Bengal health minister seeks outside probe into Swasthya Sathi, citing bills for the dead

West Bengal's Health Minister, Sharadwat Mukherjee, says he wants an independent agency to investigate alleged fraud in Swasthya Sathi, the state health insurance scheme launched under the previous Trinamool Congress government. He said he would submit a report on the alleged irregularities to Chief Minister Suvendu Adhikari, the Millennium Post reported late on Tuesday.

According to the paper, the minister's report says bills were raised under the scheme in the names of people who had died. In some cases, it says, patients who were admitted under the scheme and later died appeared on fresh bills two to three years afterwards, showing them readmitted, and insurers cleared those bills. Mukherjee said he suspected that officials of the state Health department might be involved. "There is corruption everywhere," he was quoted as saying. The allegations have not been tested by any investigating agency or court.

What the minister has alleged

The claims have built up over the past week. On Friday, 30 October, Mukherjee said door-to-door verification of beneficiary records had flagged about 25 to 30 lakh cards as fake, untraceable or suspect, UNI reported. The check is part of the state's plan to move beneficiaries to the Centre's Ayushman Bharat scheme and a new state insurance scheme.

He told Bartaman that a financial forensic audit had found fake beneficiaries, hospitals, patients, doctors, signatures and bills. In one case cited by the paper, a single surgery was split into four separate bills, and several such bills were approved. The Millennium Post reported him as saying that spending linked to untraceable beneficiaries could run to Rs 25,000-30,000 crore, and that the audit "will take time". These are the minister's estimates; no audited figure has been published.

The Millennium Post also reported, citing unnamed sources in Swasthya Bhavan, an allegation that a doctor in the department's Swasthya Sathi cell leased a nursing home in Panskura, Purba Medinipur, in relatives' names and took money from patients admitted there under the scheme. The doctor has not been named or charged.

An association of private hospitals and nursing homes welcomed the inquiry and estimated, according to Bartaman, that about 5% of private hospitals and nursing homes were involved.

Trinamool's response

Trinamool spokesperson Anirban Bandyopadhyay dismissed the allegations last week. "We have seen such threats before," he said, according to Uttarbanga Sambad, adding that past claims against the party had come to nothing and this one would too. Mukherjee has said it was unusual that the former chief minister, Mamata Banerjee, was unaware of the alleged fraud; he has not produced evidence linking her to it. BJP leader Sayantan Basu called for Banerjee to be investigated, the Millennium Post reported.

Background

Swasthya Sathi was launched by Mamata Banerjee in December 2016. It offered families cashless hospital treatment, with the card issued in the name of the senior woman of the household, and it became one of the Trinamool government's flagship welfare schemes. Bengal stayed out of Ayushman Bharat for years under the previous government. The BJP government formed after this year's Assembly election has said it will bring the state into the central scheme.

BJP state president Samik Bhattacharya claimed at the weekend that more than 20 lakh fake Swasthya Sathi cards had been found. The figures given by different BJP leaders and officials have varied, and none has yet been backed by a published audit.

What happens next

Mukherjee said complaints involving senior officials such as the Health Secretary fall outside his jurisdiction and must go to the chief minister, the Millennium Post reported. Adhikari must now decide whether to hand the case to a state or central agency. The forensic audit is continuing, and district-by-district checks of the nursing homes involved are planned, according to Bartaman.