Dr Meenu Singh—executive director of the All India Institute of Medical Sciences in Uttarakhand’s Rishikesh—rushes from one health ministry video conference to another, even as a long list of things await her urgent attention at the beleaguered institution she has headed for seven months.
The doctor from the microbiology department has resigned, and she must find a tennis coach for another head’s daughter. She must also find a way to make recruitment transparent, patient queues shorter, and negotiate the demands of striking Group D employees.
And to top it all, at least two new RTI (Right to Information) applications land on her door every day.
“What happened to the result of the beautician’s exam in 2018? How did Triveni medicos get the tender? What due process was followed during the appointment of these 32 doctors?”— The RTI queries are like a drip from a leaky tap that can never be fixed.
Last year, when the Union health ministry recommended appointing Singh as the executive director of AIIMS-Rishikesh, everyone asked her. “Why are you going to Rishikesh AIIMS? Its image is completely tarnished by rampant corruption. Why are you going there?”
In its short life, AIIMS-Rishikesh has gathered a lot of muck. Multiple raids were conducted here by the Central Bureau of Investigation (CBI) in February 2022 to probe allegations of rampant corruption in recruitment and fraud in the purchase of equipment. Now, the chargesheet in the two FIRs is underway. And the Uttarakhand High Court is still hearing the transparency PILs filed by a local activist in 2021.
After over three decades at the Postgraduate Institute of Medical Education and Research (PGIMER) in Chandigarh, Singh finally joined AIIMS-Rishikesh in July 2022 as its first woman director. Her single goal since July has been to repair the institution’s image.
She got the auditorium functional; work was stalled for the last 10 years. She issued tenders for constructing the second campus in Kumaon and is on track to launch her pet project, Heal in India—a holistic health centre for international tourists where yoga, meditation and therapy will be the focus. The centre is one of the many steps toward rehabilitating the image of AIIMS- Rishikesh.
“The core focus is to make this institute a hub of telemedicine and popularise the ABHA [Ayushman Bharat Health Account] app among OPD [Outpatient Department] patients so that long queues are cut down,” says Singh.
In a mammoth forward-looking policy, former Union finance minister Jaswant Singh’s 2004 Budget speech followed up on then Prime Minister Atal Bihari Vajpayee’s Independence Day promise. It announced that India was ready to spread the excellence of Delhi-based AIIMS to smaller cities and towns across India to make premier healthcare accessible to all.
“Poverty and disease are interlinked…this ‘Pradhan Mantri Swasthya Suraksha Yojana’ envisages six new AIIMS-like hospitals, one each in the states of Bihar, Chhattisgarh, Madhya Pradesh, Orissa, Rajasthan and Uttaranchal,” he had announced in the 2004-05 budget.
Almost two decades later, the story of ‘small-town’ AIIMS is a mixed one – of huge hope and relief for patients, a boost for local economies and ambitions and of just rescuing millions of rural folk from exorbitant and dubious private hospitals. But in some cases, it has also become a saga of corruption, shortcuts and red tape—dragging the brand of AIIMS into a rut.
In the first part of this series on regional AIIMS hospitals, ThePrint looks at how an institution of national importance became the centre of large-scale corruption and job scams over the years.
Corruption, chaos and CBI raids
An hour’s drive from Uttarakhand’s state capital, Dehradun, Rishikesh draws yogis, tourists, adventurers and seekers of spirituality. It was the first town where the new generation of AIIMS would get off the ground. The announcement brought new hope about access and aspirations.
Initially, the institute was allocated a total fund of Rs 860 crore, but by the time it was finally inaugurated in 2014, costs had escalated to over Rs 1,000 crore. The intake for MBBS courses was later increased to 100 from the earlier 50.
“The state has always needed specialised medical treatment facilities due to its difficult geographical terrain. The opening of AIIMS-Rishikesh will help the people of Uttarakhand access the required specialised medical treatment,” then Chief Minister Harish Rawat had said.
Spread over hundreds of acres, AIIMS-Rishikesh initially made headlines for its slow construction progress. Rumblings of discontent continued with the musical chairs of directors—three in four years—followed by a shortage of faculty housing, forcing doctors to rent accommodation outside the campus.
But allegations of corruption grew louder and louder—from overcharging patients to tampering with the tendering process. When professor Ravi Kant, former Vice-Chancellor of King George’s Medical University in Lucknow, joined the institute as its head in 2017, he gave a candid interview to the Indian Express on all that plagued AIIMS-Rishikesh.
“Stalled construction work and lack of flexibility in recruitment norms are the main reasons why there is still some way to go before AIIMS-Rishikesh becomes a preferred destination for the people of Uttarakhand,” he had said at the time. But this was followed by charges of corruption and irregularities and over-invoicing of equipment. By early 2022, these allegations echoed in the political corridors of power. Amid a flurry of FIRs, CBI launched search and seizure operations at the institute. Teams parked themselves in the hospital from 3-8 February, going through tender documents, invoices, desktops, laptops, and mobile phones.
While this raid didn’t affect the hospital’s day-to-day operations, it got tongues wagging. Everyone—from patients to doctors, nurses to orderlies—was uneasy on campus. Outside, it provided residents with fodder for gossip, especially because several doctors had been accused in the FIRs of abusing their positions.
It was in this climate of suspicion, suspense and shock that Singh stepped foot in Rishikesh.
“The corruption charges have definitely caused a lot of harm to the perception of the institute among peers, but we are cooperating with agencies,” says Singh. But she hopes to put it behind her—and AIIMS-Rishikesh.
“Whatever is asked from us, we are providing,” she says.
Young doctors show no interest
Restoring the institute’s shattered reputation is Singh’s priority, but it didn’t take long for her to realise that there was an equally pressing problem at hand. The issues of AIIMS-Rishikesh go beyond the corruption drama; doctors aren’t flocking to the institute either. Rishikesh may be a beautiful river city on the Himalayan foothills, but it doesn’t sit very well on their aspirational ladder.
Doctors, and these are some of the best in the country, don’t want to spend crucial years of their career in the countryside. They are young, restless, and want the best resources for their families. It’s where Rishikesh falls short.
“A head of department, whose daughter is a top tennis player in the state, is struggling to find a coach. There are none in Rishikesh. He plans to move to Hyderabad for his daughter’s future,” says Singh. She will either have to let him go or find a good tennis coach in Rishikesh itself.
For the HoD—who does not wish to be named— in question, the sheen of the position faded fast, especially when he realised how it jeopardised his long-term career prospects and his family’s future.
“You may head a department post, but then you feel like you’re failing your children when they don’t get what they deserve. Small towns don’t offer much in terms of our kids’ education, spouse’s career and personal life,” said the HoD.
“Regional AIIMS are for those who are going to retire. ”
The problem of retaining talent is not limited to AIIMS-Rishikesh alone. The same ‘disease’ is afflicting AIIMS in smaller towns as well. Bhopal, Patna, Jodhpur, Bhubaneswar, Raipur and Rishikesh AIIMS are part of the first phase of institutes that were established under the AIIMS Amendment Act, 2012. But it’s a revolving door of recruitment and resignations, one with endless entries and exits.
“Whenever any doctor comes to me to resign, I can delay the process, but eventually I have to let him or her go. There is an acute shortage of human resources and faculties,” said another director of a regional AIIMS, who did not want to be named.
The problem goes beyond just good roads and connectivity: Tier-2 and Tier-3 cities have little to offer in terms of good schools, extra-curricular activities and so on.
“Initially, the creamy layer of assistant professors and associate professors came [to Rishikesh] from PGIMER Chandigarh and Delhi AIIMS. But they soon got disillusioned,” said a senior doctor heading another department at the institute.
For Singh, it’s a handicap in her grand plan to build morale, restore the institute’s reputation, and ensure its smooth operations. AIIMS-Rishikesh currently has more than 1,500 students, 31 departments with 58 specialised clinics, 960 beds, and employs more than 4,000 people.
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Tender, chemist scams
Singh is eager to put the CBI investigation behind her so the institute can get back on track. But the skeletons that came tumbling out of the closet provided enough fodder for the media. During its investigation, the CBI registered two cases: one for alleged malpractice while awarding tenders for procuring a road–sweeping machine, and the second over a chemist shop. Both FIRs were registered on 20 April 2022, but the investigative agency has yet to file the chargesheet.
‘Rishikesh AIIMS Ghotala: 3 crore mein khareede Haddi aur Kankaa’ reads one Hindi headline. The reference to ‘haddi aur kankaa’, or bones and skeletons, is based on allegations that a tender for original bone sets for the anatomy department was given to an unauthorised vendor, Pro Medic, in 2017. Incidentally, the same company had also been awarded tenders for road-sweeping machines that same year.
“For Original Human Bones Sets, Disarticulated Original and Disarticulated Original Skeleton (5 Nos.), a total of Rs 2.9 crore invoice was raised by Pro Medic,” says the FIR.
CBI is also investigating the tendering process for compact road sweeping machines, which AIIMS-Rishikesh floated on 27 October 2017. It’s part of the same FIR.
The investigation showed that members of the institute’s Tender Evaluation Committee (TEC) had allegedly “abused their official position as public servants” and “entered into a criminal conspiracy with Pro Medic Devices”. They stand accused of cheating AIIMS, resulting in a “wrongful loss” of Rs 2.05 crore.
TEC has been accused of screening out all the reputed bidders on bogus grounds to keep Pro Medic in the fray. Seven people, including doctors, have been named in this FIR. The list of accused includes a former additional professor in the microbiology department, a former HoD of the anatomy department, an assistant professor (hospital administration), an accounts officer, and an administrative officer.
According to the FIR, Pro Medic Devices, which has offices in Delhi’s Shakarpur, allegedly submitted a notarised affidavit falsely claiming to be a start-up firm.
The second FIR, filed the same day, is based on another tender that Rishikesh-AIIMS floated for setting up a chemist shop inside the campus on 14 November 2018. Here, TEC members allegedly entered into a “criminal conspiracy” with a Delhi-based pharmacy by “circumventing the rules and guidelines of the government of India”.
Other bidders were allegedly disqualified from the tender process on false grounds. Instead, a Delhi-based pharmacy was awarded the contract for running a chemist shop on the AIIMS-Rishikesh campus at a throw-away price of Rs 50.4 lakh per annum, against the Rs 2.51 crore per annum bid offered by another well-known pharmacy, says the FIR.
Ravi Kant, who was director at the time, has not been named in the FIR.
“I personally have not violated any rule,” he told ThePrint.
But a local activist, Ashutosh Sharma, also filed a petition in 2021 with the Uttarakhand High Court, alleging irregularities in the appointments of 32 doctors on reserved seats during professor Kant’s tenure.
“The scale of the corruption was to such an extent that even if they bought a needle or an injection, they raised invoices twice and thrice the price,” he told ThePrint.
Sharma also alleged that Kant’s wife, also a doctor, was appointed as a contractual professor in the surgery department without due process. The petition names another close acquaintance of Kant, who was appointed to the surgical oncology department without an interview.
In August 2022, based on the PIL, the Uttarakhand High Court directed the state government, central government and the director of AIIMS-Rishikesh to submit their replies.
“We are cooperating with the agencies and providing all the information that is being asked,” Singh told ThePrint.
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Patients flock to AIIMS-Rishikesh
On any given day, the OPD at AIIMS-Rishikesh sees as many as 3,000 patients, many of whom make the trek from as far as Uttar Pradesh.
One of them was a Muzaffarnagar-based tractor mechanic, a 45-year-old man who had met with a bike accident last year. He was admitted to a Meerut-based district hospital and later referred to PGIMER Chandigarh. After spending more than Rs 8 lakh in government and private hospitals, the doctors there delivered their verdict.
“The infection has spread. There is no other way but to chop off that leg,” he was told.
The tractor mechanic was devastated. Six months ago, he arrived at AIIMS-Rishikesh, and after four operations, he was able to save his leg and use a wheelchair.
“AIIMS is AIIMS,” he said resolutely. “Once you get there, you will be treated.”
It is this faith that brought 68-year-old local resident Jalakpuri to this hospital with her son, who had suffered cardiac arrest. He was rushed to the emergency ward in the dead of night.
“He was discharged some days ago. We have come here for some reports for him. My arms are constantly in pain, so I tagged along as well,” says Jalakpuri while waiting on a parking-lot bench outside the OPD building where her daughter-in-law and son are consulting with doctors.
The OPD is packed with patients. So are the trauma centres and emergency rooms. The tide of patients rarely ebbs. For all its internal problems, AIIMS-Rishikesh has become a haven for patients. From flu to Kidney stones to complex surgeries, patients trust the hospital to fix anything and everything.
“Doctors are good. They talk to you,” says Jalakpuri.
Moreover, the institute has revived the local healthcare sector. “It has brought a lot of opportunities for us. Lodges, dhabas, medicos to testing labs, a whole new ecosystem has flourished,” says Shresath, who runs New Sai Medicos, one of the oldest pharmacies in the area.
Singh wants to tap into this goodwill to rebuild AIIMS-Rishikesh’s reputation. But first, she has to retain talent.
Another doctor, who left AIIMS-Delhi to join the Rishikesh institute two years ago, has just submitted his resignation papers. “You have got the institutional infrastructure, but you are not able to develop the same culture,” he says cryptically.
This article is part of a series on the state of regional AIIMS hospitals. Read all articles here.
(Edited by Zoya Bhatti)