In your interest.
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No beating about the bush.
The powerful Public Health Foundation of India or PHFI is packed with corporate luminaries and India’s most powerful bureaucrats, international academics, Nobel prize winner Amartya Sen and global NGOs to enhance its credibility. But instead of being a shining example of smart policy making in the crucial healthcare segment, why does it appear dodgy about facts and economical with the truth?
Wrong facts, false information, changing descriptors (sometimes as an autonomous body, at others a public-private-partnership) in official communications—make for a rather dubious image for the powerful Public Health Foundation of India (PHFI). How and why is the government indulging in this obfuscation? Let’s look at more ways in which PHFI seems to be pulling the wool over the public’s eyes.
For starters, the government told Parliament and a parliamentary panel that PHFI would limit itself to public health education and, at the most, some research work that can be put to use in policy making. Specifically, it said, “…this experiment will be confined to the area of public (medical) education only”. But very swiftly, PHFI was turned into a virtual government body. It has been allowed to participate directly and widely in policy formulation, win very lucrative public procurement contracts without any competitive bidding, and even receive aid as part of the health-related agreements that the Centre signs with the foreign governments.
* PHFI acted as a secretariat for the High-Level Expert Group on Universal Health Coverage, chaired by its president Srinath Reddy at public cost. The report of this group is meant to be a blueprint for national health policy for many years to come.
* PHFI was chosen without any competitive bidding as technical partner in the National Initiative for Allied Health Services (NIAHS), an Rs1,100 crore project of the health ministry for expanding paramedical capacity. (The list of handsomely paid central and state projects that it has bagged is too long to be documented here.)
* PHFI received hefty funding from the Norwegian government as part of the Norway India Partnership Initiative (NIPI) for reduction of child mortality in five states.
Private body in public garb
The parliamentary panel was also given an exaggerated sense of government’s ability and intent to influence decision-making at the PHFI. It transpires that the government has never had any significant power—or even the intention—to influence any decision at PHFI. In fact, it does not have direct power to even convene a meeting.
PHFI’s rules limit the number of government representatives on the board and also give non-government members (read Big Business) the super-majority to decide who would be recognized as a “government representative”. For instance, “MS Ahluwalia is a member of the PHFI board as MS Ahluwalia, not as deputy chairman of the Planning Commission,” a counsel for PHFI informed the Central Information Commission (CIC) on 24th January at a hearing that this writer attended.
This is a new record of pushing powerful public servants into powerful bodies by inducting them in their “individual capacity”. It opens the doors to lawlessness and corruption and creates a situation, which the CIC termed as “untenable”.
“It is difficult to assume that senior public servants can be on the board of an organization like PHFI, which has numerous interactions with the government, in private capacity. In fact, this would necessarily imply a conflict of interest. The Commission can only assume that such public servants must necessarily be acting on behalf of the government, when they are required to take executive decisions as members of the board… Any other conclusion would be an improper slur on their integrity,” the CIC wrote in its decision of 14 February. This “improper slur on their integrity” was, nevertheless, written into the rules of PHFI with the connivance of the “senior public servants” themselves.
The government’s covert and overt support to PHFI has been deliberately obfuscated from the very beginning. In February 2006, Srinath Reddy, then head of the cardiology department at AIIMS, and RA Mashelkar, then secretary-DSIR, were encouraged to team up with Rajat Gupta, his two McKinsey colleagues and two corporate lawyers to register PHFI as a society. The Central Civil Services (conduct) Rules, 1964, don’t allow a government employee to form an organization that will replicate or resemble the work of his parent organization on a significant scale and explicitly prohibit him from soliciting funds.
Information obtained through RTI shows that Dr Reddy’s ‘deputation’ from AIIMS to PHFI —effected by a ministerial fiat—was irregular and arbitrary. The AIIMS rules do not allow any such deputation, nor was the proposal was ever placed before AIIMS governing body. Dr Reddy is currently drawing a salary of Rs 60lakh a year and has been provided bungalow accommodation for this job of improving public health and public finances. In fact, ‘deputations’ of all government employees to PHFI can only be regarded as illegal because PHFI does not fit the description of any organization to which rules would allow public servants to be seconded.
Information released by DSIR pursuant to an RTI query shows that it hastily certified PHFI as a Scientific and Industrial Research Organization (SIRO) without any worthwhile record of research work or visiting its facilities. Similarly, PHFI’s public health management courses have no recognition or accreditation from any statutory regulator in the country. This clearly raises several queries.
Whys and the wherefores
(a) Why would the government deceptively empower what is essentially a private club to make crucial decisions in the sensitive area of public health policy concerning a billion plus people?
(b) If the government really wanted a PPP to take care of India’s public health policy and administration, why didn’t it first create policy framework for its operation?
(c) Why did the government lavish vast public resources on an organization without demanding control, accountability and public audit?
(d) Why would the government parcel out the ability to influence public policy to chosen individuals based on their influence, connections, or ability to pay?
(e) Why would the government choose not to have the power to influence decision-making at PHFI (which is packed with big private business houses), when is contrary to notoriety acquired by our bureaucrats for never giving up power?
(f) How has the government addressed the possible conflict of Big Business on PHFI who have an incredible opportunity to further their interest?
g) A look at PHFI’s super powerful board of director will explain why the lack of clarity and transparency is so worrying. The board comprises NR Narayana Murthy, Dr Montek Singh Ahluwalia, Ashok Alexander from the Bill and Melinda Gates Foundation, Ms Mirai Chatterjee- SEWA, Dr Lincoln Chen-Global Equity Center, Harvard’s Kennedy School, Dr James W Curran- Dean, Rollins School of Public Health, Emory University, Dr Gary Darmstadt- Director, Bill & Melinda Gates Foundation, Dr Timothy G Evans-Dean, James P Grant School of Public Health, Bangladesh, Dr Vishwa Mohan Katoch-Director General, Indian Council of Medical Research, Uday Nabha Khemka -Vice Chairman, Sun Group, Gautam Kumra -Director, McKinsey & Company, Dr David Lynn-Director, Strategic Planning & Policy Wellcome Trust, Ms Kiran Malhotra-chairperson, AKM Systems Pvt Ltd, Dr Raghunath A Mashelkar-CSIR Bhatnagar Fellow, National Chemical Laboratory, Mr Raj Mitta-Chairman, Essential Value Associates Pvt Ltd, Mr Shiv Nadar -Founder, HCL, TKA Nair-Advisor, Prime Minister's Office, Dr Ravi Narayan -community health advisor, SOCHARA, Dr Peter Piot-director, London School of Hygiene & Tropical Medicine, PK Pradhan -Secretary, Ministry of Health, Dr Jagdish Prasad -Director General of Health Services, Ministry of Health, JVR Prasada Rao, UNAIDS India, Prof K Srinath Reddy -President, Public Health Foundation of India, Dr Y Venugopal Reddy-Former Governor, Reserve Bank of India, Dr Anil Seal-Director, Cambridge Commonwealth Trust, Dr Amartya Sen-Professor of Economics & Philosophy, Department of Economics, Harvard University, Dr Jaime Sepulveda-Executive Director, Global Health Sciences, University of California, Dr AK Shiva Kumar -Advisor, UNICEF, Mr Michel Sidibé -Executive Director, UNAIDS, Mr Harpal Singh-chairman, Fortis Healthcare (India) Ltd
These questions need to be answered in public interest by PHFI’s eminent board. The writer has written several letters of complaint to at least a dozen members of PHFI’s governing body, including Nair, Ahluwalia, PK Pradhan (Secretary Health), Amartya Sen and Mirai Chatterjee, but has not yet received acknowledgement from any of them.
This is the concluding part of a two-part series.
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(The writer is a Delhi-based freelance journalist who has written about PHFI in the past. He will have much more to say on the topic in the coming days. He has since made his formal complaint about forgery, in the form of first RTI appeal to PHFI.)
The year-long agitation, confined to Indinthakarai and nearby villages, spilled over to neighbouring Tuticorin district and was intensified after authorities announced loading of uranium fuel in the Kudankulam Nuclear Power Plant
Kudankulam (Tamil Nadu): An uneasy calm prevailed here on Tuesday with police tightening vigil as anti-nuclear protesters continued with their relay fast at Idinthakari, epicentre of protests against the Kudankulam Nuclear Power Plant (KNPP), condemning the action against anti-KNPP activists, reports PTI.
Police said the situation was calm but they are keeping a strict vigil. "Security has been stepped up," sources said.
Sources close to SP Udhayakumar, convener of People's Movement Against Nuclear Energy (PMANE), spearheading the protest against KNPP, said key leaders including him and Pushparayan, will court arrest by turning up at the Kudankulam Police Station tonight.
The agitation had turned violent yesterday when one person was killed in police firing when protesters tried to attack a police station at Manapad in Tuticorin district.
The year-long agitation, confined to Indinthakarai and nearby villages, spilled over to neighbouring Tuticorin district and was intensified after authorities announced loading of uranium fuel in the plant.
Police had also resorted to lathicharge and firing of teargas shells yesterday as the seashore in Indinthakarai village turned into a battlefield with clashes between protesters and police.
Slamming the police action, PMANE had yesterday launched a 48-hour relay fast against it.
A cameraperson of an English TV channel allegedly suffered injuries on the forehead during the melee in the police action. Channel authorities said a complaint has been lodged at the police station here.
Tirunelveli District Superintendent of Police V Bidari promised strong action by identifying the personnel involved in the alleged assault on the cameraperson..
Expressing solidarity with the protesters and condemning the police action, fishermen in southern districts are staying away from fishing today.
Situation in neighbouring districts is normal, according to police.
The anti-KNPP protest took a new turn when PMANE gave the call for a siege of the plant as a last-ditch effort to stall the Indo-Russian project after regulatory authorities gave their clearance for loading the uranium fuel in the first of the two reactors.
Around 4,000 security personnel, including Rapid Action Force, have been deployed in the area.
Tamil Nadu Chief Minister Jayalalithaa has defended the police action and appealed to people not to fall prey to the "designs" of anti-nuclear lobbyists and to maintain calm.
The first unit of KNPP was scheduled for commissioning in December last, but ran into trouble with locals demanding its scrapping on safety concerns.
The powerful Public Health Foundation of India, packed with corporate and government luminaries, has come up with dubious and contradictory information about its structure and formation when subjected to Right to Information scrutiny
In a significant decision dated 14th February, the Central Information Commission (CIC) noted “with some dismay that the highest levels of public servants in India did not accept the citizen’s enforceable right to information in PHFI, despite the government substantially funding it and exercising some control”.
It was referring to Public Health Foundation of India (PHFI), a powerful body that has received generous land and funding from the central government to chalk out India’s public health policy. PHFI remained outside the purview of the Right To Information (RTI) Act 2005 for six years since its inception in February 2006 despite the presence of a galaxy of government luminaries including TKA Nair (Advisor to the PM) and Dr Montek Singh Ahluwalia (Deputy Chairman, Planning Commission) on its governing board. This writer had previously written a series of articles in Moneylife (Will PHFI be any different under Narayana Murthy?, Will PHFI become transparent and accountable under Narayana Murthy?, Mr Narayana Murthy, PHFI reply to questions about the authority and functioning of the organisation, and PHFI’s reply gives hope, not confidence) about PHFI’s structure, lack of transparency and conflicts of interest when it was headed by Rajat Gupta, the former McKinsey chief who quit after being accused of insider trading (he has since been convicted for securities fraud in the US and seems likely to serve a jail term).
The CIC ruling in PHFI’s case declared it a public authority under Section 2(h) of the act and ordered it to start complying with the law. Interestingly, the phrase “highest levels of public servants in India” used by the CIC may well apply to Prime Minister Manmohan Singh himself, who implanted PHFI into the heart of India’s public health policy and administration and described it as a “public-private partnership” (PPP). RTI queries however reveal a scandalous and deliberate lack of transparency in its creation and clearance.
Fabrication given away
In response to my RTI query on 5th July, Kalpana Swamy, the public information officer (PIO) at PHFI had sent me a document on 13th August that is wrong and contradictory to the point of being a forgery. The 5-page ‘Annexure B’, purportedly a photocopy of an officially certified document has strangely asynchronous information on something as simple as the composition of the governing council of PHFI as on 31 March 2006. The original document was ostensibly stamped and signed by president K. Srinath Reddy on 03 August 2006. But consider this:
(a) Dr RA Mashelkar who was Secretary, DSIR (Department of Scientific and Industrial Research) and Director General of CSIR (Council of Scientific and Industrial Research) in March 2006, has been listed as ‘CSIR Bhatnagar Fellow, National Chemical Laboratory’, which he became only after his retirement in December 2006.
(b) K. Sujatha Rao has been listed as ‘Former Secretary, Ministry of Health & Family Welfare’. Ms Rao retired from her post as Secretary of the health ministry in November 2010.
(c) Rajat Gupta – prime mover in the formation of PHFI and its chairman until March 2011 – is listed as ‘Former Partner, McKinsey and Co.’. However, according to publicly available information, he was Senior Partner at McKinsey & Co. in the year 2006.
There is more. While the ‘Annexure-B’ lists 24 persons as part of the governing body that came into effect on 27 March 2006, the same PIO at PHFI had earlier informed Kishan Lal, a Mumbai-based RTI applicant ,that “The Governing Council with 21 members came into effect on March 27, 2006”. (I had represented Kishan Lal before the CIC Shailesh Gandhi in that case -decision No. CIC/SG/C/2011/001273/17356)
The date of 27 March 2006 is important, because it is the eve of PHFI’s “launch” by Prime Minister Manmohan Singh. ‘Annexure-B’ lists four top bureaucrats − Nirmal Ganguly, Prasanna Hota, K. Sujatha Rao and R.K. Srivastava − as members of the PHFI board on 27 March 2006, even though there is nothing in the public domain that attests to the government authorizing these four to join the board on or before that date.
There are more such mysteries about the composition of the board and the contradictory information provided to the RTI query on13th August, but we will come to those later.
In a separate RTI query to the Union health ministry, I asked whether it recognized PHFI as ‘autonomous body’ and, if it did, whether the union Cabinet had approved its formation as an ‘autonomous body’. On 16th August, I received the CPIO’s response. Strangely, the ministry had forwarded my query to PHFI and sent me a reply labeled the “PHFI Response”. Needless to say it is full of misleading information.
The larger deception
The 14th February order subjecting PHFI to RTI scrutiny has exposed several uncomfortable facts, or downright deception.
For over six years the government has described the PHFI as a “public-private partnership (PPP)”, an “autonomous body” or an “autonomous PPP” (a special coinage) – depending on its convenience – in formal statements to the Parliament and a parliamentary committee. For example:
* In mid-2006, PHFI was introduced as a PPP to the Parliamentary Standing Committee on Health and Family Welfare, which was considering a demand for grants (2006-07).
* On 24 November 2006, Panabaka Lakshmi, then minister of state for health, described PHFI as an “autonomous body” to the Rajya Sabha.
* On 31 August 2007, Lakshmi described PHFI as an “autonomous public-private partnership” while speaking in the Rajya Sabha.
RTI queries now reveal that PHFI was never intended to be a “PPP” or an “autonomous body” in the normal sense of those descriptors. Responding to another query by activist Kishan Lal, the health ministry not only denied the existence of any PPP initiated by the government in the health sector, but also the existence of any “PPP policy for the social sector, viz. education and health”. This matter was before the CIC too. Needless to say no contractual agreement was ever signed between the supposed ‘private partners’ and the supposed ‘public partners’ to form PHFI.
In other words, PHFI is not only a law unto itself, but is meant to be a durable, flexible, arrangement for powerful bureaucrats and corporate houses to use as convenient.
The claim that PHFI is an “autonomous body” seems more dubious. Responding to my RTI query on 16th August (which was forwarded to PHFI), the health ministry clearly said that “PHFI cannot be defined as an autonomous body”. But describing it as an autonomous body allowed it to obtain a massive “grant-in-aid” of Rs 65 crore approved as a “one-time contribution” to PHFI’s corpus on 06 July 2006. The government had never envisaged PHFI as an ‘autonomous body” because that would need to meet the very elaborate conditions laid down by the General Financial Rules 2005 (GFR 2005) for forming such bodies.
One of those conditions is a prior Cabinet approval, which was never obtained and never intended to be obtained. In fact, the so called “grant-in-aid” of Rs 65 crore was rendered illegal from the moment it was conceived because it was provided in violation of GFR 2005. As for “autonomous PPP”, this special coinage was merely to pull wool over the public’s eyes.
(PART -2 – More wool over public eyes – tomorrow)
(The writer is a Delhi-based freelance journalist who has written about PHFI in the past. He has written a formal complaint about forgery, in the form of first appeal, to PHFI. He has also sent letters of complaint to at least a dozen members of PHFI’s governing body, including T K Nair, Dr M S Ahluwalia, P.K. Pradhan (Secretary Health), Amartya Sen and Mirai Chatterjee, but has received no acknowledgement from any of them.)