039. Kerala's E-Health In Dark Shadows

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Kerala’s E-Health In Dark Shadows

By Special Correspondent

E Health is new to Kerala State in India and, considering the strange avenues into which massive corruption has penetrated into, we have decided to closely follow the state’s activities in this field from the very beginning to as far as we can follow in time and space such that when something happens good or bad, no one will have to wonder. When corruption occurs in large scale in this field which surely will and e-health in Kerala reported to be in shambles and disarray, there will certainly be investigations but within that time, millions of rupees will have gone. We wish to report things from the beginning so that we can pinpoint persons who were responsible when considerable amounts money are lost from public funds. We certainly will have repercussions, oppositions and even retaliation from those involved, which we do expect, which also we hope to report through these pages.

The centres of activities in implementing this project in Kerala are the Health Secretary’s office in Government of Kerala in the Secretariate, the Directorate of Health Services and the Mission Directorate of the National Rural Health Mission, all situated in Trivandrum. The first thing which was got done by those involved was getting prepared a report on the possibilities and scope of implementing e-health in Kerala which, we believe, was commissioned out to persons not in this field. This report got approved and then what we heard was media news about some funds being brought to Kerala, allocated by the Government of India. (We, in these columns earlier have reported the same). Some reported it to be 97 crores and some said it was only 92 crores but all wondered in secret where the balance did go, considering the usual rate of ten percent realized by political agents in India for getting a project approved and financed. Government of India usually allots 100 crores. It is inconceivable that the full amount reached Kerala, if it did, in contradiction to North Indian standards. Or has our country progressed beyond being a puritan state?

All digital health activities in a state will have to be controlled and monitored from a single centre, to minimize theft of confidential patient data which is costly and which would be beneficial to a multitude of commercial organizations from insurance companies to health psychic predictors. We will be startled at the incompetence and lack of imagination with which the Directorate of Health Services operates its own simple website, let alone the massive and complicated encrypted data flow in connection with e-health governance. It is a crude website where people cannot interact; data are scanty, incomplete and unreliable, what shall be there is not there and what shall not be there is there, data never updated since inception and pages will not open and if they open will have only a few irrelevant sentences. We enquired and learned that there was no one there to do these things except temporary hands lent by peripheral institutions. No one can believe that such gross neglect and ignorance can be engaged to monitor the digital clinical maneuvers in the whole state, unless the same is outsourced-something feared in even England, United States, France and Germany. Insurance companies alone will spend a million dollars to see central stores of people’s health data established. Let us take the example of the E-Health Link in the DHS’ web site:

Since the starting of this digital front of the state’s health in 2013, the E-Health link remains skeletally maintained and laughable; it has no important data or information to display. See a snap-shot of this page as on 19 March 2014 which is self-revealing. There is not mention of the important things in the field that have happened! The importance is laid not in enlightening people on this new subject which even these ‘authorities’ know nothing about and which is going to affect people’s lives every way, but on how the 92 crores could be spent safely without public interference.

An Expression of Interest in May 2013, an inevitable corrigendum six days after, four ridiculous queries the same month- this was all. And it was the month of the greatest digital activity in this Directorate- or that was what they wished to make public. Five Months later, in October 2013, there was application invited for the post of Manager but no mention of who applied for and who was selected.  

The Expression of Interest was posted on 3 May 2013 with a deadline on 18 October 2013 with no mention after the deadline of who expressed interest and who were approved and short-listed. Note that this was a period in Kerala when the greatest number of fraudulent people and organizations submitted bids and took part or collaborated in heavily-funded government projects, with Solar Scam in the lead. No wonder the names of people who expressed interest in government’s e-health project could not be publicized!

Things are dubious and large amounts of public money are involved. Why permit them to steal away people’s money in leisure instead of going after them and following every move? We know that there is a Vigilance Wing in the Directorate of Health Services, administered by an Additional Director of Health Services who does nothing but hunt petty lowly employees like Hospital Attendants, Nursing Assistants, Nurses and Clerks. How many doctors and officers of authority did they found out guilty and charged in the past 25 years? Their main duty is to hand over the names of those who report corruption and misdeeds to reported culprits, their actual subordinates! Never did they detect something in their own initiative without someone reporting or complaining. That is the same situation with the government’s vigilance department. No one in vigilance detects something on their own account. Everything has to be detected by people or newspaper reporters and details conveyed to them. Then they will investigate, reluctantly.

So it is now our own duty to detect and report, which we shall do; let us see what they do to charge-sheet and punish them, if there happens to be something punishable. We, decided to follow two routes- private investigation and the broad route of the Right to Information Act. What our private investigations revealed shall be reported to you readers later in its time but we find it nothing inappropriate to publish in time to time what we found out via the broad path.

Here is our original Registered Letter to the concerned Public Information Officers on 20 March 2014. We think these questions we asked are pertinent, which everybody may wish to ask:

Application for information under the Right to Information Act

To

The Public Information Officer,

Government of Kerala, Secretariate, Trivandrum.

Department of Health and Family Welfare,

Government of Kerala, Secretariate, Trivandrum.
Directorate of Health Services, Trivandrum.
Directorate of National Rural Health Mission, Trivandrum.

Dear Sir,

I request you to kindly make available to me under the Right to Information Act, in writing, the following information which is not classified, within the prescribed time limit. I have affixed Rs.10/ worth of Court Fee Stamps as fees.

Does Kerala State Government wish to implement E Health in Kerala?

If yes, which are the agencies/offices through which it is to be implemented? Have the Government of Kerala Collaborators/ Nodal Agencies for formulating/implementing this project?

Did Government of Kerala or any of its departments/offices/collaborators receive any funds from anywhere for formulating, developing or implementing E Health project, and if so, who is the custodian of this fund? Please give name and full official and postal address.

If funds were received or offered, which were the sources of such funds? Please give specific details of communications allowing/releasing/offering of such funds.

Were any amounts from the funds transferred to any individuals/ establishments/ organizations on account of fees, services, salaries, honorarium and/or allowances? If so, please give the mode of payment, their names and full postal addresses and reasons for transfer of money, along with details of cheques, demand drafts and acquittances.

Were any advertisements given in any media inviting Expression of Interest on this project, and if so, where? What were the dead lines and who were the persons/institutions/organizations who expressed their interest? Please give full postal addresses.

Did the names and addresses of those who expressed interest in the project published in media where the original invitation for EOI was advertised, and if not, why? Where else was it published?

Which are the posts created for implementing this project? Please give full pay scales, incentives and other perks.

Where were advertisements inviting applications to these posts published? Please give specific links and dead lines.

Who were selected for each post? Please give their names, full postal addresses and the last institutions where they served with name of designation and period of service there. Were their names and posts published anywhere?

Which posts are yet/proposed to be created in connection with this project and when and where are they going to be advertised?

Please include names and addresses of Appealing Authorities also in your reply.

Sincerely Yours,

P.S.Remesh Chandran, Padmalayam, Nanniyode,
Pacha Post, Trivandrum-695562, Kerala.
Dated: 20 March 2014.

We sent these requests by registered post, and they have 30 days time to give us their answer, if they give in time which is unusual. We will wait and post their replies here, along with papers of appeal if it goes up to there. Meanwhile we will see what other things happen in this field.

Here is a book being announced and we would like to add excerpts from the book here for the readers’ knowledge:

The RTI Letter we sent to The Public Information Officer, Government of Kerala, Secretariate, Trivandrum was returned by the Indian Postal Department, with the endorsement, ‘Not Sufficient Address’ and not with ‘There Is No Such Addressee’. We know government functions through its various departments, but why as a single entity government did not appoint a Public Information Officer? It is dubious. A delivery postman, as per rules, cannot determine in his office whether the designation exists or not or whether the concerned officer would accept it or not, provided the name of the government office and the place where it functions is printed in the address. He certainly has to take the letter to that office. So we shall assume the postman did take the letter to the office but the officer-in-charge declined to accept the letter. What right has a government officer to reject a letter from a citizen addressed to government, on the basis of whatever technical grounds? Even if a citizen does not mention the Right to Information Act in his letter, is not the government liable to convey the information he requested?

The Department of Health and Family Welfare sent a reply signed by one Mr. Sudarsanan, Additional Secretary, which stated that ‘the Government of Kerala implemented the e-health through the National Rural Health Mission and details are available with them’. Does not this department have a Public Relation Officer to reply to RTI letters and why is that designation absent in this reply? He did convey information on point number 1 but omitted point numbers 2 to 10. If government is implementing E-Health in Kerala, why are not details available with Government of Kerala but only with NRHM which is not Kerala Government’s? What kind of a government and what kind of an administration is that? Why are details not available in Secretariate, the seat of government? Are details of E Health available in Secretariate or not? Or is this dubiousness to hide facts or prevent contradictory information from being released from two sources, i.e. from Government and NRHM? These are the usual questions which rise in the minds of common man. We are certainly raising these issues of discrepancy with this department’s Appellate Authority. We are credibly informed that the bids mentioned in the beginning are being finalized on the extended date and things are being kept secret till then.

Shady Recruitment Procedures Adopted For Several E Health Posts.

Dubious advertisements appeared in equally dubious places, inviting applications to these posts. In one place, the How to Apply link leads to admissions section of the Manipal University and the CLICK HERE MORE DETAILS FOR THIS JOB link leads to http://dhs.kerala.gov.in/index.php/transfer where there is nothing about these posts. The DHS, NRHM and Arogya Keralam have nothing to show on these posts in their websites. It is an old trick- to advertise in places where no one will look and even if someone looks there, the links shall lead to nowhere. It is clear these posts are reserved for favourites, to be recruited through shadow agencies. And the posts do have handsome salary packages, in Kerala standards.

1. Finance Manager 50,000

2. Administration Manager 50,000

3. Technical Manager 50,000

4. Manager (Change Management) 50,000

5. Asst. Manager (Finance) 30,000

6. Asst. Manager (Admn) 30,000

7. Office Assistant 15,000

The following was one of the advertisements (or the only advertisement?) for these posts in e-health. It was online and it appeared in one of the shadiest of places:

‘Directorate of Health Services (DHS Kerala) hiring Managers & Office Assistant (CA/ ICWA, B Tech/ MCA, MBBS, B Com, Any Degree holders). Applications are invited for the following posts in the eHealth Project Management Unit (eHealth PMU) on contract/deputation basis. The contract basis appointment will be for a period of two years. Deputation basis appointments will be based on Government rules. Maximum age limit for posts 1 to 6 is 58 years and for post 7 is 40 years as on 01-01-2014. All the postings will be in Thiruvananthapuram.

Company Name: Directorate of Health Services (DHS Kerala)

Position: Managers & Office Assistant

Education: CA/ ICWA, B Tech/ MCA, MBBS, B Com, Any Degree

Experience: 3-10 yrs

Location: Kerala 

Applications may be send to State Mission Director, NRHM, General Hospital Junction, Trivandrum – 35 so as to reach the office on or before 12-03-2014.’

http://www.hirelateral.com/directorate-of-health-services-dhs-kerala-hiring-managers-office-assistant/

Who make money and who use government projects to do favours and repay favours received? So, that's why this great reluctance in conveying information under the right to information act. If what usually happens in Kerala happens in this project also, we will see that the relatives of the very authorities who were bound to give information out were undergoing the recruitment process. 

Updated as on 26 April 2014, 02:35 PM

So, as we feared, government do not know who the custodian of the 92 crores they gave is. The NRHM Directorate also does not know who the custodian of this amount is and how it is spent. See the reply from Smt. Vijayalekshmi P. Nair, Senior Administrative Assistant. We have to wait for months for an information which is available under the roof of a building adjacent to her own office building.

Updated as on 30 April 2014, 12:47 AM

Will continue.....Visit again

020. Silent Genocide: Kerala's Health Model Has Failed In Tribal Heartland

Silent Genocide: Kerala's Health Model Has Failed In Tribal Heartland

By Cracktivist.Wordpress.Com

22 May 2013 

B. Ekbal, public health activist and neurosurgeon, who headed a six-member medical expert team appointed by the Communist Party of India (Marxist) to study the health problems faced by the tribal people of Attappady, has said that “what the team saw in this tribal heartland is silent genocide.” The team has been sent to study the problems and suggest remedial measures as 48 tribal infants died of malnutrition during the past 16 months in the hill region.

Addressing presspersons here on Tuesday, he said: “The tribal population is facing extinction in Attappady. If the government does not intervene to stop this genocide, it will remain a black mark on Kerala society.” He said such a grave situation had not developed suddenly, but over many years. So no particular government or political party was to blame. Everybody was responsible for this deteriorating situation. He said the medical team, during its two-day visit to the tribal hamlets, found that 99 per cent of the tribal women were anaemic. Almost all tribal children were malnourished.

Dr. Ekbal said the Kerala health model had failed in Attappady. He would no more speak about the model, which claimed that the State had achieved health standards on a par with those of some developed nations. But in Attappady, the health standards were much below the average health indicators of India. The infant mortality rate in Attappady was 66 per 1,000 births as against the national average of 40. He said intervening in the health sector alone would be insufficient to address the grave situation in the tribal area. An integrated approach covering other sectors too was required. He urged Chief Minister Oommen Chandy to appoint a young, dynamic IAS officer to coordinate the works of various departments in Attappady to implement the various special packages announced by the government.

No co-ordination

He said that what one could see was total anarchy in Attappady. There was no coordination among the various departments and the three grama panchayats to take urgent steps to provide relief in this emergency situation. He said that tribal people were supplied the Matta variety of rice through ration shops, which they did not eat. They should be supplied their traditional food. Thus, there should be structural changes in the rationing system. Nutritious food such as milk, egg and bananas should be directly supplied to the Anganwadis. Accredited social health activists, Anganwadi workers and Integrated Child Development Scheme promoters should be given reorientation training to take up new challenges in Attappady.

The Mahatma Gandhi National Rural Employment Guarantee Scheme should be restarted in Attappady to provide employment to the tribal population. The tribal people should be brought back to their traditional agriculture, which had ensured food security to them. The Right to Forest Act should be implemented in Attappady to provide land to landless people. It was only in Kerala that the Act had not been implemented.

Link:
http://kractivist.wordpress.com/2013/05/22/silent-genocide-kerala-health-model-has-failed-in-tribal-heartland/


Republished here by courtesy of:Cracktivist.Wordpress.Com

019. Kerala Struck By Jaundice And Dengue

Kerala struck by jaundice and dengue

By India.com Health

June 5, 2013 

Nine people have died of fever in Kerala and 14,000 new cases, including those of jaundice and dengue, have been reported from across the state, an official said on Tuesday. Thiruvananthapuram has reported the highest number of such cases. More than 2,000 fresh cases have been reported from the hilly district of Wayanad. At least 91 people Monday tested positive for dengue. Nine people died Monday, and 14,000 new cases were reported, the official said. ‘The health department has now come out with guidelines for the doctors for treating fever… depending on their condition,’ said state Health Minister V.S. Sivakumar.

‘Three categories A, B and C have been drawn up. Those in the C category have to get treated from any of the state-run medical colleges. The medical professionals will now go according to the protocol that has been published,’ Sivakumar said. For each of the district medical officers Rs.7 lakh has been allocated to tackle the outbreak of the disease. ‘The chief minister is calling a special meeting to discuss this issue Tuesday and all the legislators (140) have been asked to call a meeting in their respective constituencies before the 10th of this month to get a first-hand information on the steps taken to address the issue,’ said an official attached to Chief Minister Oommen Chandy’s office.

State secretary of Communist Party of India-Marxist Pinarayi Vijayan slammed the government for not coming out with effective steps to contain the spread of fever. ‘The health of the people is an important factor for the overall health of the state. Kerala’s acclaimed health status has taken a beating… as no scientific method of waste disposal has been commissioned… even after this government completed two years in office,’ said Vijayan. Monday night, a premier private hospital in the state was refusing to take in more patients.

‘What can we do, even the corridors are full of patients and we have outlived our capacity and hence we have no other go,’ said the director of the hospital. Chandy has expressed his helplessness in finding a solution for waste disposal because all the past efforts of successive governments failed and people do not have faith in any model. He has formed a special cabinet subcommittee to tackle the waste issue and with the assembly session coming up on the 10th of this month, the Left opposition is certain to nail the Chandy government.

Source: IANS

Link:
http://health.india.com/news/kerala-struck-by-jaundice-and-dengue/

Republished here by courtesy of: Health. India. Com

018. Cities In Kerala Have Low Doctor Density

Cities in Kerala have low doctor density: Study

By The Hindu Business Line

P.T.Jyothi Datta
Mumbai, 31 July 2013

Cities like Malappuram, Kannur and Thrissur in Kerala share a common trait with Dhanbad in Jharkhand — they have a low density of doctors, reveals a study by IMS Health. Compared to Gurgaon that has three doctors per 1,000 patients, some cities in Kerala have less than one doctor for 1,000 patients, said the study that covered 120 top cities in the country, mapping the details of their doctors and chemists. Explaining the findings, against the backdrop of Kerala’s strong health indicators, Amit Backliwal, Managing Director of IMS Health (South Asia), said that low density did not necessarily translate into health indicators in the State. Kerala’s literacy, awareness and hygiene levels, for instance, also contributed to its strong health indicators.

New methods

In fact, even within cities there is a skew, where the doctors or healthcare providers sit, and patients have to travel to them. What needs to be done is to device methods to take healthcare to patients through other methods, including tele-medicine etc, he said. Kumar Hinduja, a Senior Director with IMS Health, further points out that low doctor density also presents an opportunity for setting up hospitals, for instance. Absence of doctors in the vicinity would result in people travelling out of the city for treatment.

The global parameter is 1.2 doctors for 1,000 people. And while the study found that 76 of these top cities were comparable, it meant 44 were below this parameter, and this further meant that other smaller cities could be in a similar situation, he observed.

Other interesting insights from the study were that North India was “over-served” by the healthcare system, compared to East and South India, that have a lower density of general practitioners (GPs- non-MBBS), compared to the Indian average, the study said. Explaining non-MBBS, he said it included practitioners of other forms of medicine, who also prescribed allopathic drugs.

High doctor fees

Cities in North India account for 31 per cent of doctors in the country, but only 28 per cent of the country’s people reside there. Delhi has the highest number of doctors, at about 40,500, the All India Institute of Medical Sciences being a huge magnet, they said. Kolkata and Mumbai were neck-to-neck at over 30,000 doctors, Hinduja said.

But Mumbaikars paid the highest doctor consultation fee, about 20 per cent higher than the rest of the country, the study found, for predictable reasons like the high realty cost, among other things. Interestingly, less than three per cent of doctors surveyed where tech-savvy, or used technology to maintain medical records.

Chemists’ sales

In other findings, the study found that 42 per cent of chemists in India were in the top nine most populated cities and 29 per cent of chemists’ sales were done without prescription. Over 35 per cent of chemists’ sales came from non-pharma products, such as over-the-counter products and medical devices like glucometers to check blood-sugar and blood pressure monitors, for instance.

Link:http://www.thehindubusinessline.com/news/cities-in-kerala-have-low-doctor-density-study/article4973208.ece

Republished here by courtesy of: The Hindu. Business Line

017. Blood Banks In Kerala Function Without Licenses, No Inspection For Years

Blood banks in Kerala function without licenses, no inspection for last 10 years

By Pharma Biz.Com

Peethaambaran Kunnathoor, Chennai
August 22, 2013

More than 160 blood banks and 50 blood storage centres in Kerala are working without licenses for the last ten years as these units did not receive their renewed licenses and no inspection has been carried out in these units during the last several years, thanks to the apathy of the Central Drugs Standard Control Organisation (CDSCO). The renewal applications of these units are pending with the drug authorities for long time, it is learnt. The AG’s and CAG’s reports had also carried remarks about the pending of renewal applications of blood banks with the drug control authorities and lack of inspections in these centres. According to sources, if inspections are not carried out on time, the entire operations of the blood banks are likely to fall in total fiasco. In Kerala, joint inspections were not conducted in two terms of renewal periods, in 2007 and 2012. The state authorities alone cannot do anything in the case of blood banks as it mandates a combined team of central and state agencies to inspect the units. As per the letter given to the comptroller and auditor general of India (CAG) by the state drug control authorities, the reason for the long delay is the non-cooperation from the side of CDSCO’s Chennai office. Sources said the Chennai office is not concerned about the seriousness of Kerala’s problems, so renewal applications of 161 blood banks are pending with the state drug control (DC) department. When contacted, sources in the state DC department said a total of 161 blood banks are working in Kerala, out of which 33 units are functioning under government control, and 128 in the private sector. The number of blood storage centres is 50. “We are forwarding all the applications to the CDSCO Chennai office as soon as we receive them. But they are not responding to our letters. The renewal of licences of blood banks is done after a combined inspection of officials from central and state departments. We have informed the matter to the CAG also,” said B Hariprasad, drugs controller of Kerala. To a question whether the units can function without renewing their licences, the DC said the blood bank units are doing the procedures for renewal properly. They can continue functioning after submitting the application. But it is the duty of the inspecting agencies to conduct inspection and issue licenses. He said more than 50 applications for fresh licenses are also pending with the office. All the attempts to contact the CDSCO officers were failed. There is report that the central office has no sufficient staff to carry out all the work on time.

Link: http://www.pharmabiz.com/NewsDetails.aspx?aid=77257&sid=1

Republished here by courtesy of: Pharma Biz. Com

007. Alleged Health Corruption Scam Rocks Kerala Assembly

Alleged health corruption scam rocks Kerala assembly

By Two Circles Net

3 March 2009
Via IANS
 

Thiruvananthapuram : The Kerala assembly was Tuesday rocked by a heated debate over a media report that alleged corruption in the medical department, following which the entire opposition staged a walkout.

Health Minister P.K. Sreemathy denied all allegations of corruption that were leveled by the popular Malayala Manorama daily and its sister concern MMTV.

"It has not even been a year since the KMSC (Kerala Medical Service Corporation) replaced the five decade old Central Purchase Committee but it is continuously been attacked. The Manorama has been particularly harsh on it by making baseless allegations," said Sreemathy.

Since the past week, the Malayala Manorama group has been publihsing reports on how drugs are being purchased by the government from some blacklisted pharmaceutical companies.

"The rules are very clear. Only medicines that are found wanting in quality are blacklisted and not the companies that produce it. The media should behave more responsibly," added Sreemathy.

However, Congress leader V.D. Satheesan said one particular company whose product was blacklisted was allowed to supply the same drug.

"The sad fact is that KMSC officials have requested the state government to hold a vigilance inquiry against the media, which has uncovered the corruption. And this decision was taken in the presence of the health minister. A vigilance inquiry can be initiated only against public servants," said Satheesan, whose leave for adjournment was disallowed.

Opposition leader Oommen Chandy said that if the Malayala Manorama report is wrong, the government should file a defamation suit.

"We want to ask Chief Minister V.S.Achuthanandan if the government intends to gag the media and if they plan to launch a vigilance inquiry," asked Chandy.

Intervening in the debate, Achuthanandan made it clear that his government has no plans of ordering a vigilance inquiry against the media.

However, Chandy led the entire opposition out of the assembly since he said Sreemathy's explanation was not adequate.

Mathews Varghese, associate editor of Malayala Manorama, told IANS that they stand by their report.

"The sting operation that we did was just meant to bring out corruption in its original form after we received several complaints about the manner in which the KSMC is being run," said Varghese.

Link: http://twocircles.net/2009mar03/alleged_corruption_scam_rocks_kerala_assembly.html

Republished here by courtesy of: Two Circles Net.

006. Unethical Behaviour And Corruption In Clinical Drug Trials In Kerala

Corruption and unethical behavior in clinical drug trials in Kerala.

By PARTNERSHIP FOR TRANSPARENCY FUND. 

Inadequate rules and regulations and poor or no government enforcement of these rules within the sector of clinical drug trials in Kerala State, India, have led a local CSO, JANANEETHI, to start investigating the field and research structural flaws that violate human rights and result in poor delivery of public health services. Through its actions, Jananeethi has successfully engaged authorities to take up the issue and create awareness among stakeholders. Closing loopholes, eliciting an ethics debate and prompting government agencies to enforce and oversee drug trials have rendered Jananeethi’s intervention highly successful. A second phase of the project is under way.

India has become a global hub for clinical drug trials on human subjects, reportedly worth $400 million USD and growing by over 30% per year. Until the 1990s, most clinical research was carried out in academic medical centers and financed by the Government. Recently, commercial interests have started dominating the drug trial scene in which the financial bottom-line can override ethical and human rights concerns. A number of factors are responsible for the current increase in drug trials conducted in India. These include the low cost of experiments, almost 60% less than comparable trials in Europe or the US, and access to a large pool of illiterate and relatively less educated patients with a wide variety of diseases. Trials became easier after the 2005 amendment of the Drugs and Cosmetics Act of 1940 permitting concurrent trials. These factors and the absence of specific laws to protect patients have lead to widespread corruption in clinical drug trials.

Rampant corruption has been alleged from the highest policy level down to local institutions. The regulatory mechanism is steered from the drug controller’s office at the center with little involvement and control at the local levels. Bio-equivalence trials offer participants large payments in violation of existing ethical guidelines inducing poor people to risk their lives. At present, sound and ethical clinical trials depends mostly on personal integrity and honesty of the investigator concerned. While corruption is so widespread, there are no specific laws to prosecute illegal or unethical activities. 

Actions Taken by Jananeethi.

During the first phase of the project, Jananeethi focused on identifying the problems in drug trials and the underlying structural weaknesses in the regulatory system. It identified five participants of drug trials and recorded their experience. In continuation, the CSO identified the weaknesses in the regulatory mechanism through personal interviews conducted with members of a variety of institutions, including medical colleges; ethics review boards, hospitals, staff and doctors responsible for the trials and others working on ethical standards of drug trials. The research exposed serious shortcomings and loopholes.

Jananeethi felt that the Government of India had aggressively encouraged foreign drug trials without establishing necessary protective measures and without guaranteeing inadequate effective regulatory mechanisms. 

Jananeethi also felt that the Central Drugs Standard Control Organization (CDSCO), the principal regulatory agency, lacked capacity and/or the will to carry out its functions including the scientific review of trial protocols and monitoring the conduct of trials. Ethics committees were not adequately equipped or trained nor were they held accountable for their decisions. The confidentiality clause in the Indian Council for Medical Research (ICMR) guidelines indemnified the researchers who violated ethical norms and good practices while not protecting the privacy of trial participants. Physicians received huge incentives and payments to recruit trial subjects. Often patients would not know they were being used as test cases. Simultaneously, necessary medical treatments and compensations were denied or withheld for a growing number of trial related injuries and deaths occurring among the test population.

Jananeethi has published a handbook on ethical standards of clinical trials for capacity-building purposes and undertook awareness raising activities with the full range of stakeholders involved, including briefing media representatives aiming to launch a state wide campaign on appropriate practices and ethical standards for drug trials reaching out to the public through radio programs, television and other media.

The CSO also reinforced existent outreach to medical professionals and members of various ethics committees, awareness raising classes for medical students and other affected parties. Project activities furthermore included: advocacy through presentations to government officials, Members of Parliament, the State Legislative Assembly and heads of medical institutions; select monitoring of drug trial activities; and coalition building among concerned institutions.

All these activities will be reinforced and strengthened in a follow-up to the first project phase to ensure sustainable results and make use of the successfully created momentum.

Impact and Results Achieved.

Jananeethi has successfully carried out an extensive investigation and has brought to surface the serious shortcomings, malpractices and violations of guidelines in the fast growing business of clinical drug trials in India. Its research has also shown that while there were a few guidelines, no specific law existed to enforce them and punish violators.

Jananeethi has been highly successful in elevating the issue of corruption in drug trials to the national level. As a result, Jananeethi was contacted and has submitted a report to the Human Rights Commission which is investigating rights violations in drug trials. Jananeethi also participated in the first ever national consultation on the regulation of clinical trials which was held in collaboration with representatives from ICMR, World Health Organization, CDSCO, international medical research organizations and members of a Parliamentary Committee. While there was initial resistance on behalf of the authorities at first, constant pursuance and endurance on behalf of Jananeethi has prompted officials as well as doctors and other stakeholders to constructively engage with the project and start furthering its objectives of realizing safe and ethical drug-testing.

Jananeethi has succeeded as a whistle blower in Kerala, publicly challenging and protesting corrupt practices in drug trials. Jananeethi was promised by the Health Secretary of Kerala that strict measures would be taken to respect ethical practices in drug trials. The second phase is expected to create further results in awareness building through campaigning for sound ethical practices under international accepted norms in clinical drug trials.

Link: http://ptfund.org/2012/04/corruption-drug-trials-kerala-india/

Republished here by courtesy of: Partnership For Transparency Fund.

005. Lack Of Accountability Of Medical Practitioners In India And Corruption

Corruption in health care and lack of accountability of medical practitioners in India

By Instablogs.com

It is sad that Mr. Gulam Nabi Azad, our Hon’ble Health Minister not much active in handling various grievances of public domain and addressing the corruption in health sector. This is the vast area which need to be addressed by the UPA II urgently. The corruption from the date of entrance/ admission for a student. Most of the doctors today doing pharmacist job and even a better salesman can give good medicine compare to a doctor in India. The corruption in pharma sector is alarmingly increasing day by day and doctors-pharma companies-hospital nexus come out with new methods every day and it is very difficult to nab them. The doctor-patient relation is reached worst ever. Just to grab the money, doctors and hospital authorities prescribe unwanted medicines, unwanted tests (even one lab test not admissible to other doctors, the reason they only known, may be commission is the reason), lack of standard in testing lab, fake expensive medicines prescribing by doctors to intentionally complicating and troubling patient to increase their problem, so more problem, more money that is the method adopted by doctors nowadays. Earlier one doctor used to handle all the human body. Now the new avatar of specialists making the matter more complicated and earning much more than the good doctors.

They never prescribe low cost generic medicines and they prescribe high expensive multinational’s medicines with various unwanted testings and this way apart from their fees, they are taking lots of commission. There is also fake drugs in famous labels, even in generic medicines available in the market.

There is no policy and control over drug pricing in India. Cancer like disease the price of drugs even not affordable to upper segment of the society. A comprehensive drug pricing policy need to bring and giving compulsory and free licencing to Indian pharmaceuticals to reduce the drug prices. Some countries like Venezuela etc. adopted such system to make more affordable on medicine.

Govt. need to form a specialized body inviting public suggestion and find ways and means in redressing the unredressed grievances of the public at large. In India, it is difficult to find fault on the doctor, and always patients and their relatives are blamed, with no fault on their part. Doctors even by law are well protected while poor patients despite spending lots of money, have to face the music of hospital authorities and doctors. They always behave like a god like manner and the victim is most of the time treated (especially in major disease admitted to hospital) like a convict in Tihar jail. Most of the time, the relatives don’t have the access to the victim patient and hospital authorities use every trick to grab the money by admitting in ICU, putting in oxygen mask and even kill the patient. Even after killing the poor victim patient, they keep the body even for one or two days more on ventilator.

The readers think that this is a cooked story. My family members faced similar experience at my native place i.e. my brother in law’s wife admitted for delivery at Divine Hospital, in Trichur Dist, Kerala. Delivery was normal. To grab the money by hospital authorities, they did not care the child despite repeated request to due to carelessness, the child died. The child did not give a single drop for more than 12 hours. When the child lost the control, they admitted to ICU and killed there. The dead body kept for many hours and at midnight 3.00 O clock, they told to take the child to any big hospital. Their ambulance left with oxygen mask left to a big Jubilee Mission Hospital. There the India’s leading gynecologist a foreign told my brother how you brought the dead body to their hospital. The child already dead for more than 5 hours, says in Hospital itself. Doctor immediately understood the foul play and he told that there was some foul play. In any case, during pregnancy, there was no symptom of any difficult to the child and the child was very healthy and active at the time of delivery even before delivery. Child specialists saying that there should be always a system if there is any trouble to child.

There are many such incidents, I witnessed in life while dealing with doctor. State and central govt. come out with better legislation and bring transparency and accountability on health sector and doctors and hospital authorities made accountable and make awareness of public their basic rights while dealing with doctors.

Link: http://www.instablogs.com/corruption-in-health-care-and-lack-of-accountability-of-medical-practitioners-in-india.html

Republished here by courtesy of: Insta Blogs Dot Com.

004. Health Director To Be Removed From Post

Health Director to be removed from post.


By Newz First
 
Thiruvananthapuram
11 Nov 2009

Kerala Health department has decided to remove K Shylaja, Director of Health Services (DHS), from her post after Vigilance department initiated steps to prosecute her in a corruption case involving purchase of medicines in 2002.

The Vigilance case was that Shylaja, who was the then District Medical Officer here, and the then DHS VK Rajan had purchased hepatitis-B vaccine in excess of the required quantity, causing a loss of Rs 1.9 crore to the department. Rajan is the first accused in the case and Shylaja, the second accused.

Sources at the office of the Health Minster said it would not be proper to allow her to continue in the post of DHS in the wake of Vigilance department's decision last month to prosecute her. She would be shifted to the state AIDS control society as its director, the sources said.

Link: http://www.newzfirst.com/web/guest/full-story/-/asset_publisher/Qd8l/content/health-director-to-be-removed-from-post?redirect=/web/guest/health

Republished here by courtesy of: Newz First Dot Com.

002. Kerala Health Minister Resigns From Cabinet

Kerala Health Minister Resigns From Cabinet 

By Press Trust of India

Thiruvananthapuram, 13 January 2006

Kerala Health Minister KK Ramachandran on Friday submitted his resignation to Chief Minister Oommen Chandy following allegations against him and his office. The allegations were that the Minister and his office had threatened some officials who had given statements to the Lok Ayukta in connection with a case relating to alleged corruption in transfers and postings in the health department. 

While disclosing that he had received the Minister's resignation letter, Chandy said a decision on it would be taken after consultation with his senior party colleagues.

Defending his beleaguered colleague, Chandy said he was convinced that Ramachandran did not commit any irregularity, as it was evident from the report given by IG, South Zone, who was asked to probe the facts regarding the charges made against the Minister.

The Chief Minister, however, said the probe had found that an Additional Personal Secretary (APS) in the minister's office had spoken to the District Medical Officer (DMO) in Wayanad in "a threatening voice."

The Minister had been asked to drop the APS from his personal staff.

Ramachandran's position became untenable after a television channel today aired the audiotape of a telephonic conservation he purportedly had with DMO in Wayanad, Raveendran, in which the minister sought to know about the statement he had given to the Lok Ayukta.

Link: http://www.hindustantimes.com/News-Feed/NM5/Kerala-Health-Minister-resigns-from-cabinet/Article1-51265.aspx

Republished here by courtesy of: The Hindustan Times Dot Com.

001. Probe Corruption In Health Department. The Hindu.

Probe Corruption In Health Department

By The Hindu.

THIRUVANANTHAPURAM: The Leader of the Opposition, V. S. Achuthanandan, has urged the Chief Minister, Oommen Chandy, to conduct an inquiry by an independent agency into the `grave' instances of corruption in the Health Department. 

In a letter to the Chief Minister, released for publication on Wednesday, Mr. Chandy said that corruption was rampant in the department in purchase of medicines and equipment and appointment and transfer of doctors. He alleged that there was large-scale corruption in the inclusion of seven new companies after opening the tenders for drug supply and subsequent purchase of drugs from these companies at prices that were 50 to 81 per cent higher than those permissible under the stores purchase norms. 

He alleged corruption in appointment and transfer of doctors and said Rs. 1.5 lakhs was being charged for posting persons selected as assistant surgeons in their home districts. Posting in district and taluk offices would cost Rs. 3 lakhs that as District Medical Officer would cost Rs. 5 lakhs. Majority of doctors were now being 'subjected' to discretionary transfers so as to collect amounts ranging from Rs. 2 lakhs to 20 lakhs as bribe, he said. 

Link: http://www.hindu.com/2005/04/21/stories/2005042113360400.htm

Republished here by courtesy of: The Hindu Dot Com.