UNHEALTHY PRACTICES Health Department indulges in open scams. Day Light loot in Purchasing

 By Firoz.T.Totanawala

The Bangalore Metro Reporter

                                  

1st July 2010 Issue

                                             UNHEALTHY PRACTICES

                 Health Department indulges in open scams. Day Light loot in Purchasing

Dr. Nanjundappa’s report on the regional imbalances in the state a few years back became an excuse to unscrupulous and corrupt officials to indulge in blunt corruption. While the state Government is pumping crores of Rupees to provide balanced development in north Karnataka region, the officials in league with equally unscrupulous contractors and suppliers are swallowing a lion’s share of the money by taking up unnecessary projects and purchasing.

The state Government in its effort to take up developmental projects in the north Karnataka region decided to upgrade the 45 Primary Health Centers to 30 bed community hospitals, most of which were located in remote areas. As a first step, the Government also released 10 crores for purchase of medical equipments to these 45 ‘soon to be’ upgraded Primary Health Centers.

However, it is a known fact that the Government was yet to build proper buildings and infrastructure to upgrade the Public Health Centers. Yet, the Health Department immediately went on a purchase spree of technical equipments in spite of the absence of the infrastructure and the required staff. The reason was to spend Rs. 10 Crore released amount so that they can demand more in the ensuing budget. They were not bothered whether the equipments they were buying were necessary and can be made functional in the existing infrastructure. They merely wanted to spend the grants, purchase the equipments and enrich themselves along with the suppliers.

The X-Ray Machines

Their purchase of 45 sophisticated X-Ray machines provides an insight into the greediness of these officials and suppliers.

On the State Governments decision to upgrade 45 Primary Health Centers, Dr Ramesh, the DD (Medical) was open to an enriching opportunity and he immediately seized it. He decided to procure 45 sophisticated X-Ray machines and that too from a particular firm only. Through deft manipulations he managed the technical specification committee to stipulate particular specifications for the supply of X-Ray machines so that all other suppliers are prevented and his favourite firm gets the clearance for its tender.

The Health Department floated tenders for procurement of High Frequency 100 MA X-Ray machines. However, the specifications of the required machines were so stipulated; that only Siemens had the possibility to supply the same. All other suppliers in the X-Ray machine field became ineligible to supply the machines due to the manipulated specifications condition. The dealer of Siemens, Mr. Suresh, had already grabbed many such orders in the past at exorbitant rates since the specifications were always based on Siemens machines.

Forceful Procurement

Most importantly, the Public Health Centers which were going to be upgraded to 30 bed hospitals actually did not need these sophisticated machines in the first place because of the rural population and the requirement. A normal and standard linear frequency X-Ray machines were actually needed for these hospitals which can be operated by a dark room Assistant. Or at the most, LF 60 MA X-Ray machines would be have been the perfect solution. These normal and standard machines costs less than 2 lakhs and can be operated with single phase power. Besides, the X-Ray machines procured are used to do the X-Ray of the chest and for detecting broken bones. However, as per the practice in the rural area, if the health problem is severe, the patients are referred to district hospitals also because specialized Doctors are not easily available for rural practices in the rural areas.

In such a situation, standard x-ray machines would have done justice to the task. But the top brass opted for high frequency 100 MA x-ray machines. Now, the Government has to spend some more crores to recruit technical persons and radiologists, without whose services these HF 100 MA x-ray machines are of no use.

As per their proposed specifications, the x-ray machines were required to have Fluoroscopy, two tube x-ray and a five position table, which are totally ill suited for rural areas. In 2 tube x-ray the machine can take x-ray from both atop the table and below the table which is mainly used to screen serious patients to save time. However, Rural Hospitals do not attend severe cases and refer them to District Hospitals.

Electrifying Decision

Since there was also a specification that x-ray machines should have fluoroscopy attachment, the services of a radiologist become mandatory, because only a radiologist can analyze fluoroscopy. And more than any thing else, this x-ray machine needs a continuous 3 phase power supply. It should also be noted that rural areas in the state are starving for power. In the north Karnataka region, power is available for a few hours a day and the situation becomes severe in summer.

The technical specification committee did not consider any rational consideration before calling for tender. And the sad side of the story is that no one in the committee was an expert in this field. The health equipment officer Sridhara Murthy is an automobile engineer. The FA is an accounts man. The Director and Joint Director are too busy with their work and as such they could not spare their precious time to study about the best suited and the cost effectiveness of the machines. Dr, Ramesh the DD (Medical) who forced his way to the committee through deft manipulation was bluntly backing Siemens and made other members to agree on the specifications of siemens.

Monopoly Business

The tender was submitted only by Siemens. Though it is a practice to call for a re-tender in case there is only one bid, the Health Department accepted the tender despite the protests by other X-Ray manufacturing companies and placed the order of machines to Siemens. The Siemens quote was Rs. 4.28 lakh for each machine which totalled up to Rs. 1.92 Crores for 45 machines.

Wicked Splitting

Now there was a need for another conspiracy. As per law, the Principal Secretary for Health & Family Welfare has a limit to approve and sanction the bills valued under 1 crore. And anything more than that needs Government approval, which in this case would take at least 2 to 3 months for obtaining. Since the Health Officers were in a hurry to finish this deal, they worked out another plan. They split the requirements in two orders, and first issued an order for only 23 machines which valued at 98/- lakhs. This bill was approved by the Principal Secretary and there was no need to go for the Government approval. Some time later, another order for 22 machines was issued which was also within the limits of Principal Secretary to approve.

Money Comes First

Worst is that after receiving the first order of 23 machines, Siemens submitted a bill of Rs. 98/- lakhs within a week and the same bill was paid in two days without the actual supply of the machines by the company. As per the contract, the payments have to be made after the total installations of the machines and on receipt of satisfactory installation report received by the concerned officials. However, in this case there was no chance of installations as the Primary Health Centers did not have enough infrastructures for installations of these machines. The Department then openly violated the rules and made the payments. Same was repeated even for the second order supply of 22 machines.

 Now, almost after 3 years of the manipulated procurements, the sophisticated machines are lying in dust, uninstalled and in some places unpacked. The primary Health centers do not have proper infrastructure to equip it with x-ray machines, video endoscopy, mammography, CRM, operation theatres etc. There are also no qualified staffs, specialists and doctors available. Even technicians and supporting staff are not available. It is due to these reasons that many video endoscopic machines purchased in the past were also later dumped in store rooms without even unpacking them.

The story of Health corruption is mind boggling. Just a decision by the Government to upgrade Health Centers and crores of rupees gulped down by the officials. So what if the Health Centers in rural areas do not have basic facilities, it does have sophisticated X-Ray machines.