KARACHI: Despite ban imposed by Health Department of Sindh government on the entry of representatives of multinational pharmaceutical companies in public sector hospital during Out Patient Department (OPDs) hours, the representatives have been found violating the rule. Medical sales representatives and doctors were not following the directives issued by the hospital administration and health department Sindh about the ban on entry of medical representatives resulting the nexus of doctors and medical sales representatives of drug companies badly affecting the patients’ care. The breach of medical ethics could be seen almost in all major hospitals of Karachi including Civil Hospital Karachi, Abbasi Shaheed Hospital, National Institute of Child Health and others hospitals where the medical representatives roam freely in different departments with the intention to get doctors’ attention and all this happens due to poor check and balance system. This unchecked practice of representatives’ meeting with doctors makes the patients to suffer a lot in health facility as some doctors are prescribing costly medicines with the direction to purchase them from targeted medial stores so as to increase sales of their favorite pharmaceutical companies. The hospital administration is unable to control these illegal activities as medical representatives are openly violating the ethics. However, according to Dr Khadim Qureshi, Additional Medical Superintendent CHK, despite vigilant system to check entry of medical representatives, it was difficult to stop every medial rep. “No activity is allowed in the premises of the hospital. If we see any medical representative in the hospital premises during OPD hours we expel such person from the hospital premises,” said Dr Qureshi. “We can’t stop every person since it is difficult to search for medical rep among them. We are unable search every person entering hospital premises,” he added. Similarly, the influence of representatives of multinational pharmaceutical companies have been increasing day by day in Abbasi Shaheed Hospital (ASH) run by Karachi Metropolitan Corporation (KMC), which has badly affected the patient care system in the institution. Executive Director, Jinnah Postgraduate Medical Centre (JPMC), Dr Seemin Jamali, said: “No medical representative is allowed to visit the wards that can affect patient care during rush hours and the administration has adopted a clear policy regarding the visit of medical representatives in premises of the hospital”. However, Dr Jamali admitted that the reps keep visiting the hospital despite ban. “Since we can not arrest them so there is nothing much we can do”, she added.