Delhi Lieutenant Governor V K Saxena has asked the CBI to probe the allegations of fake lab tests done at Mohalla Clinics in Delhi run by the Aam Aadmi Party government. This is the second scam to hit the Kejriwal govt’s health department after the supply of sub-standard medicines to government hospitals.
Notably, the Delhi govt has outsourced the lab test services to two laboratories, Agilus Diagnostics and Metropolis Health Care. As per the findings by the LG’s office, private laboratories were paid hundreds of crores for thousands of tests that were not done at the Aam Aadmi Mohalla Clinics (AAMC). The tests were recorded in the name of ghost patients registered using fake phone numbers.
The fake lab test scam at the Aam Aadmi Mohalla Clinics was unearthed during a random monitoring on the orders of the Lieutenant Governor. The order for the monitoring was issued by LG V K Saxena while clearing a file pertaining to the extension of lab testing services to private parties for patients visiting Mohalla Clinics and Delhi Govt Hospitals in December 2022.
As no impact assessment study/review report of the outsourced facilities was undertaken as recommended by the previous LG, V K Saxena ordered a random sample study of lab tests done by the private labs in the Mohalla Clinics.
The scam was first detected in August 2023, when it was found that some doctors and staff at 7 Mohalla Clinics in South-West, Shahdara and North-East districts were resorting to unethical practices to mark the attendance of patients.
They were entering patient data into the system by marking the attendance of the Medical Officer In-Charges using pre-recorded videos on 3 tablet modules, in the absence of the said officers, which is a violation of the rules. Moreover, unauthorised staff were also consulting patients and prescribing medicines in the absence of the doctors. As a result, the guilty staff members were de-empanelled and FIRs were lodged against them.
Along with this, the LG ordered a study of lab tests done in three months. For this study, sample lab testing data for 3 months, from July to September 2023, were collected from the two labs, and analysed. During the study of the sample data, it was found that a large number of fake and non-existent phone numbers were used for the registration of patients, and lab tests were supposedly done on them. Apart from fake numbers, there were duplicate phone numbers too.
This shows that tests were recorded on ghost patients and payments were made by the government for such tests.
Numbers in the fake lab test scam
Several shocking details have emerged in the study of sample data retrieved from the Lab Management Information System of Agilus Diagnostics and Metropolis Health Care, which indicate that it could be a very large-scale scam worth 100s of crores. The study showed that the de-empanelled doctors and staff were not only recording the entry of fake patients, they had also recommended a large number of lab tests for them. Moreover, the tests were prescribed in the absence of the treating doctor, another violation.
The number of fake patients found in just 7 labs in 3 months is huge. In as many as 11,657 records of patients, the mobile number had only 0s. The records of 8,251 patients do not have any mobile number recorded. In the records of 3,092 patients, the mobile number entered is 9999999999. For 400 patients, the mobile numbers start with 1, 2, 3, 4 and 5, the numbers that don’t exist currently in India. Moreover, in 999 records, the same mobile numbers were repeated 15 times or more. The number 9810467129 is recorded against 185 patients, while 165 patients have the number 9855544543. This shows that in the preliminary probe by LG office, over 23,000 fake patients have been detected.
The data were taken from 7 Mohalla Clinics, which are were Jagjeet Nagar Mohalla Clinic, Bihari Colony Mohalla Clinic, Jaffar Kalan Mohalla Clinic, Dhansa Mohalla Clinic, Ujwa Mohalla Clinic, Shikarpur Mohalla Clinic, and Gopal Nagar Mohalla Clinic.
A total of 17,725 lab tests were done in these 7 clinics in the period February 2023 to September 2023. Among this, Agilus Lab did 15,463 tests for 5 Mohalla clinics, while Metropolis did 2,262 tests for 2 clinics.
A general study of all tests by the two labs was also done. As per this, a total of 6,06,837 lab tests were done by the two labs, which includes 5,21,221 by Agilus and 85,616 by Metropolis.
Arvind Kejriwal govt didn’t take action after the scam was detected
As this clearly shows that fake lab tests are being done at Mohalla Clinics, the LG had recommended a System of online registration of patients as well as Aadhar-based / biometric tracking of patients be set up within three months. The LG had also said that a fresh proposal should be evaluated after a period of six months to ascertain its efficacy, quality and genuineness and whether it is proving to be detrimental to the existing Government diagnostic mechanism.
However, despite these recommendations, no action was taken by the Delhi govt. As a result, the LG recommended proceedings against Project Director, OLS (Outsourced Lab Services) and others in the OLS branch for non-compliance of the directions. Additionally, a detailed Vigilance Enquiry was recommended to bring out the quantum of loss to the exchequer and the collusion of Doctors/Support Staff etc with the private agencies.
The vigilance report also said that despite strongly advised by the previous LG, no impact assessment study / review report of the outsourced facilities was undertaken. After the irregularities were exposed, state AAMC cell had issued directions to file FIR against the doctors of 7 Mohalla Clinics, but it was not done, and only generally diary entries were made by police. Despite this, CDMO (NED) Dr. Sandeep Gautam made false statements that FIR have been registered.
The vigilance further stated that CBI is already looking into various anomalies in setting up of Mohalla Clinics, and now the functioning of the clinics has also come under the scanner, as actual data is being manipulated/distorted to serve vested interests at the cost of exchequer. This along with the recent discovery of supply of sub-standard drugs in govt hospitals point towards the fact that ‘Health’ sector is besieged with various omissions and commissions at all fronts at the cost of public who are badly dependent on these essential services.
Moreover, while advertisements were issued to rent locations to set up the Mohalla Clinics, over 50% of the premises were taken on rent on “pick and choose basis”, and not on the basis of the advertisement, as per the vigilance report. It further states that Diagnostic lab services were approved without the approval and concurrence of Finance Department.
The remuneration of the Doctors and staff is based upon the footfall of the patient, but no audit has been done and there is no proper accounting system. “The number of patient visiting the premises/clinic is not captured in a transparent manner,” the report stated.
Based on these findings, the Vigilance Department recommended to refer the matter to CBI. Based on this, the Lt. Governor asked the CBI to take over the probe into fake lab tests done at Aam Aadmi Mohalla Clinics in Delhi.
LG Saxena slams Kejriwal, reveals how the CM tried to play politics
LG Saxena also slammed CM Kejriwal over the issue, saying that while he makes tall claims, he allowed such a big scam to continue. The LG said, “It is deeply upsetting that such fraud is allowed to be perpetrated on the general public which speaks volumes of the irresponsible and lackadaisical approach of successive Hon ‘ble Health Ministers as indeed Hon ‘ble Chief Minister, towards public health. While tall claims are frequently made in various forums by the GNCTD regarding providing world class health infrastructure in Delhi, the recent finding regarding spurious drugs and now fake lab tests, bring to the fore dark realities that belie any claims on the contrary.”
Apart from unearthing this massive scam, the LG also exposed the pathetic state of healthcare under the Arvind Kejriwal govt. While responding to Delhi Health Department’s proposal to extend contract with private labs for tests, the LG noted that it shows that the government labs are so poor in infrastructure that even basic pathological and diagnostic tests.
The LG had said, “While such a decision on the part of the Governments in remote places, that lack facilities in term of physical infrastructure and trained medical professionals in the Government sector, would have made sense, it obviously does not meet the requirements of a rational decision in the Capital of the country, owing to the fact that Government Hospitals I facilities in Delhi run by GNCI’D, as often claimed by the Government itself, are replete with ample physical infrastructure in terms of building, space, machinery and equipment as indeed medical professionals of highest caliber.”
LG Saxena also noted that his predecessor Anil Baijal had also stressed upon the need to strengthen the diagnostic infrastructure in the Government set-up, emphasizing that the public healthcare system cannot be left entirely in the hands of private players. “However, instead of making efforts to strengthen the government system as suggested, the Government has come up with a new proposal, which will further damage the public health system, by way of underutilization, disuse and neglect,” the LG noted. V K Saxena added that setting up a system of Aadhar-based I biometric tracking of patients is need of the hour to prevent any malpractices leading to financial impropriety.
The LG further noted that while the number of Mohalla Clinics in Delhi increased from 450 to 519 in 2022, the number of OPD patients in the clinics decreased from 3416 per month per clinic in 2021 to just 1824. But despite such drop in number of patients, number of diagnostic tests reported to have been conducted by the outsources labs disproportionately from 6,30,978 tests per month in 2021 to 9,30,000 tests per month in 2022.
LG Saxena also exposed how the Kejriwal govt tried to play politics over the issue to accuse him of not clearing files. Saxena said that the Delhi Cabinet had decided to extend the contract of the labs in July 2022, but the file was sent to the LG’s office in December, less than 3 weeks before the expiry of the existing contracts. And within 10 days of sending the file, CM Arvind Kejriwal wrote to him over the matter and shared the same in public domain. The LG said that it was an obvious attempt to unconstitutionally force a decision.