Systematic swindling of funds mechanism of NRHM rip-off was almost institutionalised

District and block level health officials had been given a list on the basis of which they had to save or siphon off NRHM funds.
The list reveals that there were as many as nine activities whose entire budget was eaten up as the money saved in their case was 100%. These activities include expansion of cold chain workshop and cold chain handlers training.That probably explains why some immunization drives in the state got botched up.
NRHM is a growing fund with each passing year. Allocation to UP in 2005-06, when the programme was launched, was approximately Rs 794 crore which jumped to Rs 1,956 crore in 2009-10. For 2010-11, the state had a sanctioned budget of Rs 1,741 crore till December 2010. Significantly, in 2009-10, UP spent Rs 2,212 crore nearly Rs 256 crore more than the sanctioned budget. It must have utilised the unspent budget of previous years as NRHM funds dont lapse, says a senior health official.
There were numerous activities under the NRHM which provided scope for rich pickings. The fact that that most of the activities were supposed to be of urgent nature and didnt involve the tender process made the job easier. A central team that visited in May for a random check after CMO (family welfare) Dr BP Singhs murder, found that between 2009 and 2011, contracts worth more than Rs 600 crore were given without tender.
Untied funds at the disposal of CMOs were also a major form of leakage. These funds were mainly seen to be utilised for minor repairs and maintenance, for buying fuel for generators, local purchase of emergency drugs when in short supply, providing shelter to patients and attendants, employing contractual staff for ambulances and improving quality of care.
Besides, several activities like big construction works and publicity were handled at the directorate level. The money siphoned off thus was centralized with the involvement of mafia, politicians and babus.
Jashodhara Dasgupta of Healthwatch UP Bihar, examined and documented several aspects of NRHM. Untied funds were not being used for patient welfare related activites, was one the main findings. The Janani Suraksha Yojana failed to reach the beneficiaries and patient attendants were forced to make informal payments, she said.
Lucknows Giri Institute of Development Studies conducted a mid-term review of 14 programmes/schemes started by the Centre. NRHM was one of them. The programme is not working well, is what the GIDS team concluded. Citing the example of Janani Suraksha Yojana, which is a flagship programme of the NRHM, AK Singh, director, GIDS, said, It was common knowledge that a portion of grant awarded to the mother would be deducted at the hospital level, obviously to be distributed among hospital staff.
Economist Prof Yashvir Tyagi says: Such levels of corruption in social sector like health is tragic, especially in a state where the health scenario is bad. Lack of initiative and adequate supervision from the top is to be blamed for this. When TOI contacted chief secretary Anoop Mishra with the details of rampant loot of NRHM funds, he said the state had already set up seven committees to probe the charges. We will be able to share the details only when the committees submit their report, he said.