arogyasri kind of scheme are focusing more on private and
corporate hospitals rather than strengthening Govt. Hospitals (with
doctors and facilities, equipment’s etc.) and local health care
hospitals in rural areas.
A Learning Center for Practising Engineers, Scientists and Managers
SOCIAL, ENVIRONMENTAL AND ECONOMIC
IMPACTS OF SUCH VIOLATIONS
(AS GATHERED FROM SECONDARY/ PRIMARY RESEARCH)
A Learning Center for Practising Engineers, Scientists and Managers
EVIDENCE- QUALITY OF WATER DUE TO
POLLUTION FROM PHARMA COMPANIES
Dirty water coming from the tap, due to Ground Water Pollution
caused by Pharma Companies. This is used for day to day purposes in
summer season.
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A Learning Center for Practising Engineers, Scientists and Managers
EVIDENCE SUGGESTING VIOLATION OF
BUSINESS RESPONSIBILITY IN THE BOTH
SECTORS
1. There are many oral discussions with
clients and directors.
2. It was not mandatory to collect the names
of clients/ Directors etc.
PLAY VIDEO……………………
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A Learning Center for Practising Engineers, Scientists and Managers
SECONDARY DATA COLLECTED
ANDHRA PRADESH
A Learning Center for Practising Engineers, Scientists and Managers
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A Learning Center for Practising Engineers, Scientists and Managers
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A Learning Center for Practising Engineers, Scientists and Managers
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A Learning Center for Practising Engineers, Scientists and Managers
Eenadu dated 21 June 2012
• A report by a parliamentary committee has shown that
the drug industry regulator, the Drug Controller General
of India (DCGI), has been approving, on average, one
new drug a month without conducting mandatory
clinical trials or seeking expert medical opinion—
findings that expose the deep flaws prevalent in India’s
drug approval process.
• The committee has asked the health ministry to
withdraw the discretionary powers given to the Central
Drugs Standard Control Organization (CDSCO), which is
headed by DCGI, to grant approvals to drug companies.
A Learning Center for Practising Engineers, Scientists and Managers
Eenadu dated 21 June 2012
• The committee found that an “overwhelming”
majority of the drugs were being approved on the
basis of personal prescriptions and without any
scientific evidence. The report concludes that “there
is adequate documentary evidence to show that
(expert) opinions are written by the invisible hands
of drug manufacturers and experts merely oblige by
putting their signatures”.
• The panel found “sufficient evidence” to establish a
collusive nexus between medical experts, drug
companies and CDSCO officials.
A Learning Center for Practising Engineers, Scientists and Managers
DRIVERS/ FACTORS INFLUENCING
BUSINESS RESPONSIBILITY
IN THE STATE
A Learning Center for Practising Engineers, Scientists and Managers
 Political Constraints
Desire of DOCTORS to earn money at any
cost- may be organ trafficking or nonrequired surgery
 Corruption / Bribing
 Other factors like;
• Absence of Planned cities / Industrial clusters
• Nexus
• Misuse of Government schemes like “Aarogyasri”
• Politicians looking for short term benefits
• 14 Licenses required by Pharma companies
• About 40 clearances required for establishing
hospitals. No single window clearance to establish hospitals
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A Learning Center for Practising Engineers, Scientists and Managers
BRCC PROJECT IS SUPPORTED BY
FOLLOWING
A Learning Center for Practising Engineers, Scientists and Managers
SUPPORT FROM ANDHRA PRADESH
POLLUTION CONTROL BOARD (APPCB)
Meeting with Shri B.S.S. Prasad, Member
Secretary, Andhra Pradesh Pollution Control Board
(APPCB) for collecting data of Hazardous waste
and Bio-medical waste and to provide a letter that
is required to collect the data from pharmaceutical
and healthcare sectors.
A letter received from APPCB directing hospitals
and Pharma companies to provide certain data in
the prescribed format as a support of “Business
Regulation and Corporate Conduct” project.
A Learning Center for Practising Engineers, Scientists and Managers
SUPPORT FROM ANDHRA PRADESH
POLLUTION CONTROL BOARD (APPCB)
A Learning Center for Practising Engineers, Scientists and Managers
SUPPORT FROM ANDHRA PRADESH
POLLUTION CONTROL BOARD (APPCB)
A Learning Center for Practising Engineers, Scientists and Managers
- COLLECTOR OFFICE, HYDERABAD
- DM&HO, HYDERABAD
A Learning Center for Practising Engineers, Scientists and Managers
SURVEY OF ASSOCIATIONS
Dr. R.S. Saluja
State President
Andhra Pradesh Private Hospitals & Nursing
Homes Associations, Hyderabad
- Details are furnished in the prescribed
format (Questionnaire)
A Learning Center for Practising Engineers, Scientists and Managers
SURVEY OF ASSOCIATIONS
Dr. B. Bhaskar Rao MD, MS, DNB (CT Surgery)
Director, CEO, Chief –Cardio Thoracic Surgeon
Krishna Institute of Medical Sciences (KIMS)
Hyderabad &
President, AP Corporate Hospital Association
- Details are furnished in the prescribed
format
A Learning Center for Practising Engineers, Scientists and Managers
SURVEY OF ASSOCIATIONS
Shri A. Krishna Reddy
Executive Director
Bulk Drug Manufacturers Association (India)
Hyderabad
- Details provided are furnished in the
prescribed format (Questionnaire)
A Learning Center for Practising Engineers, Scientists and Managers
SURVEY – TOP OFFICIALS, PHARMA
Shri M. Narayana Reddy
Managing Director
Virchow Laboratories Ltd
& Ex- President, BDMA
Hyderabad
- Details provided will be furnished in the
report
A Learning Center for Practising Engineers, Scientists and Managers
SURVEY – TOP OFFICIAL, MEDICAL
Prof. K.S. Ratnakar
MD., (Path-AIIMS), FICS, FIMSA, FICP
Director
Global Medical Education & Research Centre
Hyderabad
- Details provided will be furnished in the
report
A Learning Center for Practising Engineers, Scientists and Managers
SURVEY OF ACADEMICIANS, PHARMA
Dr. G. Krishna Mohan
Member Pharmacy Council of India, New Delhi
Professor & Head – Centre for Pharmaceutical
Sciences
Jawaharlal Nehru Technological University
Hyderabad
- Details provided will be furnished in the report
A Learning Center for Practising Engineers, Scientists and Managers
SURVEY OF ACADEMICIANS, MEDICAL
Dr. G.V.S. Murthy
Director
Indian Institute of Public Health (IIPH)
Hyderabad
- Details provided will be furnished in the
report
A Learning Center for Practising Engineers, Scientists and Managers
MEETINGS WITH HIGHER
GOVERNMENT OFFICIALS
• Sri Srikant Nagulapalli, IAS
CEO
Aarogyasri Health Care Trust
Hyderabad
• Dr. E. Ravinder Reddy
Managing Director & Chairman
State Medical Council, Andhra Pradesh
Hyderabad
A Learning Center for Practising Engineers, Scientists and Managers
SURVEY OF GOVERNMENT OFFICIALS
Shri K. Srinivasa Rao
Inspector of Factories
Sangareddy Circle - 1
Hyderabad
- Details provided are furnished in the
prescribed format
A Learning Center for Practising Engineers, Scientists and Managers
APPOINTMENTS WITH FORMER
HIGHER GOVERNMENT OFFICIALS
• Dr. Indra Shekar Rao
Pediatrician
Former Head of Niloufer Hospital
Hyderabad
A Learning Center for Practising Engineers, Scientists and Managers
THANK YOU
Engineering Staff College of India
HYDERABAD, AP
Email: ccc.esci@gmail.com
A Learning Center for Practising Engineers, Scientists and Managers