From Ekaki Zunj
The scam involves systematic loot of over Rs 3,700 crore of central health funds in Uttar Pradesh over the past six years (2005-2011). Many people, including Rahul Gandhi, had spoken of the NRHM bungle, but the size of the scam indicates that not only were officials at the level of CMO and above involved, but also this could not have been carried out without the knowledge and support of their masters.
A list was circulated to health officials. This was not an official document, but a guideline, and this provided the template for the loot. There were 54 heads under which NRHM funds were coming in. Under each head was mentioned how much the particular department was supposed to 'save'. And this ranged from 5% to, in some cases, 100%. It was understood that all CMOs would 'save' as per instructions given in the list and pass the money on to higher-ups. The average saving is approximately 50%.
UP received nearly Rs 8,600 crore under NRHM over the past six years and spent Rs 7,450 crore during the period. Now, considering that this document was the template for 'savings', the money that leaked out of the system could be as high as Rs 3,700 crore. Besides, as a central study points out, there was no recovery of unspent funds. So, the volume of loot could be even higher.
This also explains the clamouring for the post of CMO (family welfare) — created in May 2010 to handle the fund — as well as the involvement of mafia and a spree of killings of CMOs (one of them in police custody). One of the murder cases has reached the CBI for probe and heads of two ministers have rolled.
Many of the CMOs confirmed the existence of the 'savings' list, but none was willing to talk on record. They also confirmed that senior government doctors paid hefty sums to get the coveted post of CMO (family welfare), when it was created last year.
"When I was working, 70% of the funds was spent for public health while the rest was siphoned off. Today, it appears the case is just the reverse," a health director-level official, who retired a few years ago, said on condition of total anonymity.
The list reveals that there were as many as nine activities whose entire budget was eaten up, as the money 'saved' in their case was 100%.
NRHM is a growing fund with each passing year. Allocation to UP in 2005-06, when the programme was launched, was about Rs 794 crore which jumped to Rs1,956 crore in 2009-10. For 2010-11, the state had a sanctioned budget of Rs 1,741 crore till December 2010. In 2009-10, UP spent Rs 2,212 crore, nearly Rs 256 crore more than the sanctioned budget. "It must have utilized the unspent budget of previous years as NRHM funds don't lapse," says a health official.
The fact that that most of the activities were supposed to be of 'urgent' nature and didn't involve the tender process made the job easier. A central team that visited in May for a random check after CMO (family welfare) Dr BP Singh's murder, found that between 2009 and 2011, contracts worth over Rs 600 crore were given without tender.
Untied funds at the disposal of CMOs were also a major form of leakage. These funds were seen to be utilized for minor repairs and maintenance, for buying fuel for generators, local purchase of emergency drugs when in short supply, providing shelter to patients and attendants.
Jashodhara Dasgupta of Healthwatch UP-Bihar, examined and documented aspects of NRHM. "Untied funds were not being used for patient welfare related activites," was one the main findings. "The Janani Suraksha Yojana failed to reach the beneficiaries and patient attendants were forced to make informal payments," she said.
Mayawati government recommended a CBI inquiry into the murders of two chief medical officers (Family Welfare) at Lucknow, and into the massive bungling of Central funds allotted under the National Rural Health Mission (NRHM).