In your interest.
Online Personal Finance Magazine
No beating about the bush.
Poor box charity money failed to reimburse healthcare expenditure of poor, needy patients
The Poor Box Charity Fund (PBCF) in government hospitals, constituted to help poor patients access to healthcare which are not available for free, in reality, has remained unused with no real benefit to the needy.
According to the report, ‘Mapping the Flow of User Fees in a Public Hospital’ by Centre for Enquiry Into Health and Allied Themes (CEHAT), money collected from the patients as blood bank and morgue charges, goes into the PBCF. But the study found out that this is just around 2% of the total collections. The money is, in fact, is kept in bank accounts, to earn interests, which is used to run the PBCF.
CEHAT analyzed a Mumbai-based public hospital as a case study in the report. Moneylife had earlier reported that the user fee, paid by the patient at the time of using public healthcare facilities has kept the poor away from using the facilities.
PBCF is a fund which is used to reimburse a poor patient’s charges. Poor Box Charity Fund Committees were constituted in the hospitals run by the local government body in the year 1926 with the approval of the Standing Committee. The primary function of this committee was to provide medicines and surgical appliances unavailable for free in the hospital to the poor and needy patients.
However, statistics in report indicate that less percentage of money is actually spent to help the poor. “It is clear from that only a very low percentage of the money available—11.14%, 34.39%, 14.42% for the years 2007, 2008, 2009, respectively, was used to reimburse the expenditure incurred by the poor and the needy. The sudden jump in 2008 from 11.14% to 34.39% was not because of an increased utilisation of funds, but because of a fall in interest income. The reasons for this fall remain unclear.”
It adds that, “It would be apt to look at the bank account that keeps the seed money from the local government body, the interest income which is to be used to run the PBCF. Over the five years between 2004 and 2009, the amount in the account—in which the local government body had invested seed money was Rs1.61 crore. The interest which was to be one of the main sources that finance PBCF has actually grown from Rs1.61 crore to Rs2.37 crore. This growth is solely because of accumulated interest earnings, primarily a result of money being unused to reimburse needy patients.”
Oommen Kurian of CEHAT, who worked on the report, explains that, “Only around 2% of the user fees collected is deposited in PBCF and the latter is seemingly assumed in the CRs (Corporation Resolutions) to be a is a part of the user fees mechanism when it is not. PBCF and user fees are completely different and separate mechanisms, and PBCF should offer needy patients relief over and above what they receive as exemptions or waivers. PBCF was constituted to enable the poor to access healthcare that was not free. It must not be used to reimburse the local government body for the minimal care it is bound to offer for free to poor people.”
In fact there have been cases of charity box money being misused mainly due to lack of transparency. An enquiry commission last year revealed the ‘procedural irregularities’ in the way PBCF funds were used in KEM Hospital (Mumbai), which is run by the local government body. Another case of misuse of funds came up last year resulting in suspension of the medical superintendent from St George’s Hospital, Mumbai.
CEHAT says that barring a couple of instances, there is no clear mention of waivers in the existing policy documents/guidelines. “Whenever waivers are mentioned it is made clear that for each waiver/exemption, money equivalent to the fees that is foregone has to go from the PBCF to the local government body’s account.
This is not being followed as of now, but the researchers found out from interviews with the senior administrators that this constant fear of the local government body actually choosing to demand money from the PBCF account—following the guidelines—for each waiver granted has a devastating effect on the equity.”
It adds, “On the one hand, there is pressure on the doctors to keep the number of waivers and exemptions to the minimum so that such claims are low, and also on the PBCF to keep reimbursements to a minimum so that there is ample money in the account just in case the local government body chooses to send a bill with retrospective effect.”
Builders and buyers are silent on all quarters about the irregularities
Fountain Square, A mega residential-cum-commercial luxury project on Relief Road, Oshiwara, Jogeshwari (W) is stuck after being served a show-cause notice by the Mumbai Metropolitan Region Development Authority (MMRDA) for constructing two unauthorised basements. However, neither the buyers nor the builders are ready to answer questions pertaining to the building.
Moneylife has documents accessed under Right to Information (RTI) which show that Fountain Square, with Shri Shubh Builders and Sonata Realty—which is part of Ionic Group at its helm, was served a show-cause and stop work notice by MMRDA on 4 October 2011 after a site visit by officers on 19 September 2011. The letter to Sonata Realty by MMRDA says, “It was found that you have started construction of two level basements of the said building without obtaining permission from MMRDA. Therefore, you are instructed to show cause in writing within seven days… you are instructed to immediately stop the work and restore the land to its condition, existing before the said development took place, failing which necessary actions will be initiated.”
The commencement certificate for the project, dated 27 August 2009, says, “MMRDA has approved the proposal up to plinth (level) only in respect to the proposed building with total permissible built up area of 10,427 sq metres on plot bearing CTS no 1C/3A (pt), S.No.41/1A(pt) of village Oshiwara allotted to Sonata Realty Pvt Ltd.” Area free of FSI components is 35,335 sq mts. Entry against ‘total permissible basement area’ is ‘NA’.
Spaceage Consultants was appointed as the architect of the project. An MMRDA document on issuing of commencement certificate, dated 25 August 2009, says that the building proposal is for ground floor+14 upper floors, and the height of the building was to be 63.45 mts. However, MMRDA granted that in future, that height can go up to 70 mts; and that the architects and the realtors are to give in writing that the height will not go beyond the limit.
However, initial brochures show a building that has almost 40 storeys. Surprisingly, a recent brochure of the same project, which is available online on Ionic Group’s website, says that the project is of 30 storeys. See http://ionic.in/fl/Fountain_bro_small.pdf
On 9 May 2011 Spaceage Consultants approached the MMRDA for getting all necessary clearances for incorporating a ‘welfare centre’ in the design. After scrutinising their application, MMRDA issued a ‘deficiency letter’, listing 68 points. The 15 June, 2011 letter said that according to the lease deed, the building could have only residential and shopping use.
However, it also showed that the builders/realtors have not submitted many necessary documents, including NOCs from the fire department, civil aviation department, tree authority, electrical supply authority, high-rise committee and have also not got clearances for sewage, storm-water drain and environment impact assessment.
The letter also shows that the documents submitted neither indicates plinth level, presence of overhead tanks, facilities for the physically handicapped, undertakings against misuse, etc. Various aspects of the building like the marginal open spaces, driveway widths, distance from recreational grounds, etc, do not conform to development control regulations.
No answers could be obtained either from the builders, or the architects. Emails and phone calls to Ionic Group, Shubh Builders, Spaceage Consultants and Sonata Realty asking details like the present status of the project, scheduled date of completion, status of bookings, etc, went unanswered.
Even the buyers/investors are silent about the matter. “We cannot risk complaining as the builders may harass us. Moreover, we have only paid a nominal amount via cheque. The rest was in cash. The builders can then just give us the small cheque amount and tell us to forget the unaccounted amount we have paid,” said a buyer. The buyers, who have booked at levels beyond the 30th floor, are also unwilling to talk.
On the internet, there are many forums and discussion threads where users have expressed their anxiety about their investment. However, most of these pages cannot be accessed now. The construction hasn’t progressed much on ground either.
Rumours are afloat that the builders have submitted fresh plans to the civic authorities after the show-cause notice, but it could not be confirmed. “We have issued a show-cause notice, and the matter will be looked into,” said an MMRDA official.
Even as the government’s move to get data access of the corporate users of BlackBerry has taken a back seat, it has proposed a legal provision to get access to the encrypted data of companies such as Google and Skype. Accordingly, these companies will have to locate part of their IT infrastructure within the country, enabling investigative agencies ready access to the encrypted data on their...