055. Who Will Catch Fake DMOs Who Catch Fake Doctors?

Who Will Catch Fake DMOs Who Catch Fake Doctors?

By Special Correspondent
Kerala Health Research Online

A District Medical Officer of Kerala caught a fake doctor in the private sector. But who will catch fake DMOs in the Kerala State Health Services Department? Justice M P Menon Commission that enquired into the fake mark list and MBBS certificate cases in the 1980s concluded its report by saying that the Commission, with its limited resources, time and staff, could only catch and expose a few fake doctors and the majority of them might still be working in the Health Services Department as Assistant Surgeons and Civil Surgeons. No follow up action was ever ordered and undertaken by the Chief Ministers, Health Ministers, Health Secretaries or the Directors of Health Services of Kerala. Most of them were duly promoted and some may have eventually become DMOs and other key Programme Officers. And it is, was, not the end of faking certificates and bribing for appointments. Things became only easier since then with the advent of computers, laser printers and other advancements available to those who want to fake things. Where do they actually verify the certificates a person claiming to be a doctor produces? There are three major recruiters in government sector- the Kerala Health Services Department, the Kerala Medical Education Department and the new, free, liberal and open route, National Rural Health Mission. In the last, anything is possible with its non-accountability. In the first two, there is no initial verification before appointment; everything is taken as gentleman’s word. After appointment, when the supposed doctor goes to the concerned institution to join is the SSLC Certificate and MBBS Certificate physically verified for proof of age and entry qualification, by a lowly clerk. They rarely hand over these to the clerks but just ask them to prepare a covering letter to the Accountant General without seeing them. A clerk in Trivandrum District once reported this to his superintendent and the superintendent said: ‘this person, from Sooranad, did not show them to even me, then how would to you? Anyway, give him the covering letter.’ SSLC Book of another doctor from Karunagappalli revealed that she secured 5 marks for English I Paper and 8 marks for English II Paper in Eighth standard. How will she ever become a doctor? When these facts were reported to higher authorities, the then Deputy DMO, DMO and DHS were very, very, very eager to suppress news; after decades, they sent this clerk away without four higher grades, promotion as UD Clerk on attainment of 50 years age, gratuity or even a pension, even though he had a corruption-less service of 32 years and was recruited through PSC. (Documentations are available online). They are such long-remembering and spiteful. So, before arresting others for faking, every doctor in the Kerala Health Services Department in Kerala, including the Director, has to prove before the public that they are not fakes. Let them put relevant details with scan copies of certificates in their official website and let people verify. Let IMA and KGMOA officials do it first.

Link to news article:

കൊച്ചിയില്‍ 20 വര്‍ഷമായി ചികിത്സ നടത്തുന്ന വ്യാജ ഡോക്ടര്‍ അറസ്റ്റില്‍

http://www.indiavisiontv.com/2014/09/18/353814.html?fb_action_ids=531725000290925&fb_action_types=og.comments&fb_source=aggregation&fb_aggregation_id=288381481237582


Tags: Kerala, Kerala Health News, Health Research Online, Kerala Public Health, Health News, Health Corruption, Fake Doctors, Illegal Medical Practice, Kerala Health Department, DMO, DHS, IMA, KGMOA, MBBS,

048. Health Director Post Permanently Reserved For Caste Candidates? Merit No Bar?

How Many Times Can Communal Reservation Be Sought For Government Promotions?

By Special Correspondent

How many times can a doctor seek communal reservation for departmental promotions in the Kerala Health Services Department which is supposed to be a department of specialists? No one in Kerala seems to know. Even those who know, fear about speaking aloud, for fear of angering extremely rich communal elements and alienating powerful politicians who enslave themselves to communal zealots for a few hundred thousand community votes. This issue of only communal candidates becoming Director of Health Services has been fuming in this department for more than a quarter century and qualified doctors in this department fear it would continue to be so the next century also. An Assistant Surgeon has to pass through the posts of Civil Surgeon, Deputy Director of Health Services and Additional Director of Health Services, to become a Director of Health Services. It is justifiable for a doctor to avail the benefit of communal reservation for once, for recruitment to the entry post of Assistant Surgeon or for one promotion. But availing the benefit of communal reservation for all levels is unbelievable among specialists in the world. If it happens regularly in each recruiting year, there will soon be a host of Additional Directors in the department within 15 years, all having enjoyed the benefit of reservation multiple times, ascending to the post of the super doctor, bypassing everyone not eligible to enjoy communal reservation. Every other qualified and brilliant doctor in the department, even after thirty years, will not have a chance. How they can become a Director is a Chinese mathematical puzzle which even the Abacus cannot solve. 

It was due to imbalance in the strength of several minority communities in the government due to long neglect by authorities and lack of resources for a good education, that the reservations bill was introduced in India which guaranteed recruitment of backward castes and communities into government posts, subject to a maximum of 50 percent of vacancies, the rest earmarked for merit. Later, orders from the highest law office in the country held that this reservation could be used only once in the entire service; if used for recruitment, it shall not be allowed for promotions; if was not sought for recruitment, it could be sought for promotion once. Recruitment to the post of the Director of Health Services is the finest example in Kerala of how a specialists’ department can allow merit to be overruled by communal factors, skillfully manipulate reservation to cent percent and bring down the efficacy and competency expected of the post. 

For the past three decades, Kerala Health Services has been helpless but to reserve this post for community and caste candidates. Seniority, service merit and academic qualifications are no consideration for recruitment to this post- the bare minimum is sufficient. The only question is, ‘do you have a reservation?’ The unusually brilliant in this department are tired. They are facing the dilemma of quitting joining private service or succumbing to communal powers and suffering the shame of working far below the incompetent. The main reason for brilliant doctors leaving this department and young ones not joining is this, and the unnecessary and illogical ban on home practice. Drive away the brilliant ones and make health service a haunt of inferior opportunists- that is what the government has only been able to achieve so far. 

One former Director of Health Services was recruited as Assistant Surgeon through special communal recruitment. While still under probation, was suspended for the death of a child and mother but still she managed to get promoted as Civil Surgeon Grade II through Special Recruitment.  While other doctors became Civil Surgeons Grade II in 13 years, she made it in 5 years. The same way she became Civil Surgeon Grade I. Then the posts of Deputy Director of Health Services and Additional Director of Health Services also were secured the same way and eventually the final one: five promotions using communal reservation! We will wonder who is there to acquiesce to demands for all these promotions and grant them too: it is those who already are there in government on the same communal and caste basis. Now, we know that the senior-most among the Additional Directors of Health Services only would be posted as the DHS. While a non-communal, doctor would take at least 30 years to become an Additional Director of Health Services, she could make it within 15 years. When she reached the final level, there was little competition there because these posts are limited in number and could be filled up only when a retirement vacancy arises. She naturally had to compete only against other reservation beneficiaries. And the seniority among them counted. So, now, we have a bunch of Additional Directors in the health services department- all recruited and promoted on the basis of community and caste, competing against each other for the post of the DHS. Our doctor anyway became the DHS, even though she had to retire without full charge of the DHS due to court’s intervention. 

During the past 25 years, the post of DHS has been reserved this way. And it is expected that it would be the same for the next 50 years also. Who will work at a place where caste and creed overrule brilliance and qualification? So our question arises, for Kerala government to answer: How many times can communal reservation be sought for promotions in the health department?

What the law states about availing reservation benefits multiple times:

The Supreme Court of India held that reservation of appointments or posts under Article 16(4) included promotions (in Akhil Bharatiya Soshit Karamchari Sangh (Railway) v. Union of India 1981, 1 SCC 246), which was later overruled and held that Reservations cannot be applied in promotions (in Indira Sawhney & Others v. Union of India. AIR 1993 SC 477).

77th Constitution amendment Art 16 (4 A) & 16 (4B) were introduced to make judgement as invalid but subsequent judgement in M. Nagraj & Others v. Union of India AIR 2007 SC 71 held the amendments constitutional. Those constitutional amendments do not alter structure of Art. 16(4). 

Roster-point promotees getting the benefit of accelerated promotion would not get consequential seniority and the seniority between the reserved category candidates and general candidates in promoted category shall be governed by their panel position. This was overruled and held that the date of continuous officiation has to be taken into account and if so, the roster- point promotees were entitled to the benefit of continuous officiation (Jagdish Lal and Others v. State of Haryana and Others (1997) 6 SCC 538) which was overruled again and held that held that roster promotions were meant only for the limited purpose of due representation of backward classes at various levels of service and therefore, such roster promotions did not confer consequential seniority to the roster point promotee (Ajitsingh Januja & Others v. State of Punjab AIR 1999 SC 3471; Jagdish Lal M G Badappanvar v. State of Karnataka 2001(2) SCC 666 : AIR 2001 SC 260) 

Relaxation of qualifying marks and standard of evaluation in matters of reservation in promotion was not permissible (S. Vinod Kumar v. Union of India 1996 6 SCC 580).

If the state wants to frame rules with regard to reservation in promotions and consequential seniority, it has to satisfy itself with quantifiable data that is there is backwardness, inadequacy of representation in public employment and overall administrative inefficiency, and unless such an exercise was undertaken by the state government, the rules in promotions and consequential seniority cannot be introduced. (Suraj Bhan Meena v. State of Rajasthan; M. Nagraj & Others v. Union of India AIR 2007 SC 71) Reservation in promotion is dependent on the inadequacy of representation of members of SC, ST and backward classes and subject to the condition of ascertaining whether such reservation was at all required, as no exercise was undertaken to acquire quantifiable data regarding in adequacy of representation. The Rajasthan High Court rightly quashed the notifications providing for consequential seniority and promotion to the members of SC and ST communities and held the same does not call for any interference. 

General observations and directives made by law courts are the following:

Backwardness and inadequacy of representation are the controlling/compelling reasons for the state to provide reservations, keeping in mind the overall efficiency of state administration. Government has to apply cadre strength as a unit in the operation of the roaster in order to ascertain whether a given class/group is adequately represented in the service. Roaster has to be post-specific with inbuilt concept of replacement and not vacancy based. If any authority thinks that for ensuring adequate representation of backward class or category it is necessary to provide for direct recruitment therein, it shall be open to do so. Backlog vacancies are to be treated as a distinct group and excluded from the ceiling limit of 50%. If a member from reserved category gets selected in general category, his selection will not be counted against the quota limit provided to his class and reserved category candidates are entitled to compete for the general category post. The reserved candidates are entitled to compete with the general candidates for promotion to the general post in their own right. On their selection, they are to be adjusted in the general post as per the roster and the reserved candidates should be adjusted in the points earmarked in the roster to the reserved candidates. Each post gets marked for the particular category of candidate to be appointed against it and any subsequent vacancy has to be filled by that category alone (replacement theory). (R K Sabharwal v. State of Punjab AIR 1995 SC 1371: (1995) 2 SCC 745). The operation of a roster, for filling the cadre-strength, by itself ensures that the reservation remains within the 50% limit.

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

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