Saturday, March 10, 2012

[ZESTCaste] How They Made The NRHM Sick

From Tehelka Magazine, Vol 9, Issue 11 Dated 17 Mar 2012

How They Made The NRHM Sick

With the Mayawati government now out of power, will the NRHM scam
probe be taken to its logical conclusion, asks Abhishek Bhalla
Former family welfare minister Kushwaha

MINUTES AFTER polling concluded in the Uttar Pradesh Assembly election
on 3 March, Babu Singh Kushwaha was arrested in connection with the
multi-crore National Rural Health Mission (NRHM) scam. Standing with
folded hands in a Ghaziabad courtroom, the former family welfare
minister told the judge he was innocent.

In court, Kushwaha pinned the entire blame on former chief minister
Mayawati, claiming she took all crucial decisions relating to NRHM,
whereas he did not have much say. "I was just a minister, not the
supervisor of the scheme. All major decisions were taken either by the
chief minister or the chief secretary," he said.

The CBI is probing whether the money trail reaches the top. Along with
Kushwaha, BSP leader Ram Prakash Jaiswal was arrested. The agency
alleges that Jaiswal, a close aide of Kushwaha, helped him invest the
spoils of the crime.

It's not just the CBI. In a scathing attack, the Comptroller and
Auditor General (CAG) has strongly indicted the State Health Mission,
saying it was responsible for the NRHM scam. The audit done by the CAG
pertains to the period April 2005 to March 2011, and was conducted
between August and November 2011.

According to the CAG report, the State Health Mission did not
discharge its responsibilities adequately, resulting in Rs 5,754 crore
going unaccounted for. The total amount spent on NRHM by the state is
Rs 8,657 crore.

Some of Mayawati's decisions are being closely scrutinised as part of
the criminal investigation. Among them is the creation of a new post —
that of Chief Medical Officer (CMO), Family Welfare. So every district
now had two CMOs. The move, carried out in a hurry, was not only
opposed by CMOs but also upset the top brass in the state, including
some ministers.

The creation of this new power centre, reporting directly to the
family welfare minister, completely changed the dynamics of the health
sector. Kushwaha, already a powerful political figure, now had 72 CMOs
in the state under his control, responsible for almost Rs 3,000 crore
on average every year. "The move to have a CMO to handle NRHM funds is
definitely under the scanner," reveals a CBI officer on condition of
anonymity. How the new posts were filled in an unseemly hurry also
violated all procedural guidelines.

The separation of health from family welfare for NRHM funds was a move
that was against the guidelines laid down by the Union health
ministry, which had specified in a circular that the two should not be

'I was just a minister. All major decisions were taken by the CM or
the chief secretary,' says Kushwaha

The CAG report, yet to be made public but accessed by TEHELKA, says,
"There was absence of structural integration and convergence within
the health department."

The CAG report blames the state government's decision to appoint two
ministers for family welfare and health as a move away from
integration. "Consequently, two parallel posts of CMOs became
operational in districts. However, the government had to withdraw the
earlier orders due to institutional problems arising out of the two
posts. This indicated that the issue of integration of funds,
functions and functionaries even within the department was not
resolved as of March, 2011," the CAG report states.

It is interesting to note that the state government recalled its order
of two CMOs after the murder of two CMOs from Lucknow, Dr Vinod Arya
and Dr BP Singh.

It is in this backdrop that the CBI carried out a series of searches
and questioned CMOs across the state. Investigators believe the new
bunch of CMOs were instrumental in siphoning off huge amounts at
Kushwaha's behest, as it was the minister himself who took interest in
appointing of many of them.

"The freedom that Kushwaha enjoyed under Mayawati at one point of time
cannot be ignored in the probe. Most of the people posted as CMOs were
close to Kushwaha," says a CBI officer.

However, so far, there is little material evidence to establish the
exact money trail. The system of having two CMOs itself does not
establish criminal culpability.

The CBI is also inquiring into records of middlemen and contractors
who might have paid kickbacks to get people of their choice posted as
CMOs in their district to benefit from contracts related to NRHM

But one handicap for the investigators is gathering material evidence.
Account books, details of transactions are all tampered with.

The CAG report mentions that a lot of information required for the
audit was not made available. "The audit has been constrained due to
non-productivity of records at different tiers of the government. At
many units, it was informed that records are either not available at
all or are not available in full. In quite a few instances, original
records had not been maintained, particularly relating to accounts,"
the CAG report says.

Another reason why BSP supremo Mayawati's role cannot be ignored is
the fact that the goals of NRHM were to be achieved by the State
Health Mission, which was directly under the former CM.

Even the CAG report directly blames the State Health Mission for
various anomalies in the mega health project. The report states, "The
management of the mission, especially financial and accounts
procedures, suffered from systemic weaknesses. The improper and
deficient maintenance of books of accounts resulted in accounts not
reflecting the true and fair picture of NRHM in the state, apart from
resulting in serious financial irregularities."

THE CAG has also found anomalies in releasing of funds; the method
adopted was once again in complete violation of the NRHM guidelines.
"The State Health Mission, instead of directly releasing funds to the
executing agencies, released more than Rs 1,500 crore through the
programme management society, an unregistered society introduced by
state government," says the report.

These are not the only violations of the guidelines by the state
government. According to the CAG, the selection and awards of
construction works to agencies on nomination basis is not only a
violation of NRHM guidelines but also rules laid down by the Supreme
Court and Central Vigilance Commission. The CAG points out that
agencies were paid money for construction without even ensuring the
availability of land resulting in money lying with the agencies
without work starting and benefiting them as interest.

Fatal fallout of a scam

Even the CBI is struggling to solve the mystery of the NRHM-related deaths
Police examine the body of slain CMO BP Singh

Crime scene Police examine the body of slain CMO BP Singh

Photo: Pramod Adhikari

AS THE CBI tightens the noose in the NRHM scam, the crime scene has
been bloodied by a handful of suspicious deaths. After the murders of
two CMOs, Dr Vinod Arya and Dr BP Singh, and the mysterious death of
deputy CMO Dr YS Sachan in jail, two more government employees have
died in mysterious circumstances.

The last such death took place on 12 February in Lakhimpur district.
The body of Mahendra Sharma, a clerk with the community health centre,
was found 10 days after he reportedly went missing from home. The
post-mortem report revealed that the death was caused due to
smothering leading to asphyxia — a clear indicator that it was a
murder. But the police came up with a suicide theory claiming they
recovered a suicide note.

Sharma's family is not buying the police theory. "We have not even
been shown the original suicide note. I saw a photocopy and it's not
too clear," says Sharma's 23-year-old son Neeraj.

The family claims that Sharma, who handled accounts at the health
centre, was constantly under pressure from his bosses to fudge account
details of NRHM projects. "When my father did not succumb to the
pressure, he was transferred," claims Neeraj.

Although the case has been transferred to the CBI, sleuths have not
been able to establish the family's claims.

In another mysterious death, Sunil Verma, a project engineer with the
Jal Nigam, allegedly shot himself on 23 January. A suicide note was
found saying the CBI was harassing Verma by constant questioning on
the NRHM scam. It is not clear whether he was a suspect or a witness
for the agency.

"We have been questioning many people, especially employees who were
part of NRHM and understood its functioning to get leads. He was just
one of them," says a CBI officer.

However, Lucknow-based lawyer Prince Lenin, who filed a PIL in the
high court asking for a CBI probe in the murders of the two CMOs, says
none of the deaths should be seen in isolation. "It appears to be an
attempt to silence whoever wants to raise a voice. Even if it's a
suicide, it must be probed what led to it. It's possible that the
person was forced to kill himself," he says.

While probes are at a nascent stage, the CBI has not got any major
leads in the earlier cases. In Sachan's case, it is working on the
suicide theory despite a judicial probe indicating otherwise. On 22
June 2011, his body was found hanging in the jail premises. This was a
day before he was to be produced in court for further remand. The
police declared it a case of suicide.

The police, who claimed to have solved the murders of Singh and Arya,
implicated Sachan in the murders and arrested three shooters. The
chargesheet filed by the police was found to be unreliable and the
high court stayed any proceedings on it.

The CBI is closely following all these findings of the CAG in their
probe. According to the CBI, largescale bungling took place in the
implementation of NRHM. The modus operandi for siphoning off state
wealth included overpricing, fake supply of medicines and hospital
equipment by fictitious firms as well as huge kickbacks in
construction activity to improve health services in government-run
primary health centres in rural areas.

The CBI also discovered how some persons acted as middlemen between
contractors and influential bureaucrats and ministers to supply
medicines and equipment under the programme.

The NRHM scam surfaced just ahead of the Assembly election in Uttar
Pradesh and along with the subsequent mysterious deaths of three CMOs
and two other state employees associated with NRHM became a major
political flashpoint.

In her defence, Mayawati maintained during her election meetings that
she had nothing to hide and it was her government that recommended a
CBI probe in the multi-crore scam and the five killings that are seen
as direct fallout of the scam. But her political opponents attack her
directly, saying that since the former chief minister was at the helm
of affairs of NRHM, she should be answerable.

ACCORDING TO Samajwadi Party chief Mulayam Singh Yadav's brother
Shivpal Singh, not only is Mayawati responsible for all the
wrongdoings, she has also managed to delay the investigation. "It's
been more than a year when the first murder took place and the scam
surfaced. By not allowing a CBI probe immediately they have ensured
that by now a lot of evidence has been destroyed," Yadav told TEHELKA.

The politics over NRHM will not end with the elections. Now with the
arrest of Kushwaha on the concluding day of polling in Uttar Pradesh,
political clamour over NRHM has again started raising doubts on the
timing of the arrest.

'By not allowing a CBI probe immediately, a lot of evidence has been
destroyed,' says Shivpal Yadav of the SP

Not surprisingly, the BJP has come out in support of Kushwaha, who
joined the party after being expelled from the BSP. "It appears they
were waiting for elections to get over. Why did the CBI have to wait
all through the elections if they had evidence against him? It seems
CBI is working under pressure," says BJP leader Kalraj Mishra.

On the other hand, the CBI has made it clear that this arrest relates
only to one case. It is alleged that Kushwaha allotted work of
upgradation of 134 hospitals to a company without any bidding. There
are 12 cases registered in the NRHM scam till date and the
investigating agency says there might be more cases registered soon
and more arrests are likely.

Abhishek Bhalla is a Senior Special Correspondent with Tehelka.


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