Delhi’s dwindling health scene

An agency formed to smoothen the functioning of Delhi government hospitals has slipped into a series of allegations, an audit report compiled in January this year has said. The report, prepared by the Delhi government’s audit department, has levelled charges against the Central Procurement Agency (CPA) claiming that large amount of government’s money has run into losses. 

The audit was conducted from April 2013 to March 2017 and a recovery of Rs 3 crore has also been pointed out in the report. 

The CPA was established in 1993 under the Drug Control Department of the Delhi government. Later on, it was observed that the two departments, namely Drug Control and the CPA, could not function at one location and under only one head of the departments. Hence, CPA was transferred to the Directorate of Health Services. The objective of forming a CPA was to procure drugs and other related items required by the dispensaries and hospitals run by the state government on a centralised basis. 

The Aam Aadmi Party (AAP) government, in 2015, gave more teeth to the CPA to ease out the purchasing process. For every medicine or equipment, the hospitals had to put in a demand through the central agency. Before this, the CPA was sending the rate contract to the hospitals and the hospitals used to make the purchases.

However, many hospitals in the Capital have faced trouble while putting the demands for medicines and equipment. “The purpose of setting up a CPA was defeated every time we purchased medicines on our own. The wait to get the equipment and medicines was getting longer day-by-day,” said a senior doctor of a government hospital.  

Risk purchases

But, the process soon hit a roadblock. The hospitals were making their own purchases as the CPA failed to meet their demands. As per the process, if a hospital is purchasing any medicine from itself at a higher rate, the CPA must meet the difference and pay back the amount to the government.

“Such purchases are termed as ‘risk-purchases’. The CPA completely crashed here. The rate contract was prepared without obtaining the competitive bid. The amount lost in the process may have crossed Rs 100 crore. It clearly suggested that the tender was prepared to favour a certain company,” said a senior official from the health department.

The outgoing Directorate General of Health Services (DGHS), Beena Khurana, in February 2017, had suggested a special audit of the agency. In a letter, Khurana raised several concerns regarding the overall functioning of the procurement agency.

Delayed purchasing process 

Delhi Chief Minister Arvind Kejriwal, in April, expressed displeasure over the non-functional Operation Theatre (OT) and shortage of equipment in the government hospitals. In an inspection, it was found that procurement of the same equipment by different hospitals had vastly differing time frames. 

Regarding equipment, the response by the health department said that “some delays” had occurred in the purchase of equipment because earlier the procurement process was initiated at the level of medical superintendents. But, subsequently it was decided to be done at the CPA level.

The procurement agency, however, did not receive a positive response from the hospitals. Sources in various government hospitals alleged that the agency had failed to fulfill the demands. Even the director of the agency was changed twice as the hospitals complained about the unmet demands. 

“It was a failed experiment. The CPA is now under CBI scanner after the audit department smelled a rat in its functioning. All the hospitals are now making their own purchases,” said a senior official from Delhi government’s health department.

“The CPA has always been delaying the process. There is nothing new to it,” added the official. 

The health department, recently, informed the Chief Minister that out of 190 OTs in  Delhi government hospitals, 171 are fully functional. When Kejriwal enquired about 19 non-functional theatres, the officials said “there were small issues of Public Works Department (PWD), manpower and lack of equipment due to which they were non-functional”.

Warehouses turned into waste dumps

A proposal made by the procurement agency suggested that the medicine and surgical consumables should be stored in warehousess to ease out the process of delivering medicines and creating a proper databases. For this purpose, three warehousess were set up at the basement of Lok Nayak Hospital, Guru Govind Singh Hospital, and Rajiv Gandhi Super Speciality Hospital.

According to the sources, the medicines have been lying as a waste in the warehouses for quiet a long time. “It has been observed by the audit that hospitals are not drawing the required stock from these stores and consequently 3,400 bottles of eye drops with manufacturing date of April 1, 2016 have expired, totalling up to a loss of government’s money worth Rs 1.25 lakh. The expiry of medicine is due to unplanned procurement at CPA and not issuing stock to hospitals before its expiry,” the report said. 

Rebel leader Kapil Mishra, in his letter to the Liuetenant Governor Anil Baijal on May 30 last year, claimed to have found “life-saving drugs” dumped in three trucks in the basement of a government hospital. In a series of allegations, Mishra alleged “Jain has himself admitted that Rs 300 crore have been allocated to procure medicines. The Delhi government boasts of having the highest budget earmarked for the health sector. In such a scenario, how come there is a shortage of medicines? This is a scam.”

The Anti Corruption Branch (ACB) had then carried out searches at various locations in Delhi after Mishra filed a formal complaint.

‘Dubious purchases’ 

The procurement of H1N1 vaccines by the health department in 2015 to prevent Swine flu from breaking out in the Capital are also under scanner, with the purchases made without any approval of the competent authorities. The purchase of vaccines worth Rs 4 crore were not done through any advertisement, a process which must be followed if the procurement exceeds the estimated value of Rs 25 lakh. 

Similarly, the NSI detection Antigent Kit by ELISA for dengue, were issued to the Centre-funded and autonomous hospitals by the department but the payment has not been reimbursed to the CPA, hence causing a loss to the Delhi government. The audit report states the kits were issued to AIIMS, RML, Kasturba Hospital, Hindu Rao and Safdarjung in 2016 for around Rs 7 lakh. 

“The CPA may recover the amount and also formulate a comprehensive standard operating procedure to streamline the process,” the audit report stated.

THE VALUE OF HEALTH

• 171 out of 10 operation theatres are fully-functional in govt hospitals
   
• Rs 3 crore is the recovery amount that a report by the audit dept hints at 
   
• Rs 4 crore were spent by the health dept in procurring H1N1 vaccines in 2015
   
• Rs 7 lakh were spent in procurement of the NSI detection Antigent Kits

WHAT IS CPA?

The CPA was established in 1993 under the Drug Control Department of the Delhi government. The objective of forming CPA was to procure drugs and other related items required by the dispensaries and hospitals run by the state government on a centralised basis

WHY CPA CRASHED IN THE CAPITAL

Delhi Chief Minister Arvind Kejriwal, in April, expressed displeasure over the non-functional OTs and shortage of equipment in the govt hospitals. In an inspection, it was found that procurement of the same equipment by different hospitals had vastly differing time frames

HIGHLIGHTS FROM THE AUDIT REPORT

The procurement of H1N1 vaccines by the health department in 2015 to prevent Swine flu outbreak in the Capital are also under scanner with the purchases made without any approval of the competent authorities. The purchase of vaccines worth Rs 4 crore were not done through any advertisement, a process which must be followed if the procurement exceeds the estimated value of Rs 25 lakh 

Similarly, the NSI detection Antigent Kits by ELISA for dengue, were issued to the Centre-funded and autonomous hospitals by the department but the payment has not been reimbursed to the CPA, hence causing a loss to the Delhi government. The audit report states the kits were issued to AIIMS, RML, Kasturba hospital, Hindu Rao and Safdarjung in 2016 for around Rs 7 lakh

FACTS

37 
There are 37 state government hospitals in Delhi

The AAP government, in last two years, had come out with many new initiatives to solve the health crisis in the Capital. Increasing the OPD timings, making radiology tests free and introducing the concept of Mohalla clinics were some of the innovative moves suggested by the state government

Many hospitals still complain about shortage of life-saving drugs and essential equipment. The government had formed a Central Procurement Agency (CPA) in 2015 to cater to ease out the purchasing process. For every medicine or a equipment, the hospitals had to put in a demand through the central agency

The procurement  agency, however, did not receive a positive response from the hospitals. Sources in various government hospitals alleged that the agency had failed to fulfill the demands. Even the director of the agency was changed twice as the hospitals complained about the unmet demands 

The CPA was established in 1993 under the Drug Control Department of the Delhi government. Later on, it was observed that two departments — Drug Control and CPA —could not function under one chief. Hence, CPA was transferred to the Directorate of Health Services. The objective of forming CPA was to procure drugs and other related items required by the dispensaries and hospitals run by the state government on a centralised basis 

The health department recently informed Delhi Chief Minister Arvind Kejriwal that out of 190 OTs in Delhi government hospitals, only 171 were fully functional

It (Central Procurement Agency) was a failed experiment. It is now under CBI scanner after the audit department smelled a rat in its functioning
Senior official, Delhi govt’s health dept

The purpose of setting up a CPA was defeated every time we purchased medicines on our own. The wait to get the equipment and medicines was getting longer day-by-day
Senior doctor, govt hospital

The expiry of medicine (3,400 bottles of eye drops) is due to unplanned procurement at CPA and not the non-issuance of stock to hospitals before its expiry
Report, Delhi govt’s audit dept