Chikitsa Sansar, a healthcare advocacy group of physicians and pharmacists, has asked the union health ministry to clear the ambiguity prevailing in the implementation of Schedule H1 considering the fact that many states across the country do not strictly follow the system of prescribing medicines only by an allopathic doctor.

In a memorandum recently submitted to the ministry, it brought to the notice of the ministry that pharmacists are facing several practical difficulties due to the ambiguities in the implementation of Schedule H1.

It has been contested that clarity is being sought after on the eligibility of prescribing medicines as it has been observed that homoeopaths, ayurvedic medicine practitioners and allopaths can prescribe medicines in states like Maharashtra.  Since states follow different rule contrary to what has been mandated by the Medical Council of India (MCI) Act, which rule would be applicable and what is the judiciary's perspective on the same is being sought after, as per the memorandum.

The purpose of Schedule H1 has not been understood by the public and that only pharmacists have the onus of maintaining the register is ironical. Besides this, due to the shortage of MBBS doctors in many parts of the country, medical store owners will produce fake bills by putting names of doctors on the bill and rake in profits at the cost of patient safety.

If fake bills are made in the name of physicians, the offenders will have a free hand in evading actions from the state regulatory agencies and Income Tax department. Also, physicians from other systems of medicine can also take advantage of this lacunae and this will encourage quackery.

As per the memorandum, Maharashtra government's drugs department is not able to explain clearly the role of registered medical practitioner in Allopathy, Homoeopathy and Ayurveda streams of medicine. Government of India has formed several administrative units for governing drug trade like the excise department for narcotics and psychotropic substances; department of pharmaceuticals for drugs pricing; Food Licensing authority for food products; health department, Central Drugs Standard Control Organisation (CDSCO) for regulating drug quality and Schedule H1 drugs; and Competition Commission of India (CC) for enforcing healthy competitive practices.

These departments need to be coordinated under the purview of Drugs and Cosmetics Act, 1940. The memorandum seeks clarity whether there is any effort made for coordination of these departments and is it feasible for the retailer to understand and grasp the technicalities involved in understanding various laws governing drug trade of the land.

The implementation of Schedule H1 has become a very expensive proposition for the patient in emergency situations when the pharmacist does not give Schedule H1 drug to the patient and asks for a fresh prescription from the doctor. The patient has to go the extra mile to get the drug prescribed again at a hefty consultancy fees from the physician ranging from Rs. 200 to Rs. 1000.  

It has also been argued through the memorandum that whether computerised bill is an authorised version or the chemist has to adhere to the manual billing system for compliance to Schedule H1.