Biju Swasthya Kalyan Yojana-A Big Hoax and Fake Scheme
This not new but a scheme of financially supplementing many existing
schemes with new Name just to deceive the people of Odisha
1. What is Biju
Swasthya Kalyan Yojana ( BSKY)
As declared by Govt. of Odisha, Biju Swasthya Kalyan
Yojana ( BSKY) is a scheme of the Govt.
of Odisha which aims to provide universal health coverage , with special
emphasis on the health protection of economically vulnerable families. To
achieve its objectives, the BSKY has
two components:
A.
Free
health services for all (irrespective of income, status or residence) in all
State Government health care facilities starting from sub centre level up to
district headquarter Hospital level.
B.
Additional
facility of free healthcare District Headquarters hospital level for over 70
lakh economically vulnerable families in the state who are provided Annual
Health Coverage of Rs. 5 lakh per family and Rs. 7 lakh for the women members of the family.
C.
All
families are eligible for free health care services at Government health care
institutions upto district head quarter hospital level.
D.
With
regard to benefits under BSKY, all health services are free of cost, including free drugs, free
dialysis, free cancer chemotherapy, free OT, Free ICU, free in-patients
admission etc. in all government health institutions upto District Hospital
level for all persons.
E.
Families
having BKKY card, RSBY card, BPL card or AAY card or annual income of Rs.
50,000/- in rural and Rs. 60,000/- in urban areas can avail cashless treatment
at all Government Hospitals and 208 empanelled private hospitals.
2. Critical issued relating
to Scheme and its
implementation.
Having gone
through it and emboldened over digital
media campaign about BSKY by Chief Minister, it was thought
of to understand the
following issues.
i.
Budgetary
provision made to implement such mega
scheme in the state and details of
fund allotted to different
districts for it.
ii.
Who are the
70 lakh beneficiaries and its district-wise figure.
iii.
Status of
accessability to health services by poor
and vulnerable people to Govt. hospitals.
iv.
How many
beneficiaries have received health facility
under the scheme in different districts.
v.
Who are the
private hospitals already provided free health facility to the
beneficiaries of BSKY and fund provided to them.
vi.
What is the
status of all on-going health schemes implemented in the state.
3. Use of RTI to access information about BSKY and monitor it.
Accordingly, from October, 2018 to January, 2019,
multiple RTI Applications were filed to Department of Health and Family
Welfare , Mission Directorate, Directorate of Health Services and all 30 District Hospitals to get the
information mentioned below. Important information sought for under RTI
is as follows. ( RTI Applications are
attached herewith)
A. Information sought from 30 District Hospitals on 11.11.18
i. Provide copy of the
circular/ instruction/ order issued to district about implementation of Biju
Swastya Kalyan Yojana .
ii. Provide details of fund received from state govt. and expenses
made (under different heads) under Biju Swastya Kalyan Yojana.
iii. Provide total number of beneficiaries identified eligible to
access health service under BSKY in the district.
v. provide list of private
Hospitals which are covered under BSKY
B. Information
sought for from Dept. of Health and Family Welfare on 1.10.18
i. No. of families covered by BKKY
and RSBY ( scheme-wise
and year-wise)
ii. No. of patients
availed benefits under BKKY
and RSBY (scheme-wise and
year-wise)
iii. Total amount paid under BKKY and RSBY by Govt. (
scheme-wise and year-wise)
4.
Details of budgetary
sources from which the said amount paid under BKKY
and RSBY scheme (scheme-wise and year-wise).
C. Information
sought for from Dept. of Health and
Family Welfare, Govt. of Odisga on 15.10.18 and 21.12.18
i. Circular/
instruction/ order issued to all
districts and private hospitals about implementation of Biju Swastya Kalyan
Yojana .
ii. Details of expenses made towards cost of advertisement made in public place and print and electronic
media about Biju Swastya Kalyan Yojana
iii. Details of budgetary allocation made for Biju Swasthya Kalyan Yojana.
iv. Details of programme organized and
expenditure made towards implementation of BSKY at state level.
v.Details of fund transferred to each
district to meet expenses of implementation of Biju Swasthya Kalyan
Yojana.
vii. Details of fund already released to private
hospitals against claims of
beneficiaries for treatment under BSKY.
viii.Details of fund of NHM used for Biju Swasthya Kalyan Yojana
D. Information sought about various health
schemes from Dept. of H &FW. Govt. of Odisha on 1.10.18
i. Total
fund allocated ( specify state budget and central Govt . fund /NHM ) and spent
for implementation of Janani
Sishu Surakhya Karyakrama( JSSK) ( YEAR-WISE)
ii. Total
fund allocated ( specify state budget and central Govt . fund /NHM ) and spent
for implementation of Rashtriya Bal Swasthya Karyakrama (
RBSK) ( YEAR-WISE).
iii. Total
fund allocated ( specify state budget and central Govt . fund /NHM ) and spent
for implementation of National Ventor-borne Disease Control
Programme ( NVBDCP) ( YEAR-WISE) .
iv. Total
fund allocated ( specify state budget and central Govt . fund /NHM ) and spent
for implementation of NPCDCS ( YEAR-WISE).
E.
Information
sought for from Health and Family Welfare Dept.on 21.12.18
i. Details of expenses made towards cost of advertisement made in public place and print and electronic
media about Biju Swastya Kalyan Yojana
ii. Details of budgetary allocation made for Biju Swasthya Kalyan Yojana.
iii. Details of programme organized and
expenditure made towards implementation of BSKY at state level.
iv. Details of fund transferred to each
district to meet expenses of implementation of Biju Swasthya Kalyan
Yojana.
v. Details
of fund already released to private hospitals against claims of beneficiaries for treatment under BSKY and number of patients already
treated in each private hospital
vi. Dtails of fund of NHM used for Biju Swasthya Kalyan Yojana
F. Information sought for
from Health and Family Welfare
Dept. on 8.1.19
i. Provide
information about no. of families
covered by BKKY and RSBY
( scheme-wise and year-wise)
ii. Provide information about no. of patients availed
benefits under BKKY and RSBY (scheme-wise and year-wise)
iii. Provide
total amount paid under BKKY and
RSBY by Govt. ( scheme-wise and year-wise)
iv. Provide information about details of
budgetary sources from which the said amount paid under BKKY
and RSBY scheme (scheme-wise and year-wise)
4.Critical
analysis about implementation of BSKY
Most of
the information has not been supplied by
many offices about BSKY. However, details of analysis of
information which has been obtained
is presented below.
4.A. Integrated
Help-desk renamed as BSKY Help-Desk
In order to facilitate patients’ care
service, the State Govt. has
set up 24x7 Help-Desks ( NHM-support) like RSBY/BKKY Help-Desks
in all FRUs through outsourced
agencies . for effective functioning of
these Help-desks , the State Govt. issued
circular dated 30.11.17 to
integrate all these Help-Desks into a common Help-Desk as integrated
Help-Desk. On 13.8.18., the State Govt. against
issued instruction to rename these Help-Desk as BSKY Help-Desk in the hospitals.
4.B. No. of beneficiaries availed health
services under BSKY
On query about
number of beneficiaries
availed free health service under
BSKY scheme in different hospitals
from the period of September to Dec., 2018 , the PIOs of different hospitals have responded that
there is no categorization of beneficiaries availed
benefits under various schemes like BSKY. They have provided just
total number of IPD patients and
OPD patients month-wise who have
availed health facility from August to Nov.,18 is reported as BSKY beneficiaries. Few examples
are presented below.
|
Name of Hospital
|
Month, 2018
|
Total no. of ( IPD)
beneficiaries
|
Total no. of ( OPD)
beneficiaries
|
Remarks , if any
|
|
SCB Medical College &
Hospital, Cuttack
|
September
|
9251
|
158433
|
|
|
|
October
|
9258
|
159783
|
|
|
|
November
|
10256
|
154266
|
|
|
DHH, City Hospital, Berhampur
|
September
|
907
|
34192
|
|
|
|
October
|
938
|
32813
|
|
|
|
November
|
1025
|
30925
|
|
|
SDH, Bhanjanagar
|
Within three months
|
4877
|
33406
|
|
|
District Hospital, Bhadrak with 8 PHCs
|
DO
|
51769
|
425062
|
|
|
District Hospital, Puri
|
DO
|
23249
|
434575
|
|
|
District Hospital, Boudh
|
DO
|
3337
|
49980
|
|
4.C. Information about 70 lakh beneficiary-families under
BSKY
RTI Query about coverage of 70 lakh beneficiaries under BSKY ( Biju Swasthya Kalyan
Yojana) as declared by State Govt, it was
found that the State Govt. has taken into account total earlier enrolled beneficiaries
under BKKY ( 25,61,602) and RSBY ( 44,08,070) as 70 lakh families to be covered
under BSKY. ( BKKY- Biju Krusak Kalyan
Yojana, RSBY- Rastriya Swasthya Bima Yojana).
As the financial support under RSBY is over on 31st
Dec.18, the State Govt. decided to include all RSBY beneficiaries ( 44,08,070) in
BKKY Stream-II w.e.f. 1st
January , 2019. So that they
will avail free health facilities
upto one lakh and get coverage
under Biju Swasthya Kalyan yojana. But
it was found that though
RSBY beneficiaries have been
distributed BKKY Stream-II
card, but they
are denied free
health services under the card in
many hospitals across the state.
4.D. Huge misuse of public money by Chief
Minister
The State Govt. spent Rs. 1.21. crores ( Rs.
69,69,672.00 towards incentives for
distribution of CM letter and Rs. 51,52,600.00 towards contingency for
printing of registers and formats) for
distribution of Chief Minister’s letter on BSKY among 70 lakh beneficiaries. On 9.8.18., the Special Secretary, Dept. of Health and Family
welfare issued instruction and detailed guidelines
to all Collectors constitute a
committee at district and block level for
door-to-door distribution of CM letter
to all beneficiaries starting
from 16th august to 24th
august, 2018. Within this period,
all district and block level officials including ASHA and ANWs were
engaged just to distribute CM’s
letter to beneficiaries. This is a big
misuse of money by Chief Minister himself.
4.E. No information about free health services
provided by empanelled private hospitals
under
BSKY and fund disbursed to them.
As per
RTI information, total no. of 208
private Hospitals are empanelled to provide
free health services to the patients
who are entitled to get
Rs. 5 lakh financial support for
treatment under BSKY. RTI query was made
to Dept. of H and FW and District hospitals about how many private hospitals have provided health services under BSKY
and amount of money
provided to them. Though 3 months have passed, no response
has been obtained from any
office. However, a letter
written by proprietor of Sun Hospital, Jagatsingh Pur has
been provided under RTI Act. The proprietor
has stated on 16.1.19 that
they have not yet implemented BSKY as it’s rules and regulations are not clear
and the required software has
not yet been installed.
4.F. No information about beneficiaries availing Rs. 5 lakh benefits
under BSKY
On RTI query about how many patients have availed
health services from private hospitals or Govt. hospitals under BSKY ,
the Health and Family welfare
Department has not provided
any information. On
22.1.19., the Chief Executive officer-cym-PIO, State Health Assurance Society (
SHAS) of H&FW Dept. has forwarded RTI application to the following insurance companies to provide
information. Though one and half months passed, these companies have not
supplied any information.
i.
The AVP,
ICICI Lombard GIC Ltd.
ii. The G.M. IFFCO Tokio GIC Ltd.
iii. The CRM, New India Assurance Co. Ltd.
iv. The CRM, National Insurance Co. Ltd.
v. The Head RSBY, Max Bupa Health Insurance
Company Ltd.
4.G. No budget provision for BSKY
There is no budgetary
provision for implementation of
BSKY except incentive for
distribution of CM’s letter and
advertisement. As per RTI Information provided on 25.1.19, total amount
of Rs. 3, 17,61,762.00 has been spent
towards advertisement of BSKY . Similarly, Rs. 1.21 crores earmarked
and spent towards distribution
of CM letter. All fund usually
allotted under NHM fund and State
Fund for
implementation of various
health schemes are
utilized under newly named scheme i.e., BSKY. Allotment of fund
under NHM Fund and State Govt. fund
supplied by few offices are as
follows.
|
Name of district
|
Year
|
NHM fund allotted
|
State fund allotted
|
|
|
Office of CDMO, Nuapara
|
2016-17
|
2,262.48
|
247.21
|
|
|
|
2017-18
|
2,297.35
|
74.02
|
|
|
|
2018-19 upto Dec. 18
|
2,219.09
|
60.33
|
|
|
CDMO, Boudh
|
2016-17
|
2700000.00
|
0
|
|
|
|
2017-18
|
3100000.00
|
0
|
|
|
|
2018-19
|
500000.00
|
0
|
|
4.H. Vacancy of post of Doctors denied health
services in Govt. hospitals.
Provision
of imparting treatment to the patients free of cost as declared by Govt. under BSKY requires presence of
specialized doctors in
each hospital i.e., CHC, PHC and
District Hospitals. But astonishingly,
the Govt. has not taken
any steps to ensure filling up of vacancy
post of doctors in the hospitals. As
per RTI information, out of total required 6614 doctors, 3224 post is lying vacant in Govt. hospitals across the state. The vacancy
of doctors’ s post has damaged
prospect of availability of free health services for the patients.
On 9.1.2019, the information obtained under RTI from CHC,
Baliapal of Balasore district
exposed how free health service is
distant dream for the people in remote pockets of the
state. The absence of doctors in CHC and PHC is as
follows.
|
Sl.No.
|
Name of the Institution
|
Name and no. of vacant post as on 9.1.2019
|
|||
|
1
|
CHC, Baliapal
|
Spl. In 0 & G-1
|
|||
|
|
|
Spl. In Medicine -1
|
|||
|
|
|
Spl. In Surgery-1
|
|||
|
2
|
CHC, Pratapur
|
Spl. In Paediatric-1
|
|||
|
3
|
Ghantua PHC (N)
|
Medical Officer-1
|
|||
|
4
|
Srirampur PHC( N)
|
Medical Officer-1
|
|||
|
5
|
Jamkunda PHC (N)
|
Medical Officer-1
|
|||
|
6
|
Bolong PHC (N)
|
Medical Officer-1
|
Pradip Pradhan
M-9937843482
Date- 6.3.19
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