New laws needed for pharmacies

A new report called ‘HSA Outpatient Pharmacy Services’ has just been released by the Office of the Auditor General. The report looked specifically at whether laws governing the Health Services Authority’s pharmacy services were efficient and effective, how effective the HSA pharmacy was at ensuring the availability, safety and quality of medicines while delivery value for money, and also its efficiency at delivering dispensary services.

The report came off the back of the OAG’s 2017 performance audit report called ‘Ensuring Quality Health Care and a Healthy Population’, which had revealed there were several issues that had affected the HSA’s ability to deliver efficient and effective pharmacy services. Back in 2017, they found that the 1979 law that governed the HSA’s pharmacy needed to be updated and that there were concerns about shortages of physical space and staffing levels to provide pharmacy services to an increasing population.

This latest report has found that while the HSA provides good quality pharmacy services for outpatients, it could improve this further.

Auditor General, Sue Winspear, said: “The Health Services Authority provides vital pharmacy services for a large proportion of the population, including many of our most vulnerable people. It is pleasing, therefore, to be able to report that the HSA provides a good quality pharmacy service and has processes in place to ensure that the quality, safety and efficacy of the medicines it uses and dispenses to patients.”

The report highlighted that the HSA provided a good quality pharmacy service, which had improved over recent years, but said it needed to do more, including regularly measuring and reporting on performance.

“I encourage the HSA to continue to improve pharmacy service, by for example improving its facilities, and to regularly measure and report on a range of performance indicators. These should include measures that contribute to customer satisfaction such as waiting times,” Ms Winspear said.

The report concluded that the procurement exercise started by the HSA in late 2019 for the supply of medicines had a number of deficiencies and was abandoned early in 2021.

“The HSA spends around $9 million a year buying medicines and it is important that it obtains value for money from this,” Ms. Winspear said. “It was disappointing to note that lessons from the previous procurement exercise did not appear to have been learned. The procurement exercise that started in late 2019 was started far too late and took too long, leading to contracts, that were not providing value for money, being extended multiple times. That procurement exercise was eventually abandoned in early 2021 and a new one has now started.”

The report stated that the legislative framework is outdated and there is a lack of strategic direction at the national level for healthcare, and by extension pharmacy services.

The Auditor General said: “Not for the first time I am having to report that the legislative framework for pharmacy services is significantly out of date and there is a lack of strategic direction at the national level for healthcare. The Pharmacy Act, which dates back to 1979, is not in line with current good practice and creates risks for the control and regulation of drugs that are able to be brought into the Cayman Islands. This needs to be rectified as soon as possible.”