How Central funds meant for upgrading healthcare facilities are siphoned off
Continuing with its crackdown to ascertain irregularities in the National Rural Health Mission (NRHM) in Uttar Pradesh, the Central Bureau of Investigation (CBI), on January 5 conducted raids at over 60 places within the state and outside in Haryana, Delhi and Madhya Pradesh.
Searches were also conducted at the residence of former minister of family welfare in UP, Babu Singh Kushwaha, who was in charge of supply of medicines and medical equipment.
The CBI had earlier, on January 2, registered five cases against certain government and private sector officials alleging loss of about Rs 28 crore in implementing the Centrally-sponsored scheme meant for 72 districts of Uttar Pradesh.
Started in 2005 by the United Progressive Alliance government, Rs 10,000 crore were given to the state under NRHM, to improve health infrastructure and other facilities. The state decided to target the programme to improve accessibility to healthcare facilities and to reduce maternal and infant mortality rate. Public health experts say this is one of the reasons for rampant corruption in implementing the programme.
“Corruption in UP has definitely had an adverse impact on the public health facilities there. The health indices in the state were anyway poor because the state does not spend enough money on health. And the money that was given by the Union government was also siphoned off through the unregulated system,” says Narendra Gupta, secretary of Prayas, a non-profit.
Prior to the NRHM, he explains, money from the Centre used to go to the states’ finance departments in the form of consolidated funds. The disadvantage of this system was that it used to take months to get money from the finance departments. To reduce this bureaucratic procedure, under the NRHM, money was given directly to the health departments. “But with this direct procedure, there came no stringent checks and balances. The result of this is a scam of this scale in UP where instead of increasing the access to healthcare, government’s money was used by corrupt officials,” adds Gupta.
Women, children denied health benefits
Though six years have passed since the programme was started, the state has performed poorly in bringing down its infant and maternal mortality rates. The infant mortality rate of UP is 61 per 1,000 live births, just a point better than the worst performing state, Madhya Pradesh (62). The maternal mortality rate (MMR) in UP was 359 per 1,00,000 live births, till 2009 as per Census of India. This is much higher than the country’s MMR of 212.
The irregularities in the NRHM surfaced with the death of two chief medical officers in the state last year. The enquiry into the matter was then handed to the CBI. On the directions of the Allahabad High Court on November 15, 2011, the CBI filed five preliminary enquiries. On the basis of the evidence collected, they turned two of the enquiries into First Information Reports (FIRs).
Linking corruption directly to the crippling health care facilities in the state, public health experts say that the NRHM that was hailed as the best in the world could not meet the demand it created.
“Institutional deliveries increased even in UP because the village-level workers took pregnant women to primary health centres. But the condition of the hospitals has not improved in UP despite funds under NRHM. A lot of women die during child birth despite reaching the health facilities on time,” says C S Verma, convenor, People’s health Movement, an association of NGOs working in public health.
Meanwhile, the CBI investigation is on. The bureau officers have so far registered one case pertaining to upgradation of 134 districts hospitals for Rs 13.4 crores by Construction & Design Services, a unit of UP Jal Nigam. The materials used in the hospitals were of inferior quality and an approximate loss of Rs 5.46 crores was caused to the government exchequer, the CBI release said.
Four other cases are registered for irregularities in awarding contracts for procurement of medicine and medicinal equipments and for the expenditure incurred on printing publicity materials by the then director general (family welfare). “The procurement of these items was done through state-owned public sector units at exorbitant rates, which were four to five times more than the prevailing market rates,” said the release.
So far, the CBI has recovered “huge unaccounted cash from the accused public servants and incriminating documents related to alleged mis-utilisation of NRHM funds,” the release added.
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