PARLIAMENT of INDIA RAJYA SABHA the Functioning of All India

REPORT NO. 87

PARLIAMENT OF INDIA RAJYA SABHA

DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEE ON HEALTH AND FAMILY WELFARE

EIGHTY SEVENTH REPORT The Functioning of All India Institute of Medical Sciences (AIIMS) (Department of Health and Family Welfare) Ministry of Health and Family Welfare

(Presented to the Rajya Sabha on 11th August, 2015) (Laid on the Table of Lok Sabha on 11th August, 2015)

Rajya Sabha Secret ariat, New Delhi August, 2015/Sravana, 1937 (Saka) Hindi version of this publication is also available

PARLIAMENT OF INDIA RAJYA SABHA

DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEE ON HEALTH AND FAMILY WELFARE

EIGHTY SEVENTH REPORT

The Functioning of All India Institute of Medical Sciences (AIIMS) (Department of Health and Family Welfare) Ministry of Health and Family Welfare

(Presented to the Rajya Sabha on 11th August, 2015) (Laid on the Table of Lok Sabha on 11th August, 2015)

Rajya Sabha Secretariat, New Delhi August, 2015/Sravana, 1937 (Saka) Website : http://rajyasabha.nic.in E-mail : [email protected] CONTENTS

PAGES

1. COMPOSITION OF THE COMMITTEE ...... (i)—(ii) 2. INTRODUCTION ...... (iii) 3. ACRONYMS ...... (iv) 4. REPORT ...... 34 Introduction...... 1 I. Historical Background...... 1—2 II. Aims and Objectives of AIIMS...... 2 III. Governance Structure...... 2—6 (a) Institute Body (b) Governing Body (c) Standing Committees IV. Activities...... 6—9 (a) Education (b) Medical Research (c) Patient Care Services (d) General Administration (e) Budget and Finance V. Special Character of AIIMS...... 9—10 VI. Governance...... 10—17 (a) Major Concerns and related suggestions (b) Corruption Cases (c) Need for decentralization (d) Valiathan Committee Report (e) Staff Strength (f) Recruitment, Reservation and Promotion Policies VII. Infrastructure...... 17—20 (a) Expansion plan for the next decade and status of various expansion projects (b) Expansion and Decongestion of infrastructure (c) Expansion needs of AIIMS and Trauma Centre (d) AIIMS Campus II (Jhajjar, Haryana) VIII. Academics...... 25 IX. Research...... 25—28 X. Patient Care...... 28—32 XI. Allied Services...... 32—34 (i) Public Relation Cadre Employees of AIIMS (ii) Physiotherapy Services (iii) Speech Pathology & Audiology OBSERVATIONS/RECOMMENDATIONS OF THE COMMITTEE...... 35—47 5. MINUTES ...... 49—90 6. ANNEXURES ...... 91—116 (i) Annexure I - Composition of the Committees/Sub-Committees...... 93—102 (ii) Annexure II - List of witnesses...... 103—107 (iii) Annexure III - Communication dated 19th June, 2015 received from Department of Health and Family Welfare...... 108—116 COMPOSITION OF THE COMMITTEE (2014-15)

1. Shri Satish Chandra Misra — Chairman RAJYA SABHA 2. Shri Ranjib Biswal 3. Shri Rajkumar Dhoot %4. Shri Vijay Goel ^5. Dr.Bhushan Lal Jangde 6. Shrimati B. Jayashree 7. Dr. R. Lakshmanan 8. Shrimati Kahkashan Perween &9. Dr. Vijaylaxmi Sadho 10. Chaudhary Munvvar Saleem 11. Dr. T.N. Seema @12. Shri Jairam Ramesh LOK SABHA 13. Shri Thangso Baite 14. Dr. Subhash Bhamre 15. Shri Nandkumar Singh Chouhan (Nandu Bhaiya) 16. Dr. Ratna De (Nag) 17. Dr. Heena Vijaykumar Gavit 18. Dr. Sanjay Jaiswal 19. Dr. K. Kamaraj 20. Shri Arjunlal Meena 21. Shri J.J.T. Natterjee 22. Shri Chirag Paswan 23. Shri M.K. Raghavan 24. Dr. Manoj Rajoriya 25. Shri Alok Sanjar #26. Dr. Mahesh Sharma 27. Dr. Shrikant Eknath Shinde 28. Shri Raj Kumar Singh 29. Shri Kanwar Singh Tanwar 30. Shrimati Rita Tarai 31. Shri Manohar Untwal 32. Shri Akshay Yadav *33. Shrimati Ranjanaben Bhatt

% Resigned from the membership of the Committee w.e.f. 2nd December, 2014. ^ Nominated as a member of the Committee w.e.f. 19th December, 2014. & Ceased to be member of the Committee w.e.f. 28th November, 2014. @ Nominated as a member of the Committee w.e.f. 28th November. 2014. # Ceased to be member of the Committee w.e.f 9th November, 2014. * Nominated as a member of the Committee w.e.f. 22nd December, 2014. ** Nominated as a member of the Committee w.e.f. 22nd December, 2014. (i) (ii)

**34. Dr. Pritam Gopinath Munde SECRETARIAT Shri P. P. K. Ramacharyulu, Joint Secretary Shri Pradeep Chaturvedi, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Joint Director Shri Pratap Shenoy, Committee Officer INTRODUCTION

I, the Chairman of the Department-related Parliamentary Standing Committee on Health and Family Welfare, having been authorized by the Committee to present the Report on its behalf present this Eighty Seventh Report of the Committee on the Functioning of All India Institute of Medical Sciences (AIIMS).

2. The Committee identified the subject ‘Functioning of All India Institute of Medical Sciences (AIIMS)’ at its meeting held on 18th September, 2014. The previous Committee, during 15th Lok Sabha, had also identified the subject in 2011 and the Committee continued to examine the subject till 2013. The then Committee discussed threadbare a host of issues on the subject and also heard experts/stakeholders. A Sub-Committee was also appointed in 2010-11 and 2011-12. (List of composition of Committees year-wise that examined the subject is at Annexure I)

3. The present Committee examined the subject, in its sittings held on 18th September, 2014, 12th November, 2014, 16th January, 2015 and 3rd August, 2015 and it also took oral evidence of representatives of the Ministry of Health and Family Welfare and the AIIMS. A list of official witnesses and experts/stakeholders heard is at Annexure II. In total, the previous Committee and the present Committee considered the subject in 4 sittings and the Sub- Committee examined the subject in 12 sittings.

4. During the finalization of its Report, the Committee relied upon the following documents/papers:- (i) Status Note on AIIMS received from Department of Health and Family Welfare; (ii) Oral Evidences tendered by Secretary, Department of Health and Family Welfare along with the Director, AIIMS; (iii) Oral Evidences tendered by Experts/Stakeholders; (iv) Written submissions made by Experts/Stakeholders; and (v) Replies to the questionnaires received from the Department of Health and Family Welfare.

5. The Committee considered the Draft Report and adopted the same in its meeting held on 3rd August, 2015.

6. For facility of reference and convenience, the observations and recommendations of the Committee have been printed in bold letters in the body of the Report.

SATISH CHANDRA MISRA NEW DELHI; Chairman, 3rd August, 2015 Department-related Parliamentary Standing Sravana 12, 1937 (Saka) Committee on Health and Family Welfare Rajya Sabha (iii) ACRONYMS

AIIMS – All India Institute of Medical Sciences AFC – AIIMS Finance Committee ACP – Assured Career Progression CSIR – Council of Scientific and Industrial Research CRHS – Comprehensive Rural Health Services CVO – Central Vigilance Officer CVC – Central Vigilance Commission DST – Department of Science and Technology DoPT – Department of Personnel and Training DM – Doctor of Medicine ICMR – Indian Council of Medical Research IT – Information Technology IIT – Indian Institute of Technology IISc – Indian Institute of Science ICU – Intensive Care Unit ICDS – Integrated Child Development Services JIPMER – Jawaharlal Institute of Medical Education & Research MBBS – Bachelor of Medicine, Bachelor of Surgery NCR – National Capital Region OPD – Out Patient Department PMSSY – Pradhan Mantri Swasthya Suraksha Yojana PGIMER – Post Graduate Institute of Medical Education and Research PET – Positron Emission Tomography NISTAC – Nationwide Infrastructure Support Technical Assistance Consultants RTI – Right to Information TIFR – Tata Institute of Fundamental Research T.B. – Tuberculosis UNICEF – United Nations International Children’s Emergency Fund UPSC – Union Public Service Commission VRS – Voluntary Retirement Scheme WHO – World Health Organization

(iv) REPORT INTRODUCTORY

The All India Institute of Medical Sciences is an autonomous institution of national importance established in 1956 by an Act of Parliament to serve as a nucleus for nurturing excellence in all aspects of health care.

I . Historical Background

2. As per the information furnished by the Ministry of Health and Family Welfare, an ‘All India Medical Institute’ was first envisioned by the Advisory Committee on Professional Education, created to translate the recommendations of the Bhore Committee (1943) that laid the foundation of the health sector policy and development in modern India. The Advisory Committee, chaired by Dr. A. L. Mudaliar and whose membership included, among others, the legendary Dr. B. C. Roy, recommended creation of an ‘All India Medical Institute’ which ‘will not only provide a centre for training of medical teachers, but will combine the provision of the most up-to-date hospital facilities for the education of medical graduates and opportunities for comprehensive research without which teaching and training must fail in their object.’

3. The Ministry further informed that the above resolve made at the cusp of our Independence, was translated into reality by the first Union Health Minister Rajkumari Amrit Kaur. The All India Institute of Medical Sciences (AIIMS) was brought into existence by the Parliament through Act 26 of 1956. Moving the AIIMS Bill, she articulated the vision of AIIMS in her address to the Parliament on 18 February, 1956 wherein she stated, “It has been one of my cherished dreams that for postgraduate study and for the maintenance of high standards of medical education in our country, we should have an Institute of this nature in India which would enable our young men and women to have their post-graduate education in their own country, in their background with the necessary experience that we would like to give them to do research in the various spheres of medical education.” The Committee has been informed that the principle impetus for the creation of AIIMS, as an institution of national importance, was post-graduate education which is further evident from the Objects of the Institute laid down in Clause 13 of the Act. Clause 14 of the Act lists the Functions of AIIMS for the attainment of the stated Objects.

The Functions re-affirm the Institute’s commitment to the broad spectrum of health professional education as also to research and maintenance of well equipped hospitals. Over the years, as the Institute evolved, it emerged as an apex level hospital, indeed, a benchmark in healthcare. Thus, the trinity of the mission of the Institute is:

(1) Education of diverse health professionals

(2) Research in biomedical sciences; and

(3) Patient care at the highest care level; 2

4. Although AIIMS has consistently proved as a leader in advanced patient care, the unique and unparalleled role of the Institute has been to serve the nation as a fountainhead of world-class medical education and biomedical research, the core functions of a university. While addressing its problems, AIIMS should be seen as medical sciences university committed to excellence in research and education, to which is attached an apex referral hospital that is expected to provide most advanced healthcare.

II. Aims and Objectives of AIIMS

5. As informed by the Ministry of Health and Family Welfare, the following are the aims and objectives of AIIMS:-

To develop pattern of teaching in under-graduate and post-graduate medical education in all its branches so as to demonstrate a high standard of medical education to all medical colleges and other allied institutions in India.

To bring together in one place educational facilities of the highest order for the training of personnel in all branches of health activities.

To attain self-sufficiency in post-graduate medical education.

6. The Secretary, Department of Health and Family Welfare during his evidence before the Committee on 12th November, 2014 inter-alia submitted that ever since India Today began ranking medical institutions, AIIMS has been ranked number one consecutively for about 14 years and quite often, it is number one in all parameters. Teaching and research is conducted in 52 disciplines. AIIMS is a leader in the field of medical research with over 1600 research publications by its faculty and researchers in a year. WHO fellows also undergo elective training in AIIMS. The Institute runs a comprehensive rural health centre at Ballabhgarh in Haryana and provides health cover to about 7.7 lakh people through the Centre for community medicine.

III. Governance Structure

7. The Institute is being administered under the provisions of:

The AIIMS Act, 1956;

The AIIMS Rules, 1958; and

The AIIMS Regulations, 1999.

8. The AIIMS governance structure is multi-tiered and consists of the following entities:

(a) The Institute Body

9. As per the information furnished by the Ministry, the Institute Body consists of the following members:

The Vice-Chancellor of the Delhi University, ex-officio;

The Director General of Health Services, Government of India, ex-officio; 3

The Director of the Institute, ex-officio;

Two representatives of the Central Government, to be nominated by the Government, one from the Ministry of Finance and one from the Ministry of Education;

Five persons of whom one shall be a non-medical scientist, representing the Indian Sciences Congress Association, to be nominated by the Central Government;

Four representatives of the medical faculties of Indian Universities to be nominated by the Central Government in the manner prescribed by rules; and

Three members of Parliament of whom two shall be elected from among themselves by the members of the House of the People and one from among themselves by the members of the Council of States.

10. From the information furnished to the Committee it is seen that the Minister of Health and Family Welfare is the President of the Institute.

(b) Governing Body

11. The Governing Body of the Institute is the executive Committee of the Institute and shall exercise such powers and discharge such functions as the Institute may, by regulations made in this behalf, confer or impose upon it. The Governing Body consists of the following 11 members:

(a) President of the Institute;

(b) Director General of Health Services;

(d) One member elected by the members of the Institute from amongst the three members of the Parliament elected to the Institute;

(e) Six members to be elected by the members of the Institute from amongst themselves; and

(f) Director, AIIMS - Member-Secretary.

12. The Minister of Health and Family Welfare, by virtue of being the President of

Institute also is ex-officio Chairman of the Governing Body.

13. The Standing Committees are constituted from amongst the members of the Institute Body and are as follows:

Standing Finance Committee;

Academic Committee; 4

Standing Selection Committee;

Standing Estate Committee; and

Hospital Affairs Committee.

14. The Ministry of Health and Family Welfare vide its O.M. dated 05th November, 2014 gave an overview of the roles of various committees and meetings of these Committees during the last four years which is delineated below:

Role of Various Committees/Bodies:-

Institute Body

15. The Institute Body is the supreme body and the same is constituted by the Central Government and the functions of the Institute body is as under: Section 14 of the AIIMS Act, 1956 provides as under:

With a view to the promotion of the objects specified under section 13, the Institute may:-

(a) Provide for undergraduate and post-graduate teaching in the science of modern medicine and other allied sciences, including physical and biological sciences;

(b) Provide facilities for research in the various branches of such sciences;

(d) Conduct experiments in new methods of medical education, both under graduate and post-graduate, in order to arrive at satisfactory standards of such education;

(e) Prescribe courses and curricula for both undergraduate and postgraduate studies; and.

(f) Notwithstanding anything contained in any other law for the time being in force, establish and maintain:-

(i) One or more medical colleges with different departments including a department of preventive and social medicine sufficiently staffed and equipped to undertake not only undergraduate medical education but also post-graduate medical education in different subjects;

(ii) One or more well-equipped hospitals;

(iii) A dental college with such institutional facilities for the practice of dentistry and for the practical training of students as may be necessary;

(iv) A nursing college sufficiently staffed and equipped for the training of nurses;

(v) Rural and urban health organizations which will form centers for the field training of the medical, dental and nursing students of the Institute as well as for research into community health problems; and 5

(vi) Other institutions for the training of different types of health workers, such as physiotherapists, occupational therapists and medical technicians of various kinds; (g) Train teachers for the different medical colleges in India. (h) Hold examinations and grant such degrees, diplomas and other academic distinctions and titles in under graduate and post-graduate medical education as may be laid down in regulations. (i) Institute, and appoint persons to, professorships, readerships, lectureships and post of any description in accordance with regulations. (j) Receive grants from the Government and gifts donations, bequests and transfers of properties, both movable and immovable, from donors, benefactors, testators or transferors, as the case may be. (k) Deal with any property belonging to, or vested in the Institute in any manner which is considered necessary for promoting the objects specified in section 13. (l) Demand and receive such fees and other charges as may be prescribed by regulations. (m) Construct quarters for its staff and allot such quarters to the staff in accordance with such regulations as may be made in this behalf. (n) Borrow money with the prior approval of the Central Government on the security of the property of the Institute. (o) Do all such other acts and things as may be necessary to further the objects specified in Section 13.

Governing Body

16. The Governing Body of the Institute is the executive committee of the Institute and shall exercise such powers and discharge such functions as the Institute may, by regulations made in this behalf, confer or impose upon it.

Standing Finance Committee

17. The following matters shall be referred to the Standing Finance Committee which shall consider them and make its recommendations thereon, namely: (a) Annual accounts showing the receipts and expenditure of the Institute together with the audit report thereon; (b) Budget estimates showing the estimated receipts and expenditure of the Institute; (c) All proposals for the creation of new post; (d) All financial matters pertaining to the Institute; and

(e) All matters relating to the invitation and acceptance of tenders. 6

Standing Estate Committee

18. Standing Estate Committee is constituted for the purpose of considering additions and alterations to buildings belonging to the Institute and other questions relating to their maintenance and use.

Standing Academic Committee

19. Standing Academic Committee is constituted for the purpose of all Academic Matters.

Standing Selection Committee

20. Standing Selection Committee is constituted for the purpose of selection of Faculty.

Standing Hospital Affairs Committee

21. Standing Academic Committee is constituted for the purpose of all Hospital Matters.

22. The details of the meetings during the last four years are as under:-

(i) Institute Body: 2011-Nil, 16.01.2012, 15.05.2013, 29.09.2013 and 12.05.2014

(ii) Governing Body:

01.03.2011, 16.01.2012, 14.04.2012, 22.10.2012, 19.07.2013, 28.02.2014 and 12.05.2014

(iii) Standing Finance Committee: 04.07.2011, 26.08.2011, 16.03.2012, 28.05.2012, 18.09.2012, 22.08.2013, 27.09.2013 and 22.10.2014

(iv) Standing Estate Committee:

09.09.2011, 20.03.2012, 15.02.2013 and 05.11.2013

(v) Standing Hospital Affairs Committee:

19.06.2011 23. The term of the aforesaid Bodies/Committees is of 5 years.

IV Activities

24. Broadly, the activities of the Institute can be categorized into following:

(a) Education

25. The Institute conducts graduate and post-graduate courses in medicine, dentistry and nursing. It also conducts super specialty courses in several disciplines. 7

(b) Medical Research

26. As stated in the Status Note furnished by the Ministry of Health and Family Welfare, in the field of medical research AIIMS is the leader, having around 600 research publications by its faculty and researchers in a year. In fact many research projects are being carried out at AIIMS on topics which are of national importance. The AIIMS faculty members get research funds from various governmental and international funding agencies like Department of Science and Technology (DST), CSIR, ICMR, WHO, etc. In addition, there are many grants from bilateral collaboration programmes such as Indo-US, Indo-French & Indo-German.

27. According to background note received from Ministry of Health and Family Welfare, AIIMS receives a large number of patients from all over the country as well as from abroad. Adequate medical care is provided by doctors, nurses and other staff as per maximum handling capacity. AIIMS continues to provide best possible medical care/treatment to all patients attending the main hospital and various centres viz. Dr. R.P. Centre for Ophthalmic Sciences, C. N. Center, Dr. B.R.A. Institute-Rotary Cancer Hospital, National Drug Dependence Treatment Centre, J.P.N. Apex Trauma Centre, Comprehensive Rural Health Services Project (CRHS), Ballabhgarh.

28. The Institute also provides round the clock emergency services that are manned by specialized doctors at the level of Sr. Residents and consultants. These emergency services are equipped with all the diagnostic (including Ultrasound, CT. Scan etc.) and therapeutic facilities.

(d) General Administration

29. The Ministry has informed that AIIMS has various branches such as Personnel & Establishment, Security, Estate, Engineering Services, Stores, Budget and Finance, Vigilance, Horticulture, etc.

(e) Budget and Finance

30. As per information furnished by the Ministry, the Institute is mainly financed from grants of Government of India under the heads “Plan” and “Non Plan”. In addition, Plan grants are also received for National Drug Dependence Treatment, VVIP care and College of Nursing etc. Besides, extramural grants are also received from various external funding agencies like ICMR, DST, CSIR, WHO, UNICEF, Department of Biotechnology (DBT) etc. for various research projects. Plan and Non-Plan grants received from the Government of India and other agencies are further allocated to Super-specialty Centers/Departments/Research Sections as per their projections/requirements.

31. The status of Budget Estimates (BE), Revised Estimates (RE) and Actual Expenditure (AE) during the last five years (i.e. 2010-11 to 2014-15), as informed by the Ministry vide letter dated 19th June, 2015 is as below:- 8

The Expenditure during the last five years Plan and Non-Plan is as under:-

(` in Crore)

Year PLAN NON-PLAN TOTAL

B.E. R.E. Expdr. B.E. R.E Expdr. Budget Expdr.

2010-11 400.00 380.00 381.62 400.00 605.00 681.10 985.00 1062.72

2011-12 412.35 412.35 415.79 610.00 650.00 744.80 1062.35 1160.59

2012-13 474.00 470.00 420.32 650.00 788.70 899.68 1258.70 1320.00

2013-14 550.00 485.00 494.45 790.00 870.00 974.66 1355.00 1469.11

2014-15 550.00 621.00 669.82 815.00 1001.00 1099.08 1622.00 1768.90#

Note:- Excess expenditure adjusted from balances of previous year/out of revenue generation.

#Tentative Expenditure, Accounts 2014-15 under compilation

32. Fund Requirements for AIIMS, New Delhi

As informed by the Ministry, the details of fund requirements during the financial year

2015-16 under Plan were as under:

(` in Crore) Head Budget Estimate Remarks 2015-16 (proposed)

Grants-in-Aid 202.00 The increase of RE-2014-15 is on account of payment of (Salaries) annual increment and hike in rates of DA and filling up of 725 newly created posts of Sister Gd. II.

Grants-in-Aid 195.00 The increase RE-2014-15 is due to overall inflation and hike (General) in rates of spares and accessories, CMC, development works and computerization of the Institute.

Creation of 928.50+ There is an additional requirement of R.E.2014-15 of Capital 1000.00 `142.00 crore for construction of National Cancer Assets Institute at Jhajjar (`100.00 crore) and purchase of Machinery and equipments by the Deptt. of Nuclear Medicine.

TOTAL 2325.50 9

A separate proposal is being taken up with Ministry of Finance for residential accommodation for faculty and staff of AIIMS.

33. As per the information furnished to the Committee, the Institute has been allocated funds of ` 550.00 crore under Plan head for the financial year 2015-16 against the Institute’s projection of ` 2325.50 crore. The projection included `300.00 crore for National Cancer Institute, Jhajjar, `120.00 crore for OPD Block at Masjid Moth, `50.00 crore for Paid Ward and `60.00 crore for acquisition of land. The provision of `1000 crore was made by AIIMS for transfer of funds to the Ministry of Urban Development on demand at appropriate stage for transfer of Houses to AIIMS from Central Government Accommodation pool for the East Kidwai Nagar Housing Project and because large number of Civil Engineering projects are coming on time.

34. The Committee during the course of the examination of the functioning of AIIMS deliberated on the various issues plaguing AIIMS and made certain observations/ recommendations in respect of each of these issues after scrutinizing the Status Note/views/ suggestions received and also after hearing the views of various officials of the Ministry of Health and Family Welfare, AIIMS. The Committee also took note of the views expressed by experts/witnesses on the functioning of AIIMS before the previous Committee. The same are discussed in the succeeding paras.

V. Special Character of AIIMS

35 The Committee has been informed that in the health sector, no other institution undergoes such intense scrutiny as AIIMS. The Institute by statute is an autonomous body. Yet the Institute has to struggle for years to get its plans approved. Valuable man-hours get invested even in conceiving a project and documenting it. Every initiative gets looped into proforms, checklists, EFCs, in-principle approvals, statutory clearances, etc. If AIIMS has to deliver its true potential it has to be unshackled from normal Government processes and its growth needs to be fast-tracked.

36. The following views were expressed by various experts to deal with the issues stated above:-

(i) AIIMS should remain publically funded and democratically accountable as AIIMS serves people unlike IITs and IIMs which serve industry;

(ii) Political interference would diminish/cease if norms are followed. The time taken for financial decisions can also be decreased through discussions as in Government departments;

(iii) Intellectual autonomy was the essence of the AIIMS Act and that it was more important than financial autonomy. Lack of intellectual autonomy rather than lure of higher salaries was the main reason for senior faculty leaving institutes of national importance;

(iv) AIIMS should have functional autonomy; however, money should be spent according to Government of India (GOI) rules. Autonomy should be for the Institute, not for the individual; 10

(v) CCS (CCA) rules have no place in medical universities. There is no freedom of expression of views even on research at AIIMS. This is likely to result in dissatisfaction among the senior faculty, who would leave AIIMS on becoming eligible for retirement benefits, negating the benefits of Government’s provision for increasing the age of retirement; and

(vi) AIIMS should have formulated its rules, regulations and code of conduct on lines of a medical university, and there should be no need to rely on default Government directives.

37. The Secretary, Department of Health and Family Welfare during the course of deliberations on AIIMS on 12th November, 2014 stated that the objectives of establishment of AIIMS in the year 1956 were to develop patterns of teaching in undergraduate and post-graduate medical education in all its branches, to bring together in one place educational facilities of the highest order for training of personnel in all important branches of health activity and to attain self-sufficiency in postgraduate medical education.

VI. Governance

(a) Major Concerns and related suggestions

38. As stated previously in this Report, the AIIMS governance structure includes the Institute Body, the Governing Body and the five Standing Committees viz. Standing Finance Committee, Academic Committee, Standing Selection Committee, Estate Committee and the Hospital Affairs Committee. The Director of the Institute is the Chief Executive Officer of AIIMS. The Committee also sought the views of various stakeholders and experts on the working of these entities. The Committee has been given to understand that there are several shortcomings in the functioning of these entities which are mandated with the governance of the Institute. Some of the shortcomings pointed out by the Stakeholders are given as under:-

(i) Weak internal governance and excessive external interference is the cause of poor governance at AIIMS;

(ii) To manage huge faculty of AIIMS, there is need of trained administration to support Director’s office;

(iii) There is need to strengthen the internal structure of the Institution;

(iv) There is a need to improve the internal administration of the Institute, formulation of code of conduct and exercise of self-discipline by the faculty to resurrect the Institute;

(v) The lack of time frames for meetings of executive bodies of AIIMS has led to centralization of decision making in the hands of the President and Director. In the absence of meetings, decisions are taken by the Director with the approval of the President, AIIMS and these decisions are put up in the subsequent Institute Body/Governing Body meeting for ex-post facto approval. This has often led to bureaucratic delays in execution of civil work, purchase and up gradation of equipment, and timely selection and promotion of faculty and staff; 11

(vi) Nomination of the Health Minister as the President of the Institute was the cause for delays in holding such meetings and she/he should not serve as the President of AIIMS;

(vii) There are cases of manipulating the AIIMS examinations and leakage of papers etc. Attempts of AIIMS to conduct an impartial and thorough review of its examination system, plug the leaks, and bring the culprits to book, lacked transparency. There needs to be transparent system in this regard;

(viii) Contract appointments reduce the scope of independent opinion, which may be a short term convenience for some but causes long term damage to the individual and the institution as it leads to neglect of quality, equity and fairness. Contract employees are exploited by their seniors in terms of work and by the organization, economically. The organization on the other hand has to bear the cost of repeated recruitment. Contract employment leads to career insecurity for the individual and unstable workforce for the organization as the contract employee has to search for new jobs constantly. Contract appointments should be discouraged as they distort the system goals by negatively affecting security and career development opportunities of employees;

(ix) AIIMS has very poor financial and personnel management;

(x) An independent agency like UPSC and Staff Selection Board should be entrusted with recruitment and promotions of faculty and staff, respectively; and

(xi) If regular processes are observed transparently and honestly, many problems can be avoided. Proper selection, collective decision making by the Committees, building an organisation culture and observing processes and norms in right spirit and discussing every violation threadbare in the Governing Body are necessary to ensure adequate check in the administration processes. Except in the matter of finance, AIIMS has complete autonomy. Autonomy of the AIIMS should not mean autonomy from observance of rules and regulations. As regards autonomy and functional flexibility in creation of posts in the institute, since creation of posts has financial implications, the processes are permanent and cannot be avoided but the duration can be shortened by transparent discussions with respective Government Departments and Ministries.

39. The Secretary during evidence before the Committee on 12th November, 2014 submitted that the main Institute bodies were being reconstituted after the General Elections for the 16th Lok Sabha and all efforts will be made to notify the reconstitution of Institute bodies as soon as possible, The Director, AIIMS who was also present during evidence before the Committee on 12th November, 2014 admitted that every Committee of the Institute should meet in three- four months but that did not happen in the past. He assured the Committee that the meetings of the various Institute Committees will be held on regular intervals in future.

(b) Corruption Cases

40. Taking note of the media reports highlighting corruption cases in AIIMS, the Committee had called for the details of on-going probes into various corruption cases at AIIMS. As per 12 the information furnished by the Department of Health and Family Welfare vide its communication dated 24th February, 2015 such corruption cases under investigation include disproportionate asset cases, procurement of computers and peripherals without following due procedure, alleged financial irregularities in purchase of surgical gloves and medicines, construction of engineering works without approval of the statutory bodies, alleged tempering with selection lists of operation theatre assistants, irregularities in appointment of officials under sports quota, irregular payments to contractors, irregularities in awarding developmental works etc.

41. Informing the Committee of the number of Vigilance Cases, the Additional Secretary during his evidence before the Committee on the 16th January, 2015 submitted that AIIMS has an institutional strength of 14,850 employees including 600 faculty positions. There are 30 Vigilance Cases and in 3 cases CBI has instituted Preliminary Enquiry Proceedings.

42. The Committee has been given to understand that all powers are concentrated in one person. There are suggestions that rather than giving complete autonomy to the Director or a few offices, there is a need for decentralization and greater involvement of stakeholders in decision-making. The following suggestions came up for consideration before the Committee:

(i) Decentralisation of decision-making would provide greater time to the Director for planning and policy-making;

(ii) Regular faculty meetings should be held for better decision-making;

(iii) Decision by collegiums rather than by the Head of Department would be a better approach;

(iv) There should be regular meetings of the Institute, Governing bodies and various existing agencies; and

(v) Lack of communication in the Institute needs to be addressed.

(d) Valiathan Committee Report

43. The Committee considered the Valiathan Committee Report on functioning of AIIMS and sought action taken on the said report. The Ministry of Health and Family Welfare vide its communication dated 25th November, 2014 submitted that a High Powered Committee constituted for the purpose of implementation of Valiathan Committee recommendations has classified the recommendations into two categories Part- A & Part- B which is as follows :-

Part- A: Recommendations not requiring structural changes (31 recommendations).

Part- B: Recommendations requiring structural changes through amendments in AIIMS Act, Rules and Regulations (7 Recommendations).

44. The High Powered Committee submitted the report on 29.11.2010 which was sent to AIIMS for comments. AIIMS placed the report of High Powered Committee before the Institute Body in its meeting held on 16/01/2012 wherein it was decided that the report of the High Powered Committee be considered on receipt of the report of Department related 13

Parliamentary Standing Committee (PSC) on Health & Family Welfare which has taken up examination of the functioning of AIIMS.

45. Informing the Committee of the updated status of implementation of the Valiathan Committee recommendations, the Additional Secretary during his evidence before the Committee on the 16th January, 2015 submitted that the recommendations had been examined by a high powered committee led by Ms. Sujatha Rao, former Health Secretary. Sixteen recommendations of the Valiathan Committee have been implemented; 10 recommendations have been accepted in principle and are in the process of being implemented; and three recommendations have long-term futuristic implications.

46. The Committee has been given to understand that opinion of the medical world is divided on the Valiathan Committee Report. Some of the stakeholders had expressed reservations on the implementability of the recommendations and their relevance for AIIMS.

In brief, the opinions of such stakeholders are the following:

(i) The methodology followed by the Valiathan Committee was flawed, and could easily have been used to manipulate opinion;

(ii) The Ministry did not analyze the process by which the Valiathan Committee developed its report;

(iii) Dr. Valiathan himself admitted that none of the other Members of the Committee attended its proceedings on a regular basis and he submitted report despite Shri Hota’s (the then Secretary of the Ministry) requests for extension for accommodating further debate, particularly on statutory aspects;

(iv) Financial dependence on the industry would perforce lead to shift in accountability to grant providers rather than to the people/Government and the basic character of the Institute as the highest level provider for equitable training, public-oriented research and public service would be lost. In handing over AIIMS to the industry on a platter, the Government would abdicate on its responsibility to the Nation;

(v) AIIMS as a statutory body enjoys considerable functional autonomy and that the Valiathan Committee in effect posists a model economy divorced from accountability to the Government;

(vi) The idea of AIIMS International is rather half-baked. With faculty strength of just over 500, the Institute would be hard-pressed in terms of manpower to even carry out its national mandate and that AIIMS International would lead to distortion of priorities; and

(vii) Dr. Valiathan’s suggestions on conflict of interest management are quite at variance with good practices in reputed institutions abroad.

(e) Staff Strength

47. The Committee has been given to understand that there are a large number of vacancies in the Institute. The Committee sought details of vacancies in various categories in AIIMS. The 14

Ministry of Health and Family Welfare vide its O.M. dated 05th November, 2014 gave an overview of sanctioned/in-position doctors, nurses and supporting staff vis-a-vis requirements which is delineated below: The details of sanctioned, in-position, vacant manpower and actual requirements thereof, in respect of both faculty and Group A (non-faculty), B, C & D including technical supporting staff are as under:- Sanctioned strength and in-position excluding nurses

Group Sanctioned strength in-position

“A” (faculty) 826 594 “A” (non faculty) 347 201 “B” 1193 990 “C” 4773 3953

TOTAL 6313 5144

Sanctioned strength and in-position of nurses

Group Sanctioned strength in-position

“A” (non faculty) 215 192 “B” 4338 3849

TOTAL 4553 4041

N.B.: The figures shown against sanctioned strength and in-position vary because the faculty members, apart from being appointed under the mode of direct recruitment, are also being promoted to the next higher grade under Assessment Promotion Scheme without linkage to vacancies by carrying the sanctioned post on which they have initially been appointed. No. of faculty posts under creation : 174 Sanctioned strength and in-position of Senior Residents and unior Residents

Group A Sanctioned strength in-position Vacant

Junior Residents 163 129 34* Senior Resident 758 579 179**

TOTAL 921 708 213

* Against the above, appointment offers have already been issued to 13 Junior Residents who are likely to join. For the balance vacant posts recruitment is proposed to be held in November, 2014 **Selection process for filling up the vacant posts of Senior Residents (Non-Acad.) has already been initiated. 15

48. Some of the residents keep on resigning off and on at regular intervals due to various reasons and wherever waitlisted candidates are available, the vacant positions thus created are filled from waitlisted candidates. Otherwise, these vacancies (where it is not possible to fill from waitlist or waitlist not available) are filled in the next session. This process continues. However, overall there is no shortage of doctors at residents level as of now.

49. On being asked about the filling up of faculty posts, the Director, AIIMS during evidence before the Committee on 12th November, 2014 informed the Committee that since February 2013 to May 2014, 120 faculty members have been selected.

50. It has been informed that a total number of 905 non-faculty posts projected for creation for various areas of the hospital was placed before the Standing Finance Committee in its meeting held on 22/10/2014 and the SFC decided that creation of non-faculty posts is to be placed before the Sub-Committee. Apart from this, it was also informed that a total number of 2235 non-faculty posts (1534 for creation and 701 for outsourcing) which was approved by the Standing Finance Committee and ratified by Governing Body of the Institute subject to concurrence of Ministry of Finance, Department of Expenditure are under process.

51. At its meeting held on 12th November, 2014, the Chairman and other members of the Committee raised the issue of vacancies that existed in many faculty and non-faculty posts. From the reply furnished by the Ministry as regards the vacancy position, the Committee took note of wide gaps between the sanctioned and in-position strength in respect of various faculty/non-faculty posts. The Chairman expressed that though the AIIMS had got the budget but still there is shortage of doctors/junior residents/senior residents, when there is a queue of doctors who want to come to AIIMS to do the junior residency/senior residency.

(f) Recruitment, Reservation and Promotion Policies

52. The Committee has been given to understand that there was no post-graduate reservation-cum-preference scheme for under-graduates of AIIMS. They are not eligible for PG seats in States including Delhi except Kerala as they have not done the under-gaduation course from those States. They are left with three options, viz AIIMS PG seats; All India PG that give 50% seats in all the colleges and PGIMER, Chandigarh. In order to prevent brain drain, there is a need to adopt a model which favored retention of under-graduate students in AIIMS on the lines of JIPMER.

53. The Committee has also the following suggestions on record:

(i) Structural changes, both internal and external, cutting down the patient load, faculty development, and promotion of faculty would help in improving the functioning of AIIMS;

(ii) In the context to promotion of faculty, merit should be top criteria;

(iii) For direct recruits, there should be transparent selection process with 25% seats reserved for direct lateral entry to bring in fresh blood and to avoid stagnation at the faculty level. However, the Additional Secretary during his 16

evidence before the Committee on the 16th January, 2015 submitted that the lateral entry has reduced significantly and no lateral inductions have been made since 2009-10;

(iv) Contract appointments create distortions in the system since a person does not have any security, any kind of idealism in his medical practice, and hence all the appointments should be done on a permanent basis so that there is job security and career development ensuring whole hearted justice is done to the job. AIIMS had repeatedly made attempts at making contract appointments of faculty members. (e.g. Neurosurgery, ENT and Medical Oncology) at times even when the selection process for regular appointments at AIIMS was underway;

(v) The reservation policy of the Government of India should be implemented in letter and spirit which is unfortunately not being done in the Institute;

(vi) There is violation of the reservation policy. In the faculty at the level of Assistant Professors, reservation policy was not implemented as per the Government of India policy. When the reservation policy was accepted, it was introduced in the form of ‘floating policy’ which has led to huge under- representation in the recruitment of SC, ST and later on OBC candidates;

(vii) An expert Committee with representatives of Ministry and Department of Personnel and Training (DoPT) should be set up and the reservation issues should be resolved once and for all and then a fresh beginning should be made as per the policies of the Government of India; and

(viii) There is urgent need for issuing administrative guidelines by the Ministry of Health and Family Welfare as to what constitutes discriminatory behavior along with safeguards for violation of the same on the lines suggested by University Grants Commission to ensure secure, safe and friendly environment in the educational institutions.

54. The Committee has been given to understand that shortcomings were noticed regarding non-adherence of DoPT guidelines for filling up of posts and subsequent to that, a Committee was constituted with the officials from the DoPT and also from the Ministry of Health who after examining the issue in detail gave its report. The Committee’s recommendations were taken up in the Cabinet Secretariat. The Committee in its Report has stated that there was a difference between the shortfalls of vacancies and the backlog vacancies and that there were no backlog vacancies in the grades of Associate Professors, Additional Professors and the Professors in the year 2008. The instructions on reservation were not adhered to in the Institute since the year 1994 which had resulted in substantive shortfall of reservation. The loss caused to the reserved vacancies in the past may not be made good immediately as it was not possible to reserve more than 50 per cent of current vacancies.

55. The Additional Secretary during his evidence before the Committee on the 16th January, 2015, informed that the norms and provisions, as laid down by the Government of India regarding reservation of Scheduled Castes, Scheduled Tribes and OBCs in the 17 appointment of doctors and staff are being followed strictly. He also submitted that there have been many litigations in the Hon’ble High Court and Hon’ble Supreme Court on the issue of reservation.

56. Elaborating on the implementation of reservation policy in AIIMS, the Deputy Director (Administration), AIIMS who was also present during the evidence on 16th January 2015, submitted that the Institute Body in its meeting held on 11.01.1993 had taken a decision that AIIMS would adopt the reservation policy for Scheduled Castes and Scheduled Tribes as prescribed by the Government and it should be followed for all faculty positions. In 1994 when the OBC reservation policy was adopted, AIIMS also accepted the OBC reservation. So, in pursuance of the 1983 and 1994 decisions, AIIMS is in conformity with regard to appointments to faculty positions for all reserved categories. There had been court cases and there are two lead judgments pronounced in this regard. The larger purview whether reservation would be applicable for super-specialty posts had come up for question in the Indra Sahney Case. In pursuance of it, the Ministry of Health and Family Welfare had gone for a review petition as the nine Judge Bench had held that reservations would not be applicable to super-specialty posts. The Hon’ble Supreme Court while disposing of the petition on 16.01.2014 ordered, “We clarify that it is for the Central Government to take a decision as to whether there should be reservation for super-specialty posts”. The Government in pursuance of this decision has constituted an inter-ministerial Committee comprising the Ministry of Health and Family Welfare, Department of Personnel and Training and Ministry of Law and Justice to look at the various implications arising from the decision. The Government has also decided that the implementation of the decision would be through the Department of Personnel and Training. In pursuance of the judgment of the Supreme Court a decision is yet to be notified. The Deputy Director clarified that the notification will be through the Department of Personnel and Training on the basis of inter-ministerial consultations that are currently taking place.

57. In reply to a question, the Director, AIIMS who was also present during the evidence submitted that “since 2009-10, the reservation policy is being followed in letter and spirit. There is no deviation of even one per cent We have data to prove that. So, I can assure the Committee about that.”

VII. Infrastructure

58. The Ministry of Health and Family Welfare vide its communication dated 05th November, 2014 gave an overview of expansion plans for the next decade and status of various existing expansion projects, detailed status note on Jhajjar Campus indicating daily patient attendance, various health care facilities available there and scope for its further expansion, adequacy or otherwise of infrastructure of AIIMS, Department-wise which is delineated below:

(a) Expansion plans for the next decade and status of various existing expansion projects

59. A total of 52 Departments out of which twenty-five are clinical departments including six super-specialty centres manage practically all types of disease conditions with support from 18 pre-clinical and para-clinical departments. AIIMS also runs a 60-bedded hospital and the Comprehensive Rural Health Centre (CRHC) at Ballabgarh in Haryana and provides health cover to about 7.7 lakh people through the Centre for Community Medicine.

60. The Committee has been informed that lately the services at AIIMS are overstretched due to extremely large number of patients visiting the institution for consultation/treatment, more particularly the OPDs, leading to prolonged waiting periods and leaving very little time for doctors to devote time to the patients; the waiting spaces for patients too are overburdened. This compromises doctors’ efficiency besides reduced patients’ satisfaction levels.

61. In reply to a query regarding the software connecting all the departments, the Director, AIIMS during evidence before the Committee on 12th November, 2014 informed the Committee that the software known as VISTA is open source and has been put in use. AIIMS has also made its own modules and integrated the same with VISTA. The Director further informed that AIIMS is working with Tata Consultancy Services (TCS) under Corporate Social Responsibility and with the help of TCS, it aims to have a robust Electronic Medical Records in place. On being asked about whether there was any plan to extend the EMR to Government hospitals all over India, the Secretary, Department of Health and Family Welfare replied that the Department of Health and Family Welfare was looking at greening of AIIMS and new AIIMS-like institutions and the ultimate aim is to develop Electronic Health Records. But it will take time as even in the advanced countries it has taken three decades or more.

(b) Expansion and Decongestion of Infrastructure

62. Since its establishment, there has been a gradual increase in the total patient load in the OPD. The last decade, in particular, has witnessed quantum jump in work load. So much so that the present infrastructure and facilities have been rendered inadequate and is under severe strain. There has also been a waiting list of surgeries and other procedures in various departments like Cardiology, CTVS, Neuro-surgery, Neurology and Cancer. There has also been an increase in the number of under-graduate and post-graduate seats in all the departments subsequent to the implementation of Moily Committee’s recommendations which has also led to the need of more space and resources for the various departments of the Institute. In view of increasing demands, there is need to expand infrastructure of the present AIIMS campus. The space constraints, however, limit the creation of these facilities in the existing AIIMS campus, hence need to look for additional land to cater to the emerging metropolitan needs for tertiary care services of Delhi in particular, and the country at large.

63. The Secretary during his evidence before the Committee on the 12th November, 2014 informed that the Government has also approved a proposal for establishment of a new OPD at Masjid Moth and expansion of the Hospital at a cost of `573.00 Crore. So, in the future the AIIMS will add both in terms of facilities and in terms of patient care.

64. The Committee has been informed that currently, the 200 bedded Trauma centre needs augmentation to cater to the requirement of Delhi and NCR. After expansion, the integrated 19

Trauma Care Services Centre would be a 750 bed hospital; other hospital facilities envisaged include: Comprehensive Digestive Disease Centre - 400 beds National Transplantation Centre - 200 beds Follow up and Day Care Centre - 50 beds Long term Neuro and Spine Rehabilitation Centre - 200 beds Spinal Surgery Centre - 150 beds Nephrology and Urology Centre adding - 300 beds Plastic Surgery Centre - 200 beds Ultra modern operation theatres - 50, Critical Care Beds - 700 out of 2200 beds

Research centers

Bio-safety level-4 (BSL) Laboratory Regenerative Medicine Virtual Teaching Nano Medicine Bio-medical Engineering Drug Development Conference Centre/Auditorium

Residential facilities

Hostel for 600 resident doctors Hostel for 600 nurses 200 type-V & type-VI accommodation 65. It would thus be possible to add 2200 indoor hospital beds in disciplines not yet fully developed and catered to by AIIMS. 66. Efficient functioning of these facilities shall call for appropriate residential accommodation i.e, hostels for resident doctors and nurses as also type V & type-VI quarters and parking facilities. As regards projects/schemes of AIIMS started during the last ten years, the date of their initiation, targeted timelines for initiation, targeted timelines for their completion, their current status, estimated expenditure thereon and time and cost overruns, if any, the Department of Health and Family Welfare vide its communication dated the 19th June, 2015 has given the details (Annexure-III).

Additional Land

67. The land requirement for meeting the expansion needs for the AIIMS and Trauma centre and concomitant infrastructure is assessed at around 20 acres. This would be utilised 20 largely for creating specialised patient care services and rehabilitation along with a focus on Research Centre.

68. A plot of similar size exists adjoining the Trauma Centre, opposite to erstwhile Kamal Cinema. If allotted, it would reasonably meet the expansion needs of the AIIMS campus.

69. The expansion plan has been prepared based on maximum permissible FAR and under the guidance of Secretary, Ministry of Urban Development, incorporating all the suggestions on the line of New Moti Bagh campus.

70. In addition, the upcoming projects are those which have already been approved and in various stages of development and those which are on long term plan for the next decade or two.

On going project:

Convergence Block .

Hostel Block

Dining Block

Surgical Block

Mother and child block

Construction of U.G. multi-level car parking

Out Reach OPD at Badsha Jhajjar

Tunnel Link between AIIMS & JPNTC

Renovation of CT-2 in CNC

Refurbishment and expansion of Private Ward

New OPD Block At Masjid Moth

Expansion of Trauma Centre including Dharamshala

Re-development of Master Plan of AIIMS

Geriatrics Block

OPD at Ballabgarh

Construction of housing and hostel at Ballabgarh

Creation of space for various facilities in existing basement of PC Teaching Block and Ward Block

National Cancer Institute at Jhajjar Campus

National Cardio-vascular Centre at Jhajjar Campus

71. Responding to a query regarding the rural centers attached with AIIMS, the Director AIIMS, during evidence before the Committee on the 12th November, 2014, informed the Committee that as per the existing arrangement only one rural health centre is attached with 21

AIIMS. The new AIIMS-like Institutes will also have one rural health centre each attached with them. Dwelling further on the issue, the Director explained that normally undergraduates and interns are sent to the rural health centres, but the Comprehensive Rural Health Services Project (CRHSP), Ballabhgarh which is attached with AIIMS is different in the sense that the Senior Residents go to the rural health centre and provide patient care there. The faculty of community medicine is also stationed at Ballabhagarh, who implement the various health programmes of Government of India. 72. The Committee has been informed that a plan to take over the Janakpuri Super-specialty Hospital of the Government of NCT Delhi has been under discussion with the Delhi Government many times. If this plan comes through the immediate problem of the long waiting lists in some of the departments can be taken care of.

(d) AIIMS Campus-II (Jhajjar, Haryana) 73. The AIIMS Outreach OPD, Jhajjar has been started since November 2012. The following medical treatment facilities are available at AIIMS Outreach OPD, Jhajjar, Haryana: A. Outpatient services: (i) Medicine (ii) Surgery (iii) Orthopedics (iv) Obstetrics & Gynecology N.L. (v) ENT (vi) Ophthalmology N.L. (vii) Psychiatry B. Radiology services: Ultrasonography and X-ray C. Laboratory services D. Pharmacy services 74. One faculty from each of the departments of AIIMS are recruited to Outreach OPD, Jhajjar. In addition to this, senior residents and Junior Residents are also posted from these departments. 75. There is no indoor facility available there. 76. Approximately, 300-350 patients daily visited AIIMS Outreach OPD, Jhajjar. Attendance of the Daily Patients department-wise is as follows:- i. Medicine :- 80 ii. Surgery: - 30 iii. Orthopaedics :- 40 iv. Obstetrics and Gynaecology : 30 v. ENT : 20-30 22

vi. Ophthalmology :- 30-35 vii. Psychiatric :- 10-15 viii. Pediatrics: - 40

77. The Badsha/Jhajjar campus of AIIMS is envisioned as a knowledge city of the future and a crucible of excellence. It would emulate the ambience of world’s best universities, and would be a symbol of India’s leadership in bio-medical and health sciences. The comfort of patients and their families would be at the heart of the design of its healthcare areas. The needs of the students, scholars, residents and scientists would be central to the academic infrastructure and systems. Nurses, doctors, allied professionals, administrative staff and support workforce - all members of the Team AIIMS, shall have their respective space and opportunities.

78. The entire campus would be developed and operational zed in early 13th Plan period. The different centres, facilities and activities in different core domains are visualized as under:

79. In the Public Health and Policy domain, the priority would be to establish a School of Public Health and initiate an interdepartmental outreach program for the community and, develop an interdisciplinary system and network for supporting the national programs and facilities in Haryana and other States.

Sl.No. Description of Proposed Centres Approx. Proposal cost. in crores

1. National Cancer Institute (710 beds) `2035.00

2. National Cardio-vascular Centre ( 600 beds) `2400.00

3. General-purpose hospital (500 beds) `400.00

4. National Transplantation Centre (500 beds) `400.00 5. National Centre for Child Health (500 beds) `400.00

6. Digestive Diseases Centre ( 500 beds) `400.00

7. National Institute for Geriatrics ( 200 beds) `160.00

8. Comprehensive Rehabilitation Centre `200.00

9. Centre for Blood Disorders ( 120 beds) `200.00

10. Centre for Laboratory Medicine `200.00 11. National Centre for Nursing Education and Research `I00.00

TOTAL `6,895.00 crores

Concepts to be developed 1. Centre for Renal and Urological Disorders 2. Centre for Diabetes 23

3. School of Public Health 4. National Centre for Allied Health Sciences 5. National Centre for Health Professional Education 6. Centre for ICT-Enabled Education 7. Centre for Studies in Humanities for Health 8. School of Public Health 9. Centre for Health Policy 10. Centre for Global Health

Research Centres and Departments 1. Centre for Genomics and Proteomics 2. Centre for Bio-informatics and Health informatics 3. Centre for Nano-biomedicine 4. Centre for Inter-disciplinary Science and Technology for Child Health (CISTECH) 5. Centre for Translational and Implementation Research 6. Centre for Drug Discovery 7. Centre for Diagnosis and Control of Infectious Disease 8. Department of Stem Cell and Regenerative Science 9. Department of Bio-statistics 10. Department of Immunology 11. Department of Molecular Bio-physics 12. Department of Bio-engineering 13. Centre for Affordable Technologies 14. Industry-Biotech Park 15. Clinical Research Centre 16. Bio-repository 17. Animal Research Centre

80. AIIMS Campus II is envisioned as one integrated and harmonious institution with well- blended institutional, residential and common areas. Reasonable space will be kept for future expansion. There will be no partitioning of the land for individual centres out of the available property.

81. In addition, following general facilities would be created: — Housing, hostels, recreation areas, mini-market, schools, creches, community centre; — Convention centre, auditoria, lecture theatres, seminar rooms, hotel, guest houses, hostels for visiting fellows/trainees; 24

— Education and research resource centre, library; — Patient dharamshalas, shelters, food courts; and — Administrative Block.

82. The Badsha/Jhajjar campus will be developed at a fast pace to meet the urgent needs of AIIMS. Work on all the centres/programs envisaged at this campus should start in the XII Plan. Some of the tasks would be completed in the XII Plan period itself (e.g. National Cancer Centre, General Purpose Hospital, Research Centres, Centre for Excellence in Nursing Education and Research etc.). For the other centres/programs, the project preparatory work, and as much implementation work as possible, should be achieved as well in the XII Plan period, while the rest carried over to the next Plan.

83. Shedding light on the development and expansion activities of AIIMS, the Secretary during evidence on the 12th November, 2014 informed that the Government had approved establishment of the National Cancer Institute at Jhajjar on 300 acres of land at a cost of `2035.00 Crore.

84. Responding to a query regarding the Dharmashalas, the Director, AIIMS, who was also present during evidence before the Committee on the 12th November, 2014 informed the Committee that construction of a Dharmashala has been started in the AIIMS Trauma Centre.

85. The Committee has been given to understand that the load of out-patients is about 11,000 patients including main and all other centres. However, the bed Strength is only 2424 which results in a big waiting list and a number of patients are turned away by AIIMS or are told to come after a certain period. Every year, almost 35 lakh people visit AIIMS for treatment. However, AIIMS is not able to provide medical facilities to so many people because infrastructure and facilities have not been augmented over the years.

86. On being pointed out that there was lack of super-specialty centres in the country which was leading to over-crowding of AIIMS, the Additional Secretary; Ministry of Health & Family Welfare during his evidence before the Committee on the 16th January, 2015 submitted that a few steps have been taken in this regard. For example, the six new AIIMS have come up in various parts of the country though they are not fully functional yet. The Government is in the process of setting up more AIIMS, apart from these six new AIIMS. The Ministry of Health and Family Welfare is also going to upgrade 58 Government medical colleges in the country with super-specialty facilities. The upgradation of each Medical College would cost around ` 200.00 crore. It has also been decided that 58 district hospitals in those areas where there are no medical colleges would be upgraded as Government Medical Colleges. A redevelopment plan is also being implemented in Safdarjung Hospital and Lady Hardinge Hospital where super-specialty facilities are coming up. The Ministry has also plans to bring up super-specialty facilities in Dr. RML Hospital.

87. The Government has also decided to open 20 State Cancer Centres and 50 Tertiary Cancer Centres across the country. There is funding, support and strengthening for other institutes all across the country like NIMHANS, JIPMER, PGIMER, etc. There is increasing realization that tertiary care also has to be improved. 25

VIII. Academics

88. The Secretary, Department of Health and Family Welfare and Director, AIIMS informed the Committee that as regards education, AIIMS has 52 Departments with the total students/ residents/Ph.D Scholars numbering upto 3102. The Institute conducts various post graduate and residency programmes in various disciplines, besides the undergraduate courses. The Institute also provides long term training to defence personnel and those sponsored by the Government Institutions besides short term training in various departments to Indian nationals and trainees from oversees and elective training to foreign undergraduates from countries like Australia, Bangladesh, Canada, U.S.A to name a few.

89. The Committee has been given to understand that AIIMS has done enough to produce high quality under-graduates that it could shift its focus to strengthen post-graduate educational programmes across the country, assisting new AIIMS-like institutes under PMSSY. There can be common pool of faculty and rotation of faculty among these Institutions where some of the people would predominantly serve at AIIMS but would rotate at some other institutes and vice- versa to help in creation of strong structure of post-graduate education as well as good quality tertiary care in the country.AIIMS needs to grow out of a ‘Central elite institution’ mindset to engage much more with problems at the ground level in the States and to redesign itself for a much more national role in terms of education. For strengthening under-graduate education across the country, efforts should be made to utilize IT-enabled common classroom approach to teach many other colleges across the country. AIIMS and other institutions of national importance should participate in training of faculty both through distance as well as through periodic contact programmes.

IX. Research

90. The Committee has been given to understand that significant research needs exclusive dedication and a lot of reserved time. Most of the faculty in the Institute end up doing research in the time left after seeing patients and completing their teaching responsibilities. This can never be a “winning” model for research. The declining time for research among faculty also implies that research mentorship for the trainees, Post-graduates and Ph.D scholars becomes a victim. The Research Administration also requires to be strengthened. Faculty who have an additional responsibility to look after this aspect - are again hindered by the problem of limited time. There should be a well staffed research facilitation establishment. Besides, the salary offered to an MD level research officer at AIIMS is so low that very few are attracted towards research job; high level research recruitments get bogged down in rules and policy. E-governance model also should be less government-like and more corporate. Interaction with institutions involved in basic sciences and engineering and also industry should be facilitated. Health Research is too important to be left only in the hands of doctors. A suitable strategic tie-up with other institutions - more flexibility in appointing adjunct faculty/scientists to enhance the spirit of inter-disciplinary and inter-institutional collaboration - is perhaps the best way forward for meaningful productive research.

91. The Committee has on record that the Institute was rated as the top institution in Clinical Medicine Research in the country; top health institution in Bio-medical Research; its Bio-technology Research was classified as having a high impact and high collaboration index 26 and the Institute had a higher research output as compared to other premier scientific institutions like IIT, IISc and TIFR. The Institute had conducted landmark research of national importance on malnutrition, iodine deficiency, diarrheal diseases, liver diseases, lead poisoning in children, T.B., Genomic analysis of Malaria, Stem cell research, Vitamin D status in Indian context. The Institute research had influenced various National programmes like ICDS, Universal iodization of Salt, National Blindness Control programme, Flurosis Control programme, Tobacco Control programme, National Programme on Health Care of Elderly. The Institute also had WHO Collaborating Centres in the fields of Neo-natology, diaorrheal diseases, etc. besides International collaboration in Nepal, Bhutan and Bangladesh. 92. The Committee has also been given to understand that AIIMS publishes 1500 to 1600 Research Papers in high index Journals reputed all over the world. Professors participate in various conferences, which are fully funded by AIIMS. Addl. Professor and Associate Professor can attend one international conference every two years. 93. The Committee further noted that in the Government funding plan, budgets are mainly to augment clinical services and funds for research equipments and research, as such, was only ` 50.00 lakhs few years ago, which was increased to `5.00 Crore. 94. The Committee has got the following suggestions on record relating to promotion of research in AIIMS, given by various stakeholders: (i) There exists a lack of inter- disciplinarity as promotions are always made on the basis of departmental vacancies and departmental positions. While allowing people to do a certain amount of investigation driven research to satisfy their natural interests, there should be identification of thrust areas of nationally relevant problems and setting up of a multi-disciplinary research group addressing important problems through an inter- disciplinary approach; (ii) Even within AIIMS the possibility of cross- appointments between two departments does not exist which actually dampens some of the research productivity. The possibility of inter-institutional collaboration can be explored which could include provision of visiting professorship which is absent at present in AIIMS; (iii) Industry sponsored research like clinical trials should be discouraged in public funded institutions as they lead to distortion of priorities, conflict of interest and unethical practices. Government should ensure that AIIMS receives enough grants through Government sources to ensure that integrity of public health goals and public policy is observed; (iv) There is problem with Research governance due to the manner in which decisions are taken at AIIMS; (v) There should be collective decision with regard to the subject and it should be done in a transparent and open manner so that people are not harassed by way of pushing of files; (vi) There should be a middle-level research cadre so that continuity is maintained in research, non-monetary incentives should be given in the form of recognition like getting the research work published in journals, peer recognition, etc. 27

provision of secretarial assistance should also be considered as a facilitation measure; (vii) There is a need to strengthen research teams and resources and for centralizing resources;

(viii) It may be useful to set up cross-disciplinary research teams for infectious diseases, chronic diseases, nutritional science, and health systems etc. in addition to current department based research teams;

(ix) Public funded institutions in India should not try to follow the West in going exclusively for private grants, as Western institutions sustain themselves by selling their intellectual property; however in India that is not possible as we need to focus on scholarship, patient care, education, research and public health;

(x) Provision of funds for research alone could not ensure a strong research base for the country. A strong base of researchers needed to be set up, as the gestation period in the field of research to fructify is very long ranging from 10 to 15 years. To ensure this, stability in value systems is not enough, there is a strong urge to adapt to the changing times. In order to ensure cutting edge research, there is a need to focus more on the biology of disease instead of just focusing on studying the biology of cells. The concept of Doctor need not be seen just as a patient healer but also as a health-economist, researcher, etc. There is an urgent need to treat hospital as one part of medical school and not as a be-all and end-all focus of a doctor employed there. Therefore, there is a (i) need for division of research into Basic Medical Research, Clinical Research, Translational Research; (ii) need for diverse talent pool required for each type of research; (iii) formation of a separate eco- system; (iv) creation of centres which would support department structures which could be compartmentalized under four heads i.e. (a) Infectious disease centre; (b) Chronic disease centre; (c) Nutrition centre and (d) Health systems Research Centre; (v) need for Ministry to distinguish between Hospital Medical Centres and Academic Medical Centres; (vi) need for setting up ‘Academic Medical Schools’ throughout the country; (vii) setting up of centralized research resources for each type of research; (viii) need for making available financial resources for research not only from Government but also from the Private Sector, etc;

(xi) There is an urgent need for developing a system where besides medical practitioners, medical scholars are also produced so as to provide path breaking research in the various fields of human health;

(xii) The system should be streamlined where a researcher has freedom to use resources without having to revert to his senior for every issue which destroyed the spirit of conducting research in a conducive atmosphere;

(xiii) The Institute was actually set up to do research in areas of national concern and research in the nationally and locally relevant issues and to address the 28

concerns and improve the lot of the poor people. 80 per cent of the funds go to the research which is affecting 20 per cent people and most of the research is geared to those conditions which are prevailing in the Western world;

(xiv) Till November, 2003, there were only 12 clauses in the guidelines for grant of permission to the members of the faculty to attend various scientific conferences and other assignments in India and abroad. In August, 2005, one more clause was added which completely changed the spectrum of research in AIIMS. Clause 13 in the amended guidelines says that the faculty member may also be permitted to attend meeting related to the research project in India and abroad which may be funded by private research institutions, private foundations, private companies in which the concerned faculty member is either co-investigator or investigator. Then, there is a clause that the TA/DA will be provided by the company;

(xv) Delimiting time for research for faculty, research cadre and development of infrastructure would go a long way in furthering research at AIIMS;

(xvi) The number of papers published should not be seen as the pure indicator, rather focus should be on relevance and impact on policy, programme and clinical practice in terms of research; and

(xvii) The quality of research at AIIMS is actually on the decline partly owing to lack of support system of research as the Research cell at AIIMS is very weak in terms of understanding the needs of research and needs of collaborative research wherein the Research cell does not allow appointments to be made in other medical colleges under this Research Grant.

X. Patient Care

95. The enormous patient care load on the AIIMS hospital has dealt a body blow to the core character of the Institute as a medical university. It is impossible to deliver quality care and also to be academic and research institution, no matter how hard its highly committed faculty tries day after day.

96. As against the original character envisaged, AIIMS is expected to provide care to any patient walking into its portals, without the need for referral, for minor to the most complex ailment. Thus it is not being allowed to function as a referral centre. As a result, waiting lists for admissions/surgeries run into months, even years. AIIMS has thus been rendered as a general multi-specialty hospital rather a university hospital. Majority of the patients treated at AIIMS could have received treatment at other hospitals such as medical colleges and government hospitals in the city and state capitals and other places.

97. The Committee was informed that AIIMS was created as a tertiary care institution. Today, AIIMS serves as a primary care centre for people living in South Delhi, a secondary care centre for Delhi-NCR and a tertiary care centre for parts of North, Central and East India. Until an attempt is made to revert to the professed tertiary care status or at least a secondary care status, there can be no resolution of the problem. The services are over burdened by the 29 patient care component leaving no time for introspection, forward planning and for that matter any constructive thinking. The Committee has been given to understand that according to a study performed by Department of Hospital Administration, AIIMS in 2008, to assess the satisfaction of patients, it was found that 87.5 % patients were satisfied with the behaviour of doctors, 57 % patients were satisfied with the behaviour of Nursing staff and 60% patients were satisfied with the behaviour of Group D staff inspite of the various constraints being faced by the Institution.

98. On being asked about the mortality rate in AIIMS, the Director, AIIMS during evidence before the Committee on 12th November, 2014 submitted that in elective work, the mortality rate is at par with any hospital in the developed countries but in critical care, where AIIMS gets a lot of referral cases and the patients towards the end of their care are referred to AIIMS from various corporate hospitals as well as other hospitals, AIIMS might be having a higher mortality rate.

Average waiting time of patients in getting dates for surgeries, various processes and tests:

99. The details of average waiting time of patients in getting dates for surgeries, various process and tests is as under :-

Sl. Name of the Waiting Time No. Department

12 3 4 5

1. Cardiothoracic 3 months to 4 years

2. For Emergency No waiting

3. Neuro surgery Unit I Unit II

4. Category-IIASAFC 15 days 1½ Months Category -III ASAFC 6 months — Category-III Routine 16 months 6 months

5. E.N.T. Ear Surgery 3 to 4 years Head & Neck Cancer One month Other Benign Conditions 1 to 1½ year Cochlear implant surgery One year

6. Orthopaedics Unit I Unit II Hand Cases 4-6 months Spine Cases 3-6 months 3½ - 6 months Arthroscopy Cases 1-3 months 4-6 months Arthroplasty Cases 3-6 months 3-6 months Paediatric Surgery Cases 7-9 months 30

12 3 4 5

Oncology Malignant - 3-6 months Benign: 5-7 months

Old Trauma Cases 4-6 months 5-7 months Complicated Cases 4-6 months Infection Cases 3-6 months 3 -6 months Miscellaneous Cases 5-7 months

7. Cancer Research Radiation Oncology 0-2 weeks Medical Oncology 1 week Surgical Oncology 8-12 weeks Palliative Care Unit 1-2 Days

8. Surgery Cancer 2-3 weeks

For non emergency 6 months (benign non-life threatening)

For emergency No waiting patients (acute life threatening)

9. Urology Emergency Same day

Semi emergency surgery 48 to 72 hrs.

Routine patients (patients 4-6 weeks with malignancy, renal failure, paediatric age group

Routine patients with 4-6 months benign disease with no immediate or life threatening complication

10. Nephrology Living renal transplant 3-4 months

11. Ophthalmology Routine 1 week

Squint Surgery 6 months 31

The following are some of the suggestions made by some stakeholders on improving the patient care:- (i) Satellite OPD centres should be opened to reduce load on the hospital’s OPD. Provision of preferential treatment for people coming from long distance or from outstations, at least for part of day’s OPD’s registration. (ii) Despite all hype about IT, there is no computerization of patient records in AIIMS compared to other institutions. (iii) Creation of a few tertiary care centres in Delhi and neighboring States would be inadequate to decongest AIIMS. A health system perspective would call for a more detailed sector-wise development of primary, secondary and tertiary care services all over India including the neighbouring States. (iv) User charges are a barrier to accessing healthcare for most people and especially for the poor. Further, user charges decrease access for the more vulnerable sections among the poor, such as women, children, and the scheduled castes and scheduled tribes in India. Studies also show that sick people are more likely to die when they had to pay user charges. In India, 1 in 3 people who need hospitalization and have to pay out-of-pocket are forced to borrow money or sell assets to cover the expenses. Over 20 million Indians are pushed below the poverty line every year because of out-of-pocket spending on healthcare. (v) Revision of norms of the faculty as per patient load and creation of the posts for recruitment of faculty was required; and operational flexibility wherein Director could take people on contract to ensure effective patient care could solve the problem of long waiting time in AIIMS. (vi) Essential medication should be provided free of cost as it will only marginally increase the overall budget of AIIMS and since there are only a few such centres in India, it would not burden the exchequer. (vii) There is a need to improve the manpower, space and infrastructure (including computerization) situation at AIIMS, and the need for centralized laboratory services as patients have to often go to external laboratories and radiology centres, which get business to the tune of ` 1-1.5 crores per day from AIIMS. (viii) There is a need to expand services, especially with regard to centres and centralization of laboratories, and to build in staff accountability and norms for clinical services. (ix) In a poor country like India wherein, a person has to spend 84% of expenditure out of his pocket, the concept of user charges add to his medical expenditure burden. The Government should prepare an action plan to increase the budgetary allocation of health sector from the present less than one per cent to 2.5-3% of GDP keeping in view the severity of disease burden in India. (x) In order to restore the status of AIIMS as tertiary care provider as envisaged by founding fathers of the Institute, screening OPDs in the Institute is the need 32

of the hour in order to segregate the patients on the basis of the seriousness of their medical condition.

(xi) A 2-tier system of health care (private/general) based on paying capacity should be done away with as those who pay more tend to monopolize public health facilities, pushing the non/less-paying patients further to the margins, and corporatization and outsourcing of health care should be stopped.

(xii) The utility of Government investment decreases if user charges are levied. Selection of patients should be based on health needs and not paying capacity. The idea of ‘free health services’ is a myth. While these may be provided free at the point of delivery, the cost is ultimately borne by the patients. Every citizen pays direct or indirect taxes to the Government. The Government only fulfils its obligations towards people by providing them certain services, including health services. Therefore, the Government should commit more resources for the healthcare needs of the people to bring about an improvement in their health status. This would be expedient even in the economic sense as contributions made by a healthy population to the economic growth of a country will more than compensate for the investments made by the Government in securing the health of the people.

100. On being asked about how poor patients who are not BPL Card holders, are evaluated about their financial condition for the purpose of being provided free treatment and medicines, the Medical Superintendent, AIIMS, during evidence before the Committee on 12th November, 2014 informed the Committee that there are two modes of such evaluation. One is, through the Medical Social Service Officers who evaluate the financial condition of a patient on the recommendation of the treating doctor and thereafter the Hospital Administration approves the recommendation of the Medical Social Service Officer for free treatment of the patient. The second mode is that if the treating faculty certifies in the prescribed proforma that the patient is too poor to afford treatment, the patient is given free medicines and surgical consumables.

101. The Medical Superintendent further informed the Committee that the patients admitted to the General Ward of AIIMS are given medicines and surgical consumable items free of cost, out of 250 medicines and 125 surgical consumable items. The Drug Selection Committee has now recommended more than 500 drugs to be given free of cost to the patients of the General Ward and the proposal has also been approved by the Director, AIIMS.

XI. Allied Services

(i) Public Relations Cadre Employees of AIIMS

102. Public Relations Cadre Employees of AIIMS, through their written submission, stated that they are well qualified, with entry level qualification of graduation plus Diploma in Journalism and Mass Communication, but they have no appropriate promotion avenues and future prospects. All the existing eight centres of AIIMS and newly created centre at Jhajjar are required to be manned by professionally skilled public relations officials equipped with 33 adequate paraphernalia and powers to undertake full-fledged functions of public relations and media relation activity centres to project the image of the Institute. At least 25 Asstt. Public Relations Officers are needed to handle and supervise the huge workload of RTI related works, public information system and smooth functioning of OPDs and wards. However, there are anomalies in pay scale, designations and promotional avenues of PR cadre. They demanded that their promotion from entry level to first promotion should be on the basis of 50% on merit- cum-seniority and the 50% on merit-cum-fitness. At least 60% promotions should be on the basis of limited competitive departmental examination so that professionally qualified employees may get appropriate career progression which will result in better performance.

(ii) Physiotherapy Services

103. The Physiotherapists’ Forum of AIIMS in their written memorandum, submitted to the Committee stated that the physiotherapy services were started at AIIMS just after its inception and since then the physiotherapists were meticulously contributing in the patient care and management. Their participation and contribution was very well recognized as almost every clinical department had physiotherapists as its essential part. But they never got due appreciation. New developments in technology and research in physiotherapy and health care led to the enhancement and enrichment of the physiotherapy curriculum at graduate and post- graduate levels which is equivalent to any other professional medical programme. According to them, the physiotherapists are being treated as mere technicians in spite of the fact that their education, skills and participation in the health care is no way comparable to any other technical service at AIIMS.

104. The Forum stated that the entry level qualification for physiotherapists at AIIMS is Bachelor of Physiotherapy which is a four and a half year professional degree course and it incorporates even more than BDS in terms of syllabus and clinical responsibilities. Grade Pay of `4200/- at entry level is not justified at all and they deserve much higher Grade Pay i.e. `5400/- at entry level. For the last fifteen years most of the fresh physiotherapists recruited at AIIMS were post-graduates and they were working in super-specialty centres which signify their needs at AIIMS. Despite being involved in intense care management, they had been denied various allowances like conveyance allowance, non-practicing allowance etc. The post-graduate qualifications were imparted by the National Institutes and the Central Universities and they are eligible for the post of Assistant Professors as per the UGC guidelines. The Forum therefore requested that at these super-specialty centres, the entry level qualification should be post-graduate degree irrespective scheme for physiotherapy with the Grade Pay of `6600/-.

105. The Forum in this connection drew the attention of the Committee to the following observations and recommendations made by it in its thirty-first report on the Para-medical and Physiotherapy Central Councils Bill, 2007, presented to the Parliament on the 21st October, 2008:

“The Committee feels that all the allied health professionals including physiotherapists and occupational therapists play a crucial role in the field of medicine and physical rehabilitation. The Committee, therefore, strongly recommends that their legitimate interests should be taken care of and their existing pay structure may be revised 34

according to their qualifications and duration of the course they have to put in before entering into a Government job”. (Para 25.6)

106. The Forum also stated that the Committee on Subordinate Legislation, Rajya Sabha, in its 178th Report, presented to the House on the 19th December, 2008 had recommended as under:-

“The Committee would specifically like to comment upon the service rules conditions of the Physiotherapists. The discipline is growing in profile with introduction of new aids. Disease specific rehabilitation therapies are required accordingly the Government has introduced new degree courses in Physiotherapy. It is, therefore, required to improve the Service Conditions and emoluments of the physiotherapists and the AIIMS may also take a view on allowing them the Non-Practicing Allowances (NPA).”

107. According to the Forum the Recruitment Rules for the Physiotherapists had not been modified for the last more than forty years, contrary to the DoPT Guidelines and also despite the recommendations from various Departments/Bodies and Ministries as well. Globally physiotherapy profession is well established as autonomous and independent health care profession.

108. It was further submitted that AIIMS administration never involves physiotherapy professions nor seek their opinions and inputs in the matters relating to their professional growth, service conditions and promotional avenues. Their biased attitude has been exposed very recently when the AIIMS Coordination Committee (for revising the recruitment rules for non-faculty cadres in AIIMS) has out-rightly overlooked the recommendations of the chief of centres and various HODs regarding modifications in recruitments rules, nature of duties and pay scales. They are not designated as faculty and are being constantly exploited by the AIIMS authorities.

(iii) Speech Pathology and Audiology

109. One of the important areas of the ENT is speech pathology and audiology. The Committee was given to understand that AIIMS used to run a bachelor’s programme in this field for more than two decades. Under this programme the Institute used to train professionals on issues related to communication disorders such as hearing impairment, mental retardation, voice, fluency and phonological and language disorders. Of late, the Committee has been informed that it has been discontinued without any cogent reasons. OBSERVATIONS/RECOMMENDATIONS OF THE COMMITTEE

I. Governance Structure

110. On a perusal of the frequency of meetings of various committees of AIIMS, the Committee observes that the meetings of some bodies/committees are not being held regularly which gives a poor reflection on functioning of these important decision making bodies. The Committee feels that such a state of affairs on the part of an apex institution like AIIMS which is a role model for all medical institutions in the country should not be allowed to persist. The Committee recommends that the Annual Action Plan of AIIMS should prepare an itinerary at the beginning of the year itself to conduct meetings of these various bodies/committees and ensure adherence to the said itinerary. The Committee is of the view that even internal governance needs to be strengthened with regular, pre-notified meetings of the Staff Council whose deliberations should be available to the Institute Body for review.

111. The Committee recommends that rules, regulations, norms, guidelines and procedures should be codified for routine governance issues at AIIMS after synergizing its policy and goals with nations’ needs and public requirements. The Institute should remain publically funded and democratically accountable. It further desires that the Government should endeavour to make it the model Institute as originally envisaged as a (deemed) medical university with laid-down rules and regulations rather than as a government hospital. The funding should continue to be from Government of India rather than UGC.

112. The Committee desires that the practice of ex post facto approval of the decisions made by Director and President of AIIMS for the matters needing approval of the Institute Body/ Governing Body in its subsequent meetings should be done in very exceptional cases only. A mechanism should be developed for immediate meetings in the emergent matters.

113. The Committee feels that the existing model of governance, which has been governing the Institute for the last 60 years, needs thorough review. One of the main aspects of governance is participation which requires that faculty of AIIMS must be participating in the governance like in other institutions of higher education. There should be equitable representation in the Governing body of AIIMS, so that the faculty can present its views, opinions and ideas as to how governance can be improved in the light of their day-to-day experiences in performing their duties.

II. General administration

114. The Committee desires that standard procedures for administrative, vigilance and financial matters should be put in place immediately and be followed and implemented in letter and spirit.

35 36

115. The Committee recommends that standard Government of India (GOI) practices regarding seniority between direct recruits to substantive posts and promotees should be strictly followed. Since creation of and selection for the positions like Dean, Sub-Dean, Professor-in-Charge, Head of Departments, etc. has mostly been mired in controversies, the Committee recommends that the entire Scheme and its procedures should be reviewed and codified for strict adherence to avoid any charges of favoritism, nepotism, corruption and avoidable litigation in future.

116. The Committee feels that AIIMS is a premier medical Institute in the country and it is imperative that all possible measures should be taken to attract, retain and nurture its talent.

117. The Committee has been informed that a draft Vision Document for AIIMS has been prepared. The Committee desires that the final Vision Document should be prepared and implemented at the earliest.

III. Budgetary provisions

118. The Committee observes that availability of tertiary care services is skewed towards private domain vis-a-vis public sector which leads to high health cost burden on people, especially the marginalized and poor sections of our society. AIIMS which is an institution of National Importance and eminence, has made substantial contribution to correcting the imbalances in availability of affordable and quality tertiary healthcare, especially to the most deprived and vulnerable sections of our society, which is acknowledged unequivocally by all. Therefore, it goes without saying that AIIMS needs to be supported and nurtured with the utmost gravitas and all its financial requirements should be met by the Government by way of budgetary support to allow it to flourish and excel further. The Committee is, therefore, constrained to observe that there is a huge mismatch between the AIIMS’s projected demand of ` 2325.00 crore and allocation of ` 550.00 crore in BE 2015-16 which is incidentally, the same as it was RE 2013-14. Given the good track record of AIIMS in utilizing the allocated Plan funds during the last five years, the Committee is unable to reconcile itself with the reduced quantum of plan funds for 2015-16. Since a large number of developmental activities are currently underway at AIIMS and inadequacy of Plan funds may prove to be big factor in limiting the progress in executing important initiatives like National Cancer Institute, Jhajjar, new OPD Block at Masjid Moth etc., the Committee lends its full support for enhanced budgetary support to AIIMS and recommends that the, resource gap should not be allowed to come in the way of speedy execution of developmental projects of AIIMS. The Committee simultaneously recommends that the Department of Health and Family Welfare should oversee the quality of development expenditure to ensure strict adherence to canons of financial prudence and discipline and fulfillment of all prescribed conditionalities.

119. The Committee would simultaneously like to advise that there should be a monitoring mechanism in place to ensure that the balanced pace of expenditure is maintained. and there is no rush of expenditure in the last quarter so that the budgeted funds are utilized timely and the targeted outcomes are achieved within the prescribed timelines. 37

IV. Autonomy

120. The Committee observes that AIIMS has played and will continue to playa crucial role in frontier research in bio-medical sciences, health education and in making quality health care accessible to patients from the poorer sections of the society at a fraction of cost of the private and corporate sector hospitals. The AIIMS doctors are comparable to the best in the world. It has its failures, drawbacks and impediments but it has substantial achievements too, to its credit. The Committee, therefore, agrees that its growth needs to be fast-tracked. This will however remain wishful thinking if the Institute is not granted the requisite functional autonomy in truest Sense. The Committee accordingly recommends that the question of autonomy in the context of the Institute needs to be revisited by the Government immediately and powers should be delegated at the Institute-level to facilitate quick decision-making and optimal growth as a premier medical university, keeping in view its special character which is possible only if there are substantial reforms in the IB/GB composition.

121. The Committee is of the opinion that new policies should be designed for achieving more functional and financial autonomy in an effective manner. Keeping in mind that AIIMS is a public health institution funded by the Government, no compromise on accountability front can be made.

V. Valiathan Committee Report

122. The Committee notes that the High Powered Committee has classified the recommendations of the Valiathan Committee into two categories-Part ‘A’ and Part ‘B’. Part ‘A’ contains 31 Recommendations not requiring structural changes and Part ‘B’ contains 7 Recommendations which require structural changes through amendments in AIIMS Act and the Rules and Regulations made thereunder. The Committee, however, takes note of the opinion both pro and against on Valiathan Committee Report. The Committee impresses upon the Department to closely scrutinize all the suggestions given by the Valiathan Committee before implementing the recommendations further.

VI. Vacancies/Appointments

123. The Committee observes that the essential pre-requisite for quality health care services is the availability of adequate manpower/specialists and other healthcare professionals. A cursory reading of the vacancy position vis-a-vis the sanctioned strength reveals that there is more to it than meets the eye. What confounds this Committee is the issue that inspite of providing ample budgetary support, in-position strength in respect of faculty is 594 against sanctioned strength of 826, that of non-faculty is 201 against sanctioned strength of 347 and similar position exists in the case of Group ‘B’ and ‘C’ staff and Group ‘A’ (non-faculty) and Group ‘B’ staff in respect of nurses. Similar is the position in respect of Junior and Senior Residents. Moreover, the Committee has been informed of creation of 2235 non-faculty posts and further projected 905 non-faculty posts for creation. It is more than evident that on the one hand the Institute has revealed grand plans for expansion but on the other, it has not been able to recruit even the sanctioned strength. The Committee, therefore, exhorts 38 the Institute to streamline its recruitment policy so as to ensure that before approaching the Government for creation of posts, the Institute should at least ensure that the sanctioned posts are filled up within a targetted timeline. The Committee also recommends that the Institute should expedite the process of creation of a Personnel Department to ensure streamlining of procedures and actual process of recruitment for future appointments.

124. Given the high quality and specialized, skills and expertise of the faculty and other human resource of the Institute, the Committee is of the view that adequate incentives should be offered and other steps be taken, to attract new talent and to check their exodus from the Institute.

125. The Committee also finds that the process of appointment of Director of the Institute is done at the last moment in a hurry. The Committee is also of the view that there is a need to relook into the process of appointment of Head of Department( HoD) of the respective Departments in the Institute. The Committee, therefore, recommends that in order to ensure timely filling up of the post of Director, the required processes should be put in motion at least one year before the anticipated vacancies arose. On the issue of appointment of Head of Department, the Institute should ensure a codified policy after taking a final call on the matter of rotatory headships.

126. The Committee is of the view that a barrier to accountable administration is the practice of appointing a serving IAS/IRS/IPS officer as Deputy Director of Administration who serves at the pleasure of the Health Minister and follows the diktats of the Minister and Health Secretary, with no accountability to AIIMS as a bird of passage. This needs to be rectified if efficiency and integrity of the Administration has to be ensured. The Committee therefore recommends that a management expert be recruited by the Institute Body through open selection, with a five year term which is open to reappointment, subject to objectively conducted performance appraisal.

VII. Assessment Promotion Scheme

127. The Committee feels that the issue of Assessment Promotion Scheme(APS) has raked its fair share of controversy. The Committee is of the view that the Institute should have framed guidelines for Assessment Promotion Scheme before going for it. APS has been badly administered and has not fostered talent. Lateral entry of talent, a real strength of AIIMS in the 70’s and 80’s has been greatly restricted due to APS. The scheme definitely needs a review. The Committee, also recommends that the authorities, concerned should take a realistic assessment of the scheme and frame guidelines to overcome the lacunae existing in the Assessment Promotion Scheme to put an end to the controversy the Scheme has generated. The Committee also recommends that till such guidelines are framed standard Government of India (GOI) practices in this regard should be strictly followed.

VIII. Rotation of Headships

128. The Committee is of the opinion that rotating headship of the Department will ensure sharing of fresh, ideas, fresh endeavors and innovative thinking. The 39

Committee, therefore, desires that the matter be given a serious thought by the authorities and a well-considered decision be arrived at after discussing the pros and cons with entire array of stakeholders.

IX. Accommodation

129. The Committee has been given to understand that several doctors, senior faculty members and other staff have not been provided suitable accommodation. The Committee is also concerned to know that a substantial number of the resident doctors, both Senior Residents and Junior Residents who are the treating force of AIIMS, are not getting accommodation and have to reside outside. The Committee recommends that the Ministry should give priority to provide suitable accommodation to all doctors, faculty members & other staff and solve the problem with a sense of urgency. The Committee recommends that an early action may be taken in this regard.

X. Infrastructure and Expansion

130. The Committee agrees that there is urgent need to strengthen the health infrastructure across the country’s medical colleges, State hospitals, Community Health Centres, Primary Health Centres, etc. This would improve the quality of health care delivery in the country, thereby reducing the load on a tertiary care institution like AIIMS. The Committee, therefore, recommends that the Ministry should urgently look into the issue of strengthening the health care infrastructure across the country so as to reduce the primary and secondary healthcare burden on the Institute.

131. The Committee notes that a redevelopment plan of AIIMS is under implementation. The Committee recommends that pace and process of the redevelopment be expedited so that with capacity building it would bridge the huge gap in infrastructure and facilities and access to adequate health care.

132. The Committee notes from the information made available to it that of the five projects (both completed and on-going) of Oversight Committee costing ` 615.87 crore, four projects have witnessed time overruns and cost escalations while the fifth project concerning the construction of Houses at A. V. Nagar is yet to be finally approved by South Delhi Municipal Corporation. Similarly, of the 23 other projects (both completed and on-going) most of the projects have lagged behind their set targets and thus have not met time and cost deadlines. The Committee feels that this is a pathetic situation as such delay does not bode well for an institution of vital importance like AIIMS. The Committee is very much concerned with these delays and desires them to be addressed with utmost gravitas and promptitude. The Committee, therefore, impresses upon various agencies involved in the expansion process of infrastructure in AIIMS to resolve the clearance issues in a time bound manner as health infrastructure cannot be held ransom to technical issues like clearances and that too in the national capital of the country. The Committee also desires that the issue be taken up at the highest level in the Ministry with counterpart Ministries dealing with agencies involved in implementation of the infrastructure projects in AIIMS to ensure that there is no further delay in the schedule laid down for implementation and completion of various 40 projects in AIIMS. The Committee also impresses upon the Ministry to ensure setting up of an Oversight Committee reporting directly to the Director of the Institute to ensure strict vigil and monitoring of infrastructure projects to ensure adherence to time bound completion thereof. The Committee also recommends the Department to ensure that there is no cost escalations of projects and the work of on-going projects is executed within the approved cost.

133. The Committee has been given to understand that AIIMS catered to 35 lakh patients, which is a huge number by any standard. It is thus more than evident that there is very high burden of clinical services on AIIMS. Given the fact that a considerable number of patients availing health care facilities at AIIMS belong to the poor and deprived sections of the society, it is all the more imperative that the health care infrastructure of AIIMS is augmented to keep the same commensurate with the health care requirement of the society. The Committee, therefore, endorses the expansion plans of AIIMS. The Committee would, however recommend that an effective monitoring mechanism be put in place to ensure that the expansion plans are executed within a dedicated time-frame.

134. The Committee takes note of the plan to take over the Janakpuri Super- Speciality Hospital of the Government of NCT, Delhi by AIIMS, which has not materialized as yet. The Committee recommends the Department to expedite the process of takeover plan of this super specialty hospital from the Government of NCT, Delhi.

XI. AIIMS Campuses and Satellite Centres

135. The Committee observes that the development of AIIMS Campus II, Jhajjar, Haryana is an ambitious project and will require not only massive allocation of funds, but also sustained monitoring. The Committee would therefore like the Ministry of Health and Family Welfare to ensure that the Development Project concerning AIIMS Campus II, Jhajjar, Haryana is executed within the initially estimated project costs and time-frame in order to avoid any time-overruns and cost escalation of the project. The Committee further recommends that such satellite centers should also be set up in other parts of the NCR like Meerut, Greater Noida, Gurgaon, Ghaziabad, etc. so that influx of patients from neighboring states could be absorbed by these campuses.

XII. Other AIIMS Like Institutions

136. The Committee is aware that the main reason for the high patient load in AIIMS is the lack of adequate and quality medical facilities in the neighboring States like Bihar, U.P. and Rajasthan etc. The Committee observes that the primary objective of Pradhan Mantri Swasthya Suraksha Yojana (PMMSY) which was launched in 2006, was to correct the imbalances in availability of affordable, quality tertiary health care. The Committee takes note of the fact that the Government is setting up six AIIMS like institutions. The Committee has been given to understand that desired progress has not taken place in other AIIMS like Institutes. Infrastructure and faculty is not adequate to run the Institute. Therefore, the Committee recommends that an early action be taken to ensure that the six Institutes start functioning optimally. This would reduce 41 the load on the AIIMS, Delhi to a large extent. The Committee is also of the view that the Government should consider setting up of more AIIMS like Institutions in the health care deficient States like Uttar Pradesh, Bihar and Madhya Pradesh.

137. The Committee observes that the expansion of tertiary care institutions is essential for catering to the healthcare needs of the growing population in the country and setting up of AIIMS-like institutions and upgradation and strengthening of medical institutions under PMSSY is a major step towards guaranteeing quality health care to all. The Committee desires to be kept apprised of the progress made towards full- operationalisation of AIIMS-like institutions on a regular basis.

138. The Committee observes that it is imperative to correct the imbalances in availability of affordable tertiary level health care in the country. However, this objective can only be realised if, besides setting up of AIIMS-like Institutions, more medical institutions/colleges/districts hospitals in different parts of the Country are upgraded and strengthened through Centrally Sponsored Scheme for capacity expansion. The Committee, therefore, recommends that more medical institutions/Medical Colleges of underserved and un-served areas be included under PMSSY for upgradation and strengthening of the District Hospitals without compromising the quality of services rendered. The Committee would also like to add that recruiting quality faculty for other AIIMS-type institutions is already proving difficult. The need of the hour is to create an All-India cadre linking AIIMS-Delhi, PGIMER and JIPMER as hubs and the new AIIMSs attached to one of them in periodic rotation between the central hubs and the “regional” AIIMS. This will be akin to IAS officers rotating during their careers between their state cadre and central postings.

XIII. Referral Character

139. The Committee notes that apart from being a University by character, AIIMS has an impeccable position as a tertiary hospital also. It is, therefore, imperative that highest level of patient care is provided by the Institute. The Committee is however constrained to note that over the years the tertiary referral status of the Institute has been almost completely lost and as admitted by the Government before the Committee “today the Institute serves as primary care centre for people living in South Delhi, a secondary care centre for Delhi, NCR and as a tertiary care centre for parts of North, Central and East India”. This is a very unfortunate situation as it not only negatively impacts the patients who deserve tertiary care on priority but such a mammoth patient load with even minor ailments also adversely affects the functioning of the Institute and hampers its academic and research activities. The Committee, therefore, from the standpoint of the Institute recommends immediate filling up of all the existing vacancies and restructuring of staff and other resource requirements of the Institute based on the existing patient load. It also desires immediate investment for creation of requisite infrastructure including expansion of departments, addition of operation theatres and other paraphernalia, improvement in the existing infrastructure, etc. The Committee is of the opinion that the decentralization of medical services is necessary to decongest the main Hospital by creation of screening OPDs, outreach centres. An efficient and prompt referral to other health facilities would also go a long way in improving the patient care 42 in the Institute. Single patient friendly registration for all OPDs along with computerization of patients’ records and reports with sufficient safeguards for ensuring confidentiality and centralized laboratories services with sample collection at multiple sites would also be a hugely patient friendly initiative.

140. The Committee would, however, like to add that AIIMS cannot be a tertiary care institution as long as UG courses are run UGs need exposure to primary and secondary care too hence general OPDs etc. Either AIIMS discontinues UG programmes and focuses only on PG plus programmes like PGIMER or transfers UG training to ancillary centres linked to but not situated in the main campus. Since there are now many good UG training medical colleges, unlike 1956 when AIIMS was set up, the former may be the preferred option. On the other hand, if AIIMS has to be a role model-cum-technical resource for new AIIMS-like institutions, the composite UG+PG character has to be maintained. A final call on this issue needs to be taken urgently.

XlV. Reservation Policy

141. The Committee notes from the submissions made before it that reservation provisions have been violated in AIIMS in the past. Though, the Committee takes note of the submissions made by the Director, AIIMS on 16th January, 2015 that “since 2009- 10 the reservation policy is being followed in its letter and spirit and there is no deviation of even one per cent”, it nevertheless would like the Ministry to put in place an institutional mechanism to ensure that a robust database with multi-stage cross verifications is created for implementing the reservation policy in AIIMS. The Committee also recommends that the Ministry may also ensure that accountability of the AIIMS officials is fixed for potential violations of constitutional provisions on reservation. Action should also be taken against those responsible for violations of the reservation policy in the past.

142. The Committee further recommends that the Ministry of Health and Family Welfare devise an exhaustive plan to wipe out the backlog existing in various categories of reserved posts including faculty positions and periodically review whether or not the reservation policy and orders are being implemented in letter and spirit so that the SC/ST/OBC candidates are not deprived of the rights guaranteed to them by the Constitution of India.

XV. Procurement

143. The Committee finds that in spite of an elaborate procurement process for equipments, consumables, materials, medicines, etc, it has come to its notice that there are loopholes in the procurement process. The Committee, therefore, strongly recommends that the Department should build abundant safeguards in the procurement process to check any instance of malpractice.

XVI. Allied Services

144. The Committee would like to know the exact reasons and cause for the, discontinuance of the speech pathology and audiology programme at the Institute. The 43

Committee desires that adequate steps should be taken to re-start this programme without any further delay as there is a huge demand and shortage for speech therapists and audiologists in the country.

145. The Committee also recommends that service conditions, pay scales and career opportunities of the public relations personnel, the physiotherapists, occupational therapists, the Audiologist and Speech therapists should be given a relook so that their interest, which is intrinsically related with the interest of the Institute and the patients is not overlooked any further. The Committee further feels that there is an urgent need to ensure prioritization for accrediting all allied health professionals.

XVII. Research and Development

146. The Committee notes with satisfaction that AIIMS has maintained its position as a top research Institution in the Country. With a view to ensure that the Institute continues to remain at the forefront of research and development in health sector not only in the Country but also in the world, the Committee strongly recommends that the Ministry should ensure that all requirements of funds for R&D activities in the Institute should be met on top priority. This would not only ensure that the integrity of public health goals and public policy is observed but would also eliminate industry sponsored research like clinical trials and a host of other such activities which sometimes may lead to distortion of priorities, negligence of public good, conflict of interest and unethical practices. The Committee would also like to be informed of the evaluation of impact on national health programmes and innovations in clinical/public health service delivery that research at AIIMS contributed to.

147. Given the impeccable standing of the Institute in R&D in health sector, the Committee feels that it is high time for development of professional research cadre in the Institute along with development of requisite research infrastructure. The Committee recommends that the Ministry should prepare a well defined roadmap for the purpose within a dedicated time-frame.

148. The Committee is also of the opinion that for better command and control and monitoring and for maximizing the research inputs, the research team should be multi-disciplinary and all resources for research should be centralized. It would also be worthwhile to provide professional secretarial assistance along with non-monetary incentives including peer recognition to the human resource involved in R&D activities.

149. The Committee also desires that the ‘research governance should invariably include collective decision making and the protocols regarding research governance and manpower development should also be given due consideration in career progression.

150. The Committee observes that the concept of Research with focus on Nationally Relevant Health Problems is a sine-qua-non. AIIMS being a premier Institute and being expected to play a visionary role to the other medical Institutions, there should be definite direction for the areas on which research undertaken would help in giving a 44 proper perspective for solving Nationally Relevant Health Problems. There is an urgent need to consider the Multi-disciplinary research. Besides, making available adequate time to the faculty for pursuing research is equally important.

151. The Committee also recommends that the regulatory mechanism be strengthened to ensure that the agenda of the Pharmaceutical companies’ is not imposed on the research agenda of the Institute.

152. The Committee notes that Dr. Valiathan had advocated funding of research projects at AIIMS by the private industry including the Pharma Industry. The Committee has very strong reservations on the AIIMS drawing money from outside the Government. AIIMS is a public health institution funded by the Government. It is mandated to provide equitable tertiary healthcare, quality education and carry out premier research. The Committee apprehends that if industry sponsored research is allowed a free run in AIIMS and if AIIMS starts taking money from the industry and other sources, it will create tremendous amount of distortion, conflict of interest and also cause unethical practices because the corporate sector invests in the multi- specialty hospitals and institutes that focus on income earning treatment procedures and products and are more concerned about profitability. The Committee is, therefore, very clear that the AIIMS should remain a predominantly public funded institution and must face democratic accountability. Therefore, the Committee is not on the same page with Dr. Valiathan when he says that AIIMS should welcome funding of research projects by the industry.

153. The Committee has been given to understand that in the extramural funding from private entities which the AIIMS is getting at present, a large number of research projects belong to “drug trials” which is a very notorious commodity, as has been widely reported in the print and electronic media. In the circumstances, Committee opines that the Institute while accepting any extramural funds from private entities for research purposes should be selective and accept funds only for the projects oriented for the public good at large and ensure that all safeguards are followed while conducting the research. Besides, the Committee observes that AIIMS is a premier medical research Institution and there is no reason why AIIMS from its own budget cannot increase the intramural funding. The Committee therefore recommends that most of the fund requirements for research, should be met from governmental grants. The Committee also recommends that every faculty member should get some seed money for research from within the public fund so that the integrity of public health goals are maintained and Government’s health policy is promoted.

154. The Committee recommends that there is an urgent need to build a robust structure which would facilitate Research activities which the Institute seems to lack at present. If need be, possibilities should be explored for encouraging collaborative Research between the Institute and other reputed medical institutions in the country and abroad.

155. The Committee feels that though AIIMS has been able to carry out internationally comparable research activities, yet a lot remains to be done in translating the research outcomes into health products. The research should be result oriented and the results 45 should be implementable so that it does not remain confined to laboratory or only on paper but ameliorates the lot of the common people.

156. The Committee has been given to understand that in accepting several foreign assignments in the research arena, the faculty are in conflict of interest. All such cases should be examined and wherever conflict of interest is found to be existing, action should be taken against the person involved. A robust mechanism should be in place to address this issue.

XVIII. Patient Care

157. The Committee finds that the average waiting time for patients in getting dates for surgeries, various processes and tests is too long. The Committee is aware of the fact that in view of heavy load of patients, the dates for getting surgeries, processes etc. are unduly delayed. The Committee is of the opinion that a screening wing for each department should be opened which would, depending on the severity of the disease, put in place a grading system under which patients having disease of severe nature can be operated earlier and those who have a less serious complication can be operated later as straitjacketing of surgeries on first-cum-first serve system does not do justice to the patient having serious complications. The Committee recommends that the Institute should devise a screening wing for each Department which, the committee feels, would be much better and practical than the current system of first-cum-first serve.

158. The Committee also desires that a definite element of priority should be accorded to the patients coming from outside Delhi as they come to the Institute only after exhausting all the medical avenues and resources at their place of stay and their plight is the worst amongst all patients visiting the Institute.

159. As another patient friendly step, the Committee recommends that all essential medications should be provided free of cost by the Institute to the economically weaker patients. Moreover, once a patient is admitted in general ward, she/he should not be compelled for any out of pocket expenditure.

160. The Committee also recommends creation of multiple information desks in the Institute where qualified social workers are deployed to enable a patient friendly ambience right from the time a patient enters the Institute to the economically weaker patients. The Committee feels that these measures would go a long way in making the Institute truly patient friendly and patient caring.

XIX. Students’ Welfare

161. As in case of any university, the students are the backbone of AIIMS and they have contributed significantly to the reputation of the Institute with their selfless service and dedication. Students Welfare, therefore, should be the top most priority of AIIMS as it simultaneously ensures both a better academic environment and a better patient care. The Committee, therefore, recommends that the Government should ensure that all facilities for academic pursuits, research activities, infrastructure and welfare of students should be put in place on war footing. There should be reservation 46 for AIIMS students in post graduate entrance examination as is being done in JIPMER. It also recommends that the Ph.D candidates should be granted scholarships for the entire duration of their study period. The Committee further desires that professional counseling and other sub measures should be put in place to help the students facing difficulty with their syllabi.

XX. Innovations

162. The Committee notes that professional health education of the pioneering kind was the fundamental reason for the establishment of the Institute. Several innovations in education (e.g. rural internship, present phases of MBBS programme, 3 year postgraduate residency system, new DM/MCh courses) were pioneered at AIIMS before they became the national norm. Disappointingly, this is not the case now as the overbearing intrusion by the “service” component of the job profile perhaps does not allow for time to think freely and come up with new and innovative strategies for teaching. The Committee is concerned to note that there has been no innovation, worth mentioning in the Institute for quite some time. The Committee feels that innovations should be made and adopted in teaching, learning and assessment. It is necessary to be aware of the things going on in the rest of the world and also important to select things which are relevant to the country. Besides, the Institute should be able to come up with its own innovations in the medical field which were the prime objectives of AIIMS. The Committee would, therefore, like the Ministry to find out the impediments coming in the way of innovations and take steps to remove them. The Institute should also put in place a mechanism to encourage creative thinking and developing innovative ideas.

XXI. Issue of Corruption

163. The Committee also observes that there are five Committees of AIIMS namely (i) Standing Finance Committee (ii) Academic Committee (iii) Standing Selection Committee (iv) Estate Committee and (v) Hospital Affairs Committee and each Committee has been assigned a designated role. But from the information made available to the Committee, it has noted that though there are well laid down rules, norms and procedure even for emergency situations, meetings of these Committees are not held regularly, required details are not put in the agenda and sufficient time is not given and sometimes ex-post-facto approvals are taken. This suggests that the established structures do not seem to function as they should, which means there is a tendency to squeeze the decision-making process. This results in lack of transparency and accountability and that is why many violations occur. The Committee is convinced that if regular processes, norms and procedures are observed transparently and if there is adherence to norms, then a lot of irregularities can be avoided. Taking into account all these factors, the Committee recommends that the maximum work should be done in the AIIMS Committees because collective decision-making is the best antidote to corruption and nexus. The Committee also recommends that whenever there is a violation of norms and processes, the violation must be discussed threadbare in the Governing Body of AIIMS which is the executive body and swift remedial action taken. 47

The Committee is of the considered view that if this recommendation is implemented in letter and spirit, there will be adequate checks on irregularities and corrupt practices in AIIMS.

164. The Committee would like to make it abundantly clear that though the Committee is all for professional autonomy of AIIMS, autonomy should not mean autonomy of the Director, resulting in freedom from observance of prescribed rules, regulations and procedures.

165. Taking note of corruption cases in AIIMS highlighted by the media, the Committee had sought a status note on the probes initiated from 2011 to 2014. The Committee notes from the information furnished by the Ministry that myriad corruption cases are under investigation involving AIIMS officials and doctors. The cases include disproportionate asset cases, procurement of computers and peripherals without following the purchase procedure, alleged financial irregularities in purchase of surgical gloves and medicines, construction of engineering works without approval of the statutory bodies, alleged tempering with selection lists of operation theatre assistants, irregularities in appointments of officials under sports quota, massive irregular payment to contractors, irregularities in awarding the work of development of ward and allied spaces for Department of Pulmonary Medicine, purchase of uniforms for employees, etc. The Committee is perturbed to note that despite unraveling of corruption cases at AIIMS at regular intervals, the Ministry has done away with the regular Chief Vigilance Officer’s post at AIIMS and the role of anti-graft officer of AIIMS has been assigned to a Joint Secretary and CVO in the Ministry of Health and Family Welfare. Evidently, the Ministry appears to be non-serious in tackling corruption at AIIMS. The Committee, therefore, strongly deprecates the non-serious approach of the Ministry towards tackling such a large number of cases of corruption at AIIMS and recommends that the Ministry should quickly move towards appointing a regular Chief Vigilance Officer of unblemished credentials at AIIMS. Needless to emphasize that the Chief Vigilance Officer is the only instrument available with the Ministry to monitor statutory compliance of various prescribed procedures and norms. The Committee also recommends the Ministry to play a proactive role in ensuring expeditious investigations into all the corruption cases at AIIMS and furnish within three months from the date of presentation of this Report, an up-to-date status note detailing therein various stages of cases of investigation, involving corrupt practices and embezzlement of funds and steps taken to check occurrence of such cases in future. MINUTES I FIRST MEETING (2010-11)

The Sub-Committee met at 11.00 A.M. on Thursday the 30th June, 2011 in Room NO.‘63’, First Floor, Parliament House, New Delhi.

MEMBERS PRESENT 1. Shri Datta Meghe — Convenor

RAJYA SABHA 2. Shri Janardan Dwivedi 3. Shrimati Viplove Thakur 4. Dr. Vijaylaxmi Sadho 5. Shrimati Brinda Karat

LOK SABHA 6. Dr. Jyoti Mirdha 7. Shri Ashok Argal 8. Shri R. K. Singh Patel 9. Dr. Tarun MandaI

SECRETARIAT Shrimati Vandana Garg, Additional Secretary Shri R. B. Gupta, Director Shri Dinesh Singh, Assistant Director

2. At the outset, the Convenor welcomed the Members of the Sub-Committee. He also informed them that the Sub-Committee has been constituted to examine various aspects of the functioning of All India Institute Medical Sciences (AIIMS) which is a premier Medical Institute in the country. At the commencement of the meeting, the Convenor drew their attention to Rule 294 (1) of the Rules of Procedure and Conduct of Business in the Council of States, which requires that-

“Whenever a member has a personal or specific pecuniary interest (direct or indirect) in a matter being considered by the Council or a Committee there of he shall declare the nature of such interest notwithstanding any registration of his interests in the Register, and shall not participate in any debate taking place in the Council or its Committees before making such declaration”.

51 52

3. The Sub-Committee then discussed a number of issues pertaining to AIIMS, like-low frequency of meetings of the various Standing Committees of AIIMS; large scale migration affecting teaching as well as tertiary care; shortage of faculty; patient services being offered especially for the poor patients; faculty matters especially with regard to reservation, proper man-power utilisation by entering into some kind of bond with doctors; adequacy of infrastructure in view of long waiting period for patients; status of implementation of recommendations of Valiathan Committee; need for amendments in the existing legislation pertaining to AIIMS, etc.

4. The Sub-Committee thereafter discussed its further course of action. It decided to begin with a briefing meeting with the Secretary, Department of Health and Family Welfare along with Director, AIIMS, followed by interaction with the Experts and faculty’s/Doctors’/ Employee’s Associations of AIIMS on the subject and decided to call the Secretary, Department of Health and Family Welfare along with Director, AIIMS at its next meeting scheduled to be held on the 11th July, 2011.

5. The Sub-Committee also directed the Secretariat to seek a detailed status note and replies to a set of questionnaire on the Functioning of All India Institute of Medical Sciences (AIIMS) from the Ministry.

6. The Sub-Committee then adjourned at 11.45 A.M. II

SECOND MEETING (2010-11)

The Sub-Committee met at 3.00 P.M. on Monday the 11th July, 2011 in Committee Room, ‘A’, Ground Floor, Parliament House Annexe, New Delhi.

MEMBERS PRESENT 1. Shri Brajesh Pathak — Chairman 2. Shri Datta Meghe — Convenor

RAJYA SABHA 3. Shri Janardan Dwivedi 4. Shrimati Viplove Thakur 5. Dr. Vijaylaxmi Sadho 6. Shrimati Brinda Karat 7. Shrimati B. Jayashree

LOK SABHA . 8. Dr. Jyoti Mirdha 9. Shri Ashok Argal 10. Dr. Sanjay Jaiswal 11. Shri R. K. Singh Patel 12. Shri N. Kristappa 13. Dr. Tarun Mandal

SECRETARIAT Shri R. B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Assistant Director

WITNESSES Representatives from the Department of Health and Family Welfare 1. Shri K. Chandramouli, Secretary 2. Shri Keshav Desiraju, Addl. Secretary 3. Shri Debashish Panda, Joint Secretary

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Representatives from the All India Institute of Medical Sciences 1. Shri R. C. Deka, Director 2. Shri Vineet Chawdhry, Dy. Director 3. Dr. Nikhil Tandon, Professor, AIIMS

2. At the outset, the Convenor welcomed the Members and apprised them of the agenda of the meeting i.e. oral evidence of the Secretary, Department of Health and Family Welfare and Director, AIIMS on the functioning of All India Institute Medical Sciences.

3. The Convenor also informed the Members that the Department of Health and Family Welfare had sought extension of time for three weeks i.e. upto 21st July, 2011 for furnishing the replies to the questionnaire. The Sub-Committee discussed the same and acceded to the Department’s request for grant of extension of time upto 21st July, 2011.

4. In the meantime, the Chairman of the Committee also joined the meeting and on request from the Convenor chaired it.

5. The Sub-Committee, thereafter, heard the views of Secretary, Department of Health and Family Welfare & Director, AIIMS and other officers of the Institute on various aspect of the functioning of AIIMS. Dr Nikhil Tandon, Professor, AIIMS made a power point presentation on the subject, inter alia highlighting the following issues:

(i) the vision behind setting up of AIIMS; (ii) the main objectives of AIIMS viz. patient care, education and research; (iii) bed strength facility; optimal load v/s present load; (iv) cost to AIIMS; (v) patient satisfaction; (vi) Post Graduation & Residency Programmes; (vii) holding of various types of training to defence personnel and candidates sponsored by Government institutions, foreign undergraduates from countries like Australia, Bangladesh etc; (viii) landmark research of national importance on malnutrition, iodine deficiency, liver diseases, lead poisoning in children, tuberculosis, genomic analysis of malaria, stem cell research, vitamin D status in Indian context.

6. Prof. Tandon also informed the Committee that some National Programmes were influenced by AIIMS research like Integrated Child Development Schemes (ICDS), universal iodization of salt, National blindness Control Programme, Fluorosis Control Programme, Tobacco Control Programme and National Programme on Health Care of Elderly and that AIIMS was collaborating with WHO in the field like neonatology and diarrhoeal diseases etc.

7. During the course of the discussions, Members raised the following queries; amendments in the AIIMS Act, rules and regulations, finalization of purchase manual, accounting manual, grievances of faculty Members, students and employees; problems of seniority; vacancies and implementation of reservation in faculty posts; autonomy of the Institute; frequency of meetings of General Body and various Standing Committees of the Institute; implementation of recommendations of Valiathan Committee; roaster system prevailing in the Institute; filling up of backlog of vacancies; creation of more posts in view of increasing doctor-patient ratio; commercialisation of research at AIIMS; clinical trials being conducted in 55

AIIMS; report of Ethics Committee, considerable decline in delivery of health care including admission of patients, surgeries and number of outdoor patients.

8. The Secretary and the Director clarified the issues raised by the Members. The Chairman then directed the representative of the Ministry to furnish replies and comments on the queries not replied orally and two sets of questionnaire handed over during the meetings within a week’s time.

9. The Sub-Committee then decided to meet again on the 26th July, 2011 to hear the views of some experts on the functioning of AIIMS.

10. A verbatim record of the proceedings of the meeting of the Sub-Committee was kept.

11. The Sub-Committee then adjourned at 5.00 P.M. to meet again on the 26th July, 2011. III THIRD MEETING (2010-11)

The Sub-Committee met at 3.00 P.M. on Tuesday the 26th July, 2011 in Committee Room, ‘A’, Ground Floor, Parliament House Annexe, New Delhi.

MEMBERS PRESENT 1. Dr. Sanjay Jaiswal — In the Chair

RAJYA SABHA 2. Shri Janardan Dwivedi 3. Shrimati Viplove Thakur

LOK SABHA 4. Dr. Jyoti Mirdha 5. Shri Ashok Argal 6. Dr. Tarun Mandal

SECRETARIAT Shri P.P.K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Smt. Arpana Mendiratta, Joint Director Shri Dinesh Singh, Assistant Director

WITNESSES 1. Dr. Sneh Bhargava, Former Director, All India Institute of Medical Sciences 2. Prof. S. K. Jindal, PGIMER, Chandigarh 3. Dr. KSVK Subba Rao, Director, JIPMER, Puducherry 4. Dr. K. Srinath Reddy, President, Public Health Foundation of India, New Delhi.

2. At the outset, the Sub-Committee voted Dr. Sanjay Jaiswal, MP (Lok Sabha) to the chair in absence of the Convenor. The Members were then apprised of the agenda of the meeting viz. hearing of views of experts on functioning of All India Institute of Medical Sciences.

3. Dr. Sneh Bhargava, Former Director, AIIMS informed the Sub-Committee that the main cause of downslide of the AIIMS from the vision envisaged for it to serve as a role model

56 57 for other medical institutions was weak internal administration and strong external interference. Elaborating on her conclusions as drawn above, she dwelt upon the lack of training of Director in administration and governance, and emphasized need for restructuring the administrative set- up. She also dwelt on the issues such as need to hold the staff Council meetings on regular basis; lack of code of conduct for doctors; faculty development, implementation of Assessment Promotion Scheme etc. She also informed the Committee that the problems inherent to the AIIMS were complex and a high powered Committee viz. Valiathan Committee gave its report on the working of AIIMS in 2006. Another High powered Committee was formed on the implementation of Valiathan Committee which gave its report in February, 2010. Two other Committees viz. Professor Maheswari Committee on Internal Governance and Javed Chaudhary’s Committee on ‘How to retain faculty of AIIMS’ gave their report. She felt that it seemed that even these have been gathering dust due to lack or willingness to implement the same. With regard to patient care she was of the opinion that there should be a concept of filtering and screening OPD patients at AIIMS in view of the huge intake of OPD patients and treatment of Common ailments may be addressed by peripheral units handled by general duty doctors. She also felt that AIIMS should take measures to reduce the patient intake in the Institute to focus on research aspect. She concluded by informing that in matters of recruitment, 25% seats should be reserved for direct lateral entry to promote fresh talent in the Institute.

4. Prof. S. K. Jindal from PGIMER, Chandigarh informed the Sub-Committee that there was a gross mismatch between what was required for clinical research and what was delivered. He opined that due to doctors being highly over burdened in examining patients, cutting-edge research was the biggest casualty. He felt that the time had come for decentralization of Medical services through opening Kiosks at the peripheral limits of the city so as to reduce the pressure of patients converging at a single hospital premises, thereby reducing pressure on doctors. On the issue of decision making, he was of the view that a Group of faculty should be set up which could share responsibility of decision making thereby decreasing the burden of all decision making on the head of the Medical Institution. He was in favour of setting up of focused research groups which should focus solely on bringing path- breaking solutions to various ailments plaguing the country.

5. Dr. KSVK Subba Rao, Director, JIPMER, Puducherry, then shared his experiences on the working of his Institute. He informed the Sub-Committee that he had the pleasure of being the Director of an Institute, which was declared an institute of national importance in 2008. This had helped the Institute in getting greater autonomy to utilize funds as well as seek more funds for Education, Research and Service component, which was not the case earlier. He was of the view that for any Institute to function in a streamlined manner, there was a need for provision of different experts, say, one for administering finance, one for administering accounts etc. so that the Director/Head of the Institute could focus on planning aspect. On the issue of AIIMS, he was all for cutting down on patient care load and focusing on research. He also felt that centres of AIIMS could be set up to look after patient care and AIIMS could focus on research aspects to re-establish itself as an Institute of National eminence.

6. Lastly, Dr. Srinath Reddy of Public Health Foundation of India submitted before the Sub Committee that the Institute had been primarily set up for setting new standards and acting as a catalyst for medical education in the country. He felt that there was a need to set up 58

AIIMS like Institutes to foster competition as well as reduce the pressure on AIIMS. He felt that in order to provide uniformity in standards set by AIIMS, there should be rotation of faculty from various Medical Institutes to AIIMS and vice-versa so that the knowledge gained in medical education is disseminated across the length and breath of medical fraternity. Alternatively, he felt that a common pool of faculty like the Indian Administrative Service (IAS) in AIIMS and other Institutes could be set up. He was of the view that AIIMS should not opt out of UG courses and function as an Institute for PG courses and Super specialty disciplines. In the field of research, he stated that the quality of research was on the decline due to weak support structure; lack of collaboration in the field of research, red tapism etc. He was of the view that there was a need to identify thrust areas for National Interest, some of which can be open ended. He also felt that there should be inter-disciplinary transfer for proper exposure. He felt that there should be a provision for inviting a visitor on regular basis from outside countries in various disciplines so as to get feedback of experiences from foreign medical professionals. On the issue of patient care, he was of the opinion that there was a need to set up a network of hospitals for reducing the burden on AIIMS. AIIMS should instead focus on secondary and tertiary care. There was also a need to undertake computerization and linkage of patient records to access record of patient from all Departments of AIIMS. On the issue of governance, he was of the view that all the staff council meetings should be recorded. There was a need for credible selection systems which must be free from all political interference and emphasis should be on the basis of direct lateral entry and not on the basis of entitlement.

7. Members raised some queries which were answered by witnesses. The Sub-Committee directed the witnesses to send written note on any issue which may have remained unanswered.

8. A Verbatim Record of proceedings of the meeting was kept.

9. The Sub-Committee adjourned at 4.30 P.M. I FIRST -MEETING (2011-12)

The Sub-Committee met at 3.00 P.M. on Friday the 30th September, 2011 in Committee Room’ A’, Ground Floor, Parliament House Annexe, New Delhi.

MEMBERS PRESENT 1. Dr. Sanjay Jaiswal — Convenor

RAJYA SABHA 2. Shri Janardan Dwivedi 3. Shrimati Viplove Thakur

LOK SABHA 4. Dr. Jyoti Mirdha 5. Shrimati Jayshreeben Kanubhai Patel 6. Shrimati Harsimarat Kaur Badal 7. Shri S.R. Jeyadurai 8. Dr. Sucharu Ranjan Haldar 9. Shri Radhe Mohan Singh (Ghazipur)

SECRETARIAT Shri P.P.K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Assistant Director

WITNESSES 1. Ms. K. Sujatha Rao, Former Secretary, Ministry of Health and Family Welfare 2. Prof. M.s. Valiathan, National Research Professor, Manipal University, Manipal

2. At the outset, the Convenor welcomed Members to the first meeting of the reconstituted Sub-Committee and apprised them of the progress made with respect to the Sub-Committee’s examination of the functioning of All India Institute of Medical Sciences (AIIMS). The Convenor, subsequently, informed the Members about the agenda of the meeting i.e. hearing the views of Ms. K. Sujatha Rao, former Secretary, Ministry of Health and Family Welfare and Prof. M.S. Valiathan, National Research Professor, Manipal on the subject. 59 60

3. Thereafter, the Sub-Committee heard views of Ms. K. Sujatha Rao, Former Secretary; Department of Health and Family Welfare. Ms. Rao gave a brief presentation before the Sub-Committee inter-alia sharing her experience as a Secretary in the Ministry of Health and Family Welfare especially with respect to various aspects of the functioning of AIIMS. She stated that there has been a decline in overall working standards of AIIMS during the last twenty years. She observed that the main reasons behind this were - the large scale interference of the Ministry into its day-to-day functioning; large scale demoralization in the AIIMS staff especially senior faculty as a result of work overload due to increase in patient- load further compounded by non-filling up of vacancies; delayed decision making due to highly centralised administrative structure; less autonomy and representation to internal governance; infrastructure constraints like delay in procurement of advanced/modern hi-tech instruments like CAT-Scan; dilution in the role from a research and teaching Institute to a general Hospital; huge trust deficit between AIIMS and Government; non-availability of free drug facility to the in-patients; lack of realistic Budget for the Institute; and, lack of delegation of powers to the Director of the Institute to appoint doctors/supporting staff on temporary/contractual basis to ease out workload and carry out patient-care functions and for taking other decisions for betterment of the Institution. She suggested that in order to provide functional autonomy, especially in view of more AIIMS like Institutes coming into existence, there should be decentralization of powers and the Institute needs to be headed by a professional, not necessarily a doctor. Such professional should have sound knowledge in Human Resources, hospital management and stock and inventory management. She also touched upon the Valiathan Committee Report on the subject. During the presentation, Members raised some queries which were replied to by Ms. Rao.

4. Thereafter, the Sub-Committee heard the views of Prof. MS. Valiathan, National Research Professor, Manipal University, Manipal. During his presentation, he gave background of the Valiathan Committee constituted under his Chairmanship in 2006 with three other members. He dwelt upon various issues related to Valia than Committee Report as well as the overall functioning of the AIIMS, which included - the terms of reference of Valiathan Committee; need to make AIIMS truly professional body oriented towards generating knowledge and technology for which it was originally conceived; lack of personnel policy in AIIMS; preponderance of Government officers/Government-nominated members and lack of representatives from Faculty in the Institute Body/other Committees of the Institute; need for high quality public health oriented research in the Institute; fixing better criteria for nomination of members to various Committees/Bodies of the Institute; the need for fixing more rigorous norms for admission to PG courses of the Institute; and, the issue of expansion of AIIMS etc. Members raised some queries which were replied to by Dr. Valiathan.

5. A Verbatim Record of proceedings of the meeting was kept.

6. The Sub-Committee adjourned at 5.11 P.M. and decided to meet again on the 13th October, 2011. II SECOND MEETING (2011-12)

The Sub-Committee met at 11.00 A.M. on Friday the 13th October, 2011 in Committee Room ‘63', First Floor, Parliament House, New Delhi.

MEMBERS PRESENT 1. Dr. Sanjay Jaiswal — Convenor

RAJYA SABHA 2. Shri Janardan Dwivedi 3. Shrimati Viplove Thakur 4. Dr. Vijaylaxmi Sadho

LOK SABHA 5. Dr. Jyoti Mirdha 6. Shrimati Jayshreeben Kanubhai Patel 7. Shrimati Harsimarat Kaur Badal 8. Dr. Sucharu Ranjan Haldar 9. Shri Radhe Mohan Singh (Ghazipur) 10. Shri Ashok Argal

SECRETARIAT Shri P.P.K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Assistant Director

WITNESSES 1. Prof. Subrata Sinha, Director, National Brain Research Centre (NBRC) 2. Prof. Pratap Sharan, Department of Psychiatry, AIIMS 3. Prof. Anoop Saraya, Department of Gastro- enterology, AIIMS

2. At the outset, the Convenor of the Sub-Committee informed members about the agenda of the meeting i.e., to hear views of Prof. Subrata Sinha, Director, National Brain Research Centre, Manesar, Haryana; Prof. Pratap Sharan, Departement of Psychiatry, AIIMS

61 62 and Prof. Anoop Saraya, Department of Gastro-enterology, AIIMS on the functioning of AIIMS.

3. The Sub-Committee first heard views of Prof. Subrata Sinha. Prof. Sinha expostulated his views on the functioning of AIIMS in light of the Valiathan Committee Report and the High Powered Committee Report of Ms. Sujatha Rao on the recommendations of the Valiathan Committee Report which inter-alia also included a study undertaken by Prof. Sunil Maheswari of IIM, Ahmedabad. He was of the view that the Valiathan Committee Report was oriented more towards making the Institute a revenue generating model. According to him, the main issue concerning AIIMS was intellectual autonomy and corporatization of AIIMS would hit its intellectual autonomy. He felt that the main problems plaguing the Institute was lack of Faculty Development due to negative interpretation of rules thereby making the atmosphere restrictive instead of an enabling one. He was also of the view that the Director of the Institute should be from amongst the faculty and political appointments for the post of Director should be avoided. He also shared his views on incentivisation, Government funding of AIIMS and its impact on the autonomy of AIIMS. The Members raised some queries which were replied to by the witnesses.

4. The Committee then heard views of Prof. Pratap Sharan and Prof. Anoop Saraya. Prof Sharan informed the Sub-Committee that the model of AIIMS based on the AIIMS Act passed by the Parliament in 1956 had worked well for more than 5 decades and was being replicated to create six more AIIMS like Institutes in the country. Dr. Sharan shared his views on the Valiathan Committee Report; structural changes in AIIMS as suggested by the Valiathan Committee and grievance redressal mechanism in the Institute. Prof. Sharan stressed on the need for maintaining a balance between Research and Patient care at AIIMS which could be achieved by increasing the number of faculty which would enable the faculty to devote time for research activities in addition to meeting the needs of the patients. Besides, he also raised issues like need for a separate Research Cadre for streamlining research; setting up of a corpus of National Research; need for integration of AIIMS with National Issues; doing away with Adhoc interpretation of Rules; need for doing away with Contractual Appointments; implementation of a rule based governance rather than ad-hocism; transparency in decision making; increase in the component of research funding; not compromising the concept of equity at any cost; the financing of care and education at AIIMS. Prof. Anoop Saraya emphasized that all efforts for commercialization/corporatisation and outsourcing of clinical care should be stopped; rules and regulations of the institute should be in line with deemed university status than as a Central Government department status as this would yield greater academic and research autonomy and less bureaucratic interference; doing away with incentivization, need for screening OPD based on medical condition to filter out non-serious patients; need for the audit of AIIMS done by AGCR and CAG; need for strengthening of the Peripheral Health Institutes, reduction in bureaucratic red-tapism etc. Members sought some queries from both Prof. Sharan and Prof. Saraya which were answered by the witnesses.

5. A verbatim Record of the proceedings of the meeting was kept.

6. The Sub-Committee adjourned at 12.45 P.M. III THIRD MEETING (2011-12)

The Sub-Committee met at 3.00 P.M. on Wednesday the 7th December, 2011 in Room No. ‘63’, First Floor, Parliament House, New Delhi.

MEMBERS PRESENT 1. Dr. Sanjay Jaiswal — Convenor

RAJYA SABHA 2. Shrimati Viplove Thakur 3. Dr. Vijaylaxmi Sadho

LOK SABHA 4. Dr. Jyoti Mirdha 5. Shrimati Jayshreeben Kanubhai Patel 6. Dr. Sucharu Ranjan Haldar

SECRETARIAT Shri P.P.K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Assistant Director

WITNESSES 1. Prof. Sukhdeo Thorat, Chairman, Indian Council for Social Science Research 2. Shri P.S. Krishnan, Former Member Secretary, National Commission for Backward Classes 3. Dr L. R. Murmu, Additional Professor, Forum for Rights and Equality, AIIMS. 4. Dr. Debjyoti Karmakar, President and Dr. Bhaumik Shah, Representative, Resident Doctors’ Association, AIIMS. 5. Shri Harshit Garg, Finance Secretary; Shri Himanshu Kanwat, General Secretary, Students Union and Ms. Komal Parmar, Student, AIIMS. 6. Shri Rupesh Kumar Tyagi, Chairman and Shri Sanjay Kumar, General Secretary, Society of Young Scientists, AIIMS

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Representatives from Ministry of Health and Family Welfare and AIIMS 1. Shri Debasis Panda, Joint Secretary 2. Dr. G. K. Rath, Chief of IRCS, AIIMS. 3. Dr. Rakesh Yadav, Sub-Dean, AIIMS

2. At the outset, the Convenor welcomed the members of the Sub-Committee and apprised them about the agenda of the meeting i.e., to hear views of the experts and representatives of various associations and the Ministry of Health and Family Welfare and AIIMS on (i) the implementation of reservation policy in AIIMS; and (ii) the various aspects relating to functioning of AIIMS.

3. The Sub-Committee first heard views of Prof. L.R. Murmu, on the functioning of AIIMS with regard to implementation of reservation policy. He pointed out the deficiencies in the implementation of reservation policy in AIIMS like MBBS and PG level; Sr. Residency and Post Doctorate level and in Nursing department.

4. Thereafter, the Sub-Committee heard views of Prof. Sukhadeo Thorat, who highlighted various points for implementation of reservation policy in faculty at the level of Assistant Professor, Associate Professor and Professor; inadequacies of floating system of reservation as followed in AIIMS and the resultant deficit in reserved posts; non-implementation of reservation policy in AIIMS as per Government guidelines; treatment of backlog vacancies as shortfall being errornous; need for due representation of SC/ST/OBC students, staff and teachers, on all the committees of AIIMS to safeguard their interests; factors impacting observance of reservation policy; setting up of expert committee for resolving the problem of reservation. Further, he felt that there was a need for framing administrative guidelines by Ministry of Health and Family Welfare to address the discrimination related issues inside the educational institutions throughout the length and breadth of the country.

5. Shri P.S. Krishnan gave a brief overview on reservation policy for backward castes in the institute. He was of the view of that backlog in all posts must be cleared at AIIMS first of all and then fresh recruitments should be made. He also highlighted certain cases of discrimination with students belonging to weaker sections in the Institute. He also advocated reservation in private medical institutions.

6. Thereafter, the Sub-Committee heard the views of the representatives of Resident Doctors Association, Students’ Union and Society of Young Scientists in AIIMS. Dr. Karmakar, highlighted the following points viz. lack of transparency in many matters dealt by administration at AIIMS; absence of a vision charter, jmasterplan; loopholes in recruitment procedures and ambiguity in reservation in MBBS, MD; unimpressive leadership in areas of vital concern like research; growing concern about mishandling of funds in respect to procurement of equipments; non-percolation of benefit with regard to international collaboration to MBBS students and difficulty in getting scholarships; contractual appointments; need for corrective measures to set right perceived corruption in examinations; need for streamlining the various components of lab and diagnostic services; need for establishment of screening OPDs to filter out critical ailments. Representatives from Student Union, AIIMS raised issues like lack of a proper procurement policy; need for regular interface between administration and students; 65 installing CCTV cameras for security purposes and absence of proper reservation mechanism for Students from AIIMS for Post Graduate seats. Besides, the issue of plagiarism and the role of Medical Superintendent being made redundant also figured in the discussion.

7. The representatives from the Society of Young Scientists highlighted the disparity in the duration of fellowship program offered in AIIMS vis-a.-vis other medical institutes in-as-much as it was being offered only for six months against that of five years offered by other institutes.

8. Members sought some queries which were answered by the witnesses. The Convenor asked the witnesses to furnish their further submissions, if any, in writing to enable the Committee to examine them holistically.

9. A verbatim record of the proceedings of the meeting was kept.

10. The Sub-Committee was adjourned at 5.30 P.M. IV FOURTH MEETING (2011-12)

The Sub-Committee met at 3.00 P.M. on Wednesday the 14th December, 2011 in Room No. ‘63’, First Floor, Parliament House, New Delhi.

MEMBERS PRESENT 1. Dr. Sanjay Jaiswal — Convenor

RAJYA SABHA 2. Dr. Vijaylaxmi Sadho 3. Shri Derek O' Brien

LOK SABHA 4. Dr. Jyoti Mirdha 5. Shri Datta Meghe

SECRETARIAT Shri P.P.K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Assistant Director

WITNESS Prof. P.K. Dave, Former Director, AIIMS

Representatives from Faculty Association, AIIMS 1. Dr. Manoj Singh, President 2. Dr. Lalit Dar, General Secretary 3. Dr. B.K. Khaitan, Past President 4. Dr. Vijay Sharma, Joint Secretary

2. At the outset, the Convenor welcomed members of the Sub-Committee and apprised them about the agenda of the meeting i.e., to hear the views of (i) Prof. P.K. Dave, Former Director, AIIMS; and (ii) Dr. Manoj Singh, President, Faculty Association, AIIMS along with his colleagues.

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3. The Sub-Committee first heard the views of Prof. P.K. Dave on the administrative reforms in AIIMS, Prof. Dave shared his experiences on the working of the Institute. He highlighted the following points for improvement in the functioning of AIIMS viz. making AIIMS a referral hospital as the same would reduce the patient load and help the faculty to devote more time for teaching and research work; need for according complete autonomy to AIIMS as envisaged in the Bill piloted by Smt. Rajkumari Amrit Kaur in 1956; need to identify thrust areas in the planned budget of the governing body at the beginning of each year which would result in increase in the clinical & research facilities and development aspects; proper implementation of envisioned development plan in various centres, convention centre and other infrastructural facilities; filling of all the vacant posts; regular holding of meetings of standing committee, internal meetings (faculty meeting and staff council), etc.

4. Thereafter, the Sub-Committee heard the views of Dr. Manoj Singh and others on various aspects of the functioning of AIIMS. He pointed out that the issues affecting functioning of AIIMS are: lack of channels of communication between various sections; lack of governance in AIIMS; holding up the promotion of 39 faculty members and redressal mechanism to address their grievances; absence of rules and regulations; lack of proper manual of administrative procedures, financial procedures, store purchase procedures, vigilance matters; in-action on recommendations of the various reports including Valiathan Committee, 2006, Committee on Subordinate Legislation on AIIMS regulations, 2008, High Powered Committee, 2010. He also highlighted some suggestions for improving the functioning of AIIMS viz. presence of four elected members in Institute body; framing rules & regulations and office procedure manuals; accountability for administrative malfeasance; improvement in internal governance at AIIMS; implementing one man one post norm; fixed calendar for the faculty appointments, recruitment of new faculty members against all existing vacancies at the Assistant Professor level; preparation of Mission Statement and goals; finalization of AIIMS Master Plan in line with the Mission Statement; broad based research/medical education/ patient care in the form of consortium with ICMR,DBT,DST,PGI and other international institutions of repute, etc.

5. Members raised some queries which were answered by witnesses. The Convenor directed the witnesses to send further suggestions, if any, which the witnesses would like to share with the Sub-Committee for improving the functioning of AIIMS within a week’s time.

6. A verbatim record of the proceedings of the meeting was kept.

7. The Sub-Committee was adjourned at 4.05 P.M. V FIFTH MEETING (2011-12)

The Sub-Committee met at 11.30 A.M. on Tuesday, the 28th February, 2012 in Committee Room ‘E’, Basement, Parliament House Annexe, New Delhi.

MEMBERS PRESENT 1. Dr. Sanjay Jaiswal — Convenor

RAJYA SABHA 2. Shri Janardan Dwivedi 3. Shrimati Viplove Thakur 4. Dr. Vijaylaxmi Sadho 5. Shri Derek O' Brien 6. Shrimati B. Jayashree

LOK SABHA 7. Dr. Jyoti Mirdha 8. Shri Ashok Argal 9. Shrimati Harsimrat Kaur Badal 10. Shri Radhe Mohan Singh (Ghazipur) 11. Dr. Monazir Hassan

SECRETARIAT Shri P.P.K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director

WITNESSES Shri K.B. Saxena, Former Secretary, Government of India

Ministry of Urban Development Shri D. Diptivilasa, Additional Secretary

Ministry of Health and Family Welfare 1. Shri Vineet Chawdhary, Deputy Director (AIIMS) 2. Shri Debashish Panda, Joint Secretary

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Ministry of Science and Technology Dr. M. K. Bhan, Secretary, Department of Biotechnology

2. At the outset, the Convenor welcomed Members of the Sub-Committee and apprised them about the agenda of the meeting, i.e., to hear the views of (i) Sh. K. B. Saxena, Former Secretary, Government of India, (ii) Sh. D. Diptivilasa, Additional Secretary, Ministry of Urban Development alongwith representatives of Department of Health and Family Welfare and All India Institute of Medical Sciences (AIIMS) and (iiii) Dr. M. K. Bhan, Secretary, Department of Biotechnology, Ministry of Science and Technology, on the various aspects relating to functioning of AIIMS.

3. The Sub-Committee first heard the views of Shri K. B. Saxena, Former Secretary, Government of India on the functioning of All India Institute of Medical Sciences (AIIMS). Shri Saxena stated that during his tenure as the Health Secretary, AIIMS was managed according to good administrative practices. However, the deterioration of the Institute set in when a blind eye was turned to all the rules and recruitments in the institution were made in violation of all rules especially in matters of reservation in the Institute. To compound this, user charges were introduced on all and sundry irrespective of the economic well-being of the patient who came to the Institute for treatment. He felt that even though the Institute was still rated as a best institution, it suffered from basic governance problems. He submitted that two major kind of problems were facing the Institute (a) poor Personnel Management and (b) irregular Financial Management. On the Personnel Management front, he was of the view that the best way to avoid the mess created in the recruitments was to hand over recruitment of medical doctors to an autonomous body like UPSC and those of medical staff to SSC, which could objectively handle the recruitments by ensuring filling of seats as per Government Rules. He was of the view that the established structure was not working as per the expectations and was leading to lack of transparency and accountability. With regard to Financial Management, he informed the Committee that in order to ensure proper accounting procedures, a Selection Committee should be put in place with impetus on well defined procedures to ensure objective selection of the person who would head the Finance Department of AIIMS, who could work independently without undue pressure or interference from the Ministry of Finance or Ministry of Health and Family Welfare. He strongly favoured the financial autonomy of the institute and objected to any proposal for drawing money outside the Government for managing the Institute. The Convenor requested the witness to send further suggestions, if any, which the witness would like to share with the Sub- Committee for improving the functioning of AIIMS within a week’s time. The Sub-Committee also directed that a note on action taken against the persons involved in irregularities in AIIMS should be sought from the Department of Health and Family Welfare. Members raised some queries which were answered by the witness.

4. Thereafter, the Sub-Committee heard the views of Shri D. Diptivilasa, Additional Secretary, Ministry of Urban Development on the issue of land use change from ‘Residential’ to ‘Institutional or Hospital’ with regard to land available at Masjid Moth Campus of AIIMS in order to enable AIIMS to carry out its redevelopment plans. Shri Diptivilasa, Additional Secretary, informed that at a meeting held on 15th February, 2012, it was suggested that given the nature of health care facilities proposed at the said land and need for expediting the matter, 70 the change of the land use measuring 12.99 hectare owned by AIIMS at Masjid Moth may be moved separately and not clubbed with other cases of land use change. In pursuance to this, the proposal for change of the land use of land measuring 12.99 hectare owned by AIIMS at Masjid Moth from ‘Residential’ to ‘Public’ and ‘Semi-Public’ (PS-1, Hospital) has been moved separately and is under active consideration of the Ministry. The Sub-Committee felt that there has been undue delay in the issue of land usage change, since the proposal was moved in 2005 and nothing has happened till date. The Sub-Committee directed the Ministry to provide information on the reasons for delay and the names of the persons responsible for this inord-inate delay along with (i) copies of correspondence between DDA and Ministry of Urban Development; (ii) Minutes of meetings of the Ministry held in this regard. The Sub- Committee also sought to know, the other proposals for land use change passed by the Ministry of Urban Development during the period. The Sub-Committee directed the Ministry of Urban Development to expedite the matter. The representatives of the Department of Health and Family Welfare informed that after the notification for land use change is received from the Ministry of Urban Development, the Department of Health and Family Welfare would move forward to get the building plans approved from NDMC and construction of 3 new blocks would be started on the land in consonance with the redevelopment plans of AIIMS. The Sub- Committee sought to know from the Department of Health and Family Welfare, the steps taken by it to pursue the matter with the Ministry of Urban Development. Members made some queries which were replied to by the witnesses. The Convenor directed the witnesses to send further suggestions, if any, which the witnesses would like to share with the Sub-Committee, within a week’s time.

(The Sub-Committee then adjourned at 1.00 P.M. to meet again at 2.00 P.M.)

5. The Sub-Committee then heard the views of Dr. M. K. Bhan, Secretary, and Department of Biotechnology on research aspects pertaining to AIIMS. Dr. Bhan made a power-point presentation on the importance of research in premier medical institutions including AIIMS. He was of the view that provision of funds for research alone could not ensure a strong research base for the country. He informed that a strong base of researchers needed to be set up, as the gestation period in the field of research to fructify was very long ranging from 10 to 15 years. To ensure this, stability in value systems was not enough, there was a strong urge to adapt to the changing times. He dwelt at length on the importance of research for medical schools. He was of the view that in order to ensure cutting edge research, there was a need to focus more on the biology of disease instead of just focusing on studying the biology of cells. The concept of Doctor need not be seen just as a patient healer but also as a health-economist, researcher etc. There was an urgent need to treat hospital as one part of medical school and not as a be-all and end-all focus of a doctor employed there. He further dwelt on the (i) need for division of research into Basic Medical Research, Clinical Research, Translational Research; (ii) need for diverse talent pool required for each type of research; (iii) formation of a separate eco-system; (iv) creation of centres which would support department structures which could be compartmentalized under four heads i.e. (a) Infectious disease centre; (b) Chronic disease centre; (c) Nutrition centre and (d) Health Systems Research Centre; (v) need for Ministry to distinguish between Hospital Medical Centres and Academic Medical Centres; (vi) need for setting up ‘Academic Medical Schools’ throughout the country; (vii) setting up of centralized research resources for each 71 type of research; (viii) Financial Resources for research not only from Government but also from the Private Sector etc. The Members then raised certain queries which were replied to by Dr. Bhan. The Convenor asked him to send further suggestions, if any, which he would like to share with the Sub-Committee, within a week’s time.

6. The Sub-Committee then took cognizance of a letter received in this Secretariat, wherein serious allegations were levelled against Deputy Director (Admn.), AIIMS in respect of major works being carried out in the AIIMS. The Sub-Committee directed the Secretariat to seek clarifications from the Ministry in the regard.

7. A verbatim Record of the proceedings of the Committee was kept.

8. The Sub-Committee adjourned at 3.35 P.M. VI SIXTH MEETING (2011-12)

The Sub-Committee met at 4.00 P.M. on Thursday, the 10th May, 2012 in Committee Room ‘A’, Ground Floor, Parliament House Annexe, New Delhi.

MEMBERS PRESENT 1. Dr. Sanjay Jaiswal — Convenor

RAJYA SABHA 2. Dr. Vijaylaxmi Sadho 3. Shri Derek O’ Brien

LOK SABHA 4. Dr. Jyoti Mirdha 5. Shri Ashok Argal 6. Shrimati Jayshreeben Kanubhai Patel 7. Shrimati Harsimrat Kaur Badal . 8. Dr. Monazir Hassan

SECRETARIAT Shri P.P.K. Ramacharyulu, Secretary Shri R.B. Gupta, Joint Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Deputy Director

WITNESSES

Ministry of Personnel and Public Grievances and Pensions, (Department of Personnel and Training) 1. Shri Manoj Joshi, Joint Secretary, Department of Personnel and Training

Ministry of Law and Justice (Department of Legal Affairs)

2. Shri Satish Chandra, Joint Secretary and Legal Advisor, Department of Legal Affairs

Ministry of Health and Family Welfare (Department of Health and Family Welfare)

3. Shri Keshav Desiraju, Special Secretary, Department of Health and Family Welfare

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4. Dr. Vishwas Mehta, Joint Secretary, Department of Health and Family Welfare

All India Institute of Medical Sciences (AIIMS)

5. Shri Rakesh Yadav, Sub-Dean, AIIMS

2. At the outset, the Convenor welcomed Members of the Sub-Committee and apprised them about the agenda of the meeting, i.e., to hear the views of (i) Shri Manoj Joshi, Joint Secretary, Department of Personnel and Training, (ii) Shri Satish Chandra, Joint Secretary and Legal Advisor, Department of Legal Affairs, (iiii) Shri Keshav Desiraju, Special Secretary, Department of Health and Family Welfare along with representatives of the Department and AIIMS on the issue of implementation of reservation of SCs, STs and OBCs in the All India Institute of Medical Sciences(AIIMS).

3. The Sub-Committee first heard the views of Manoj Joshi, Joint Secretary, Department of Personnel and Training on issue. Shri Joshi stated that the Cabinet Secretariat had constituted a Committee on 11.02.2009 to examine the matter regarding the special recruitment drive by AIIMS for SCs, STs and OBCs for filling up 92 vacancies in the Grades of Assistant Professor, Associate Professor, Additional Professor and professor in the Year 2008 with the representatives from DOPT, Ministry of Health and Family Welfare and D/o Legal Affairs. The Report of the said Committee had been forwarded to the Ministry of Health and Family Welfare in 2009, but there had been no communication from the Ministry Of Health and Family on the action taken by the Ministry on the said Report. Members raised certain queries viz. the difference between shortfall. vacancy and backlog reserved vacancies, what is floating reservation, procedure for de-reserving a reserved post, applicability of DOPT guidelines to AIIMS in respect of reservation which were partly answered to by the witness. Thereafter, the Sub-Committee heard the views of Shri Keshav Desiraju, Special Secretary, Department of Health and Family Welfare on the issue of implementation of reservation policy in AIIMS. Members raised certain queries like how reserved posts can be excluded from the purview of reservation, whether Deputy Director (Administration), AIIMS can hold the charge of Chief Vigilance Officer, period for which a joint secretary of the Ministry can remain on deputation etc. which were partly answered to by the witness. The Sub-Committee felt that the answers given by the witnesses of the Department of Personnel and Training and Ministry of Health and Family Welfare were far from satisfactory. The Sub-Committee therefore decided to call the Secretaries of (i) Department of Personnel and Training (ii) Department of Legal Affairs and (iii) Department of Health and Family Welfare on 21st May 2012 to have a proper perspective on the issue of implementation of reservation in AIIMS.

4. A verbatim Record of the proceedings of the Sub-Committee was kept.

5. The Sub-Committee adjourned at 4.45 P.M. VII SEVENTH MEETING (2011-12)

The Sub-Committee met at 3.00 P.M. on Monday, the 21st May, 2012 in Committee Room’ A’, Ground Floor, Parliament House Annexe, New Delhi.

MEMBERS PRESENT 1. Dr. Sanjay Jaiswal — Convenor

LOK SABHA 2. Dr. Jyoti Mirdha 3. Shrimati Jayshreeben Kanubhai Patel 4. Shrimati Harsimrat Kaur Badal 5. Dr. Sucharu Ranjan Haldar 6. Dr. Monazir Hassan 7. Shri Ratan Singh

SECRETARIAT Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Deputy Director

WITNESSES

Ministry of Personnel and Public Grievances and Pensions, (Department of Personnel and Training) 1. Shri P.K. Misra, Secretary, Department of Personnel and Training 2. Shri Manoj Joshi, Joint Secretary, Department of Personnel and Training

Ministry of Law and Justice (Department of Legal Affairs) 1. Dr. B.A. Agrawal, Secretary, Department of Legal Affairs 2. Shri Satish Chandra, Joint Secretary and Legal Advisor, Department of Legal Affairs

Ministry of Health and Family Welfare ( Department of Health and Family Welfare) Dr. Vishwas Mehta, Joint Secretary, Department of Health and Family Welfare

All India Institute of Medical Sciences (AIIMS) Shri Rakesh Yadav, Sub-Dean, AIIMS

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2. At the outset, the Convenor welcomed Members of the Sub-Committee and apprised them about the agenda of the meeting, i.e., to hear the views of Secretaries of Departments of Personnel and Training and Legal Affairs and Joint Secretary of Department of Health and Family Welfare along with Sub-Dean of AIIMS on the issue of implementation of reservation policy in the All India Institute of Medical Sciences (AIIMS).

3. The Sub-Committee first heard the views of Secretary, Department of Personnel and Training on the issue. The Secretary, during his deposition, inter alia stated that there were five backlog reserved vacancies of STs and 5 backlog reserved vacancies of OBCs in the grade of Assistant Professor in 2005. AIIMS filled up all the above vacancies by other category candidates which was a violation of the extant reservation rules of Government of India. He also submitted that recruitment rules pertaining to reservation are equally applicable for Government as well as autonomous bodies, but the ultimate authority of implementation of the same is in hands of the Ministry of Health and Family Welfare. He also stated that each autonomous body has their own governing body which governs the functioning of institute. He was of the view that in the process of recruitment at AIIMS, rules of reservation i.e. 15% SCs, 7.5% STs, 27% OBCs as laid by the Government in filling of the posts in AIIMS were not followed in principle. He also highlighted the difference of the shortfall of vacancies and backlog reserved vacancies, stating that the vacancies which had been filled up by other category candidates fall in the category of shortfall of vacancies. The backlog reserved vacancies are treated as a separate group on which ceiling of 50% limit does not apply. He further stated that AIIMS being an autonomous body, the administration of AIIMS is responsible for taking appropriate action.

4. During the course of the meeting the members raised a number of queries like - whether the due process was followed to fill the vacant posts at AIIMS, process of de-reservation, existence of any variation in rules of recruitment between Government and autonomous bodies, etc., which were answered by witnesses. The Convenor directed the witnesses to send further suggestions, if any, which the witnesses would like to share with the Sub-Committee for improving the functioning of AIIMS within a week’s time.

5. The Secretary, Department of Legal Affairs stated that it is the responsibility of the concerned Ministry to look into any kind of mismanagement and the Ministry of Law and Justice cannot interfere in such kind of affairs. He also opined that the matter can be taken to the Cabinet for further course of action or alternatively the matter could be taken up by aggrieved person, suo-motu action could be taken by the Court, or the Standing Committee could highlight the same by way of recommendations, etc.

6. During the course of meeting, the Sub-Committee discussed the following issues, namely, allocation of business rules, authority of Institute body of AIIMS, seniority benefits for ad-hoc appointees, process of de-reservation at AIIMS, on going process of recruitment at AIIMS, etc. 76

7. Members raised some queries which were answered by witnesses. The Convenor directed the witnesses to send further suggestions, if any, which the witnesses would like to share with the Sub-Committee for improving the functioning of AIIMS within a week’s time.

8. A verbatim record of the proceedings of the Sub-Committee was kept.

9. The Sub-Committee adjourned at 4.45 P.M. and decided to meet again on the 31st May, 2012. VIII EIGHTH MEETING (2011-12)

The Sub-Committee met at 3.00 P.M. on Monday, the 31st May, 2012 in Committee Room’ A’, Ground Floor, Parliament House Annexe , New Delhi.

MEMBERS PRESENT 1. Dr. Sanjay Jaiswal — Convenor

RAJYA SABHA 2. Shri Janardhan Dwivedi

LOK SABHA 3. Dr. Jyoti Mirdha 4. Shri Ashok Argal 5. Dr. Sucharu Ranjan Haldar 6. Dr. Monazir Hassan

SECRETARIAT Shri P.P.K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director

WITNESSES 1. Dr. Seema Rao, Ex-Assistant Professor, Pathology, MAMC 2. Dr. Kameshwar Prasad, HOD, Neurology, AIIMS 3. Dr. S.K. Sharma, HOD, Medicine, AIIMS 4. Dr. H.H. Dash, HOD, Neuro-anaesthesia, AIIMS

2. At the outset, the Convenor welcomed Members of the Sub-Committee and apprised them about the agenda of the meeting, i.e., to hear the views of various witnesses on the functioning of All India Institute of Medical Sciences (AIIMS).

3. The Sub-Committee first heard the views of Dr. Seema Rao. She stated that a lot of ambiguity in the interview procedures for different posts being held at AIIMS right now is there. She cited some examples where candidates who did not even fulfill the eligibility criteria, were selected. She also informed that this was demeaning to the Governing body, AIIMS as

77 78 the interviews were conducted by the Selection Committee, AIIMS without consulting the governing body.

4. Dr. Kameshwar Prasad, HOD, Neurology, AIIMS focused his presentation under four headings viz. governance, research, patient care and medical education. He suggested the implementation of Central university model with inclusion of faculty members along with director in Governing body of an Institution, rotating headships with all perks and facilities according to government pay scales; conduct of nationally relevant research, balance between company funded research and internal research done by faculty members; formulation of stringent rules to accept the investigation reports done at AIIMS only to improvise patient care; introduction of innovative techniques in medical education system, appointment of the competent and capable candidate as Dean and not according to the seniority of the candidates, for improving the functioning of AIIMS.

5. Thereafter, Dr. S.K. Sharma, HoD, Medicine, AIIMS made his presentation, inter-alia highlighting the importance of department of medicine in any medical college viz-a-viz the very poor status of bed strength, faculty strength, lecture theatres in department of medicines at AIIMS. He also informed the Sub-Committee about the inordinate delay in considering the proposal for introduction of DM Pulmonary Medicine course in Department of Medicine, shifting of DOTS center away from the main Department in his absence without consulting him, refusal for permission to attend Canadian International Health Research on T.B Research, various administrative issues and grievances, unequal and heavily biased criteria of appointments of HoDs of various departments, difficulties in purchase of state-of-the art equipments for the department of medicine, issues related to infrastructure, laboratory facilities, security and parking issues at AIIMS etc.

6. Dr. H.H. Dash, ex-HOD, Neuro-Anaesthesia, AIIMS, made his presentation under three headings viz. education, patient care and governance wherein he stressed the need for accountability in improving teaching and training programmes, provisions for English to Hindi translation in teaching at AIIMS; centralization of all services including laboratory services, accountability of faculty in OPD clinics, auditing of equipments, medicines & patient care services; enhancement of autonomy & financial powers of chief of center etc. During the course of the meeting the members raised a number of queries some of which were answered by witnesses. The Convenor directed the witnesses to send further suggestions, if any, which the witnesses would like to share with the Sub-Committee for improving the functioning of AIIMS within a week’s time.

8. A verbatim record of the proceedings of the Sub-Committee was kept.

9. The Sub-Committee adjourned at 4.45 P.M. IX NINTH MEETING (2011-12)

The Sub-Committee met at 3.00 P.M. on Monday, the 8th June, 2012 in Committee Room ‘Main’, Ground Floor, Parliament House Annexe, New Delhi.

MEMBERS PRESENT 1. Dr. Sanjay Jaiswal — Convenor

LOK SABHA 2. Dr. Jyoti Mirdha 3. Dr. Sucharu Ranjan Haldar 4. Dr. Monazir Hassan 5. Shri Ratan Singh

SECRETARIAT Shri P.P.K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director

WITNESSES

Representatives from Ministry of Urban Development 1. Shri D. Diptivilasa, Additional Secretary 2. Shri G. S. Patnaik, Vice-Chancellor -DDA 3. Shri Ashok Kumar, Commissioner (Plg.), DDA

Representatives from Ministry of Health and Family Welfare 1. Shri P. K. Pradhan, Secretary 2. Shri Keshav Desiraju, Special Secretary, Health and Family Welfare 3. Dr. Vishwas Mehta, Joint Secretary

Representatives from All India Institute of Medical Sciences (AIIMS) 1. Dr. R. C. Deka, Director, AIIMS 2. Shri Vineet Chaudhary, Deputy Director (Admn.), 3. Shri Rakesh Yadav, Sub-Dean (AIIMS)

79 80

3. The Sub-Committee first heard the views of Shri D. Diptivilasa. He informed the Committee that the issue regarding conversion of land behind AIIMS from ‘residential’ to public/hospital had been cleared by the Ministry of Urban Development on 15th May,2012 and the Ministry is in the process of issuing notification in this regard within 3-4 days.

4. The Sub-Committee then heard the views of Shri P.K. Pradhan, Secretary, Department of Health and Family Welfare along with Director and Deputy Director(Admn.),AIIMS on various issues concerning the functioning of AIIMS viz.-delay in taking of charge by the new Chief Vigilance Officer(CVO) and reasons therefore; steps taken for divesting of charge of CVO from the present Deputy Director(Admn.); implementation of reservation policy in AIIMS and steps being taken to fill the backlog vacancies in view of opinion given by Department of Personnel to treat vacancies in the reserved category as backlog vacancies; allegation of radiotherapy treatment of dog being conducted in AIIMS; Interviews for various faculty posts being conducted without the approval of General Body (G.B.) and appointment letters being issued without G.B. approval; latest position with regard the scientific and technical posts in AIIMS; roadmap for appointment to all posts remaining vacant in AIIMS; criteria for selection while conducting interviews to various posts; details of minutes/ agenda of meetings of Standing Committees, General Body and Institute Body during the last five years; engagement of persons in contractual positions; allotment of out of turn Government accommodation which were partly answered to by the witnesses. Members also sought information from the Ministry on (i) records of all interviews held recently for recruitment of faculty posts Department-wise; and (ii) rules/practices being followed by AIIMS regarding (a) allotment of accommodation and (b) allocation/use of cars.

5. The Convenor directed the witnesses to send further suggestions, if any, which the witnesses would like to share with the Sub-Committee for improving the functioning of AIIMS along with queries remaining unanswered within a week’s time.

6. A verbatim record of the proceedings of the Sub-Committee was kept.

7. The Sub-Committee adjourned at 5.45 P.M. II SECOND MEETING (2014-15)

The Committee met at 2.30 P.M. on Thursday, the 18th September, 2014 in Room No. ‘139’, First Floor, Parliament House Annexe, New Delhi.

MEMBERS PRESENT 1. Shri Satish Chandra Misra — Chairman

RAJYA SABHA 2. Shri Ranjib Biswal 3. Shri Rajkumar Dhoot 4. Shri Vijay Goel 5. Dr. R. Lakshmanan 6. Shrimati Kahkashan Perween 7. Dr. Vijaylaxmi Sadho 8. Chaudhary Munvvar Saleem 9. Dr. T.N. Seema

LOK SABHA 10. Shri Thangso Baite 11. Dr. Ratna De (Nag) 12. Dr. Sanjay Jaiswal 13. Dr. K. Kamaraj 14. Shri Arjunlal Meena 15. Shri Chirag Paswan 16. Shri M.K. Raghavan 17. Dr. Manoj Rajoriya 18. Shri Alok Sanjar 19. Dr. Mahesh Sharma 20. Dr. Shrikant Eknath Shinde 21. Shri Raj Kumar Singh 22. Shri Kanwar Singh Tanwar 23. Shrimati Rita Tarai

81 82

SECRETARIAT Shri P.P.K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Pratap Shenoy, Committee Officer

WITNESSES

* * *

I. Opening Remarks

2. * *

3. The Chairman sought the views of the Members of the Committee on the subjects deliberated in the last meeting. After some discussions, it was decided that the following subjects may be selected by the Committee for examination and report-

(i) * * *

(ii) Working of *** and All India Institute of Medical Sciences (AIIMS)

(iii) * * *

(iv) * * *

(v) * * *

(vi) * * *

4. * * *

II. * * *

5. * * *

6. * * *

7. * * *

8. * * *

9. * * *

10. * * *

11. * * *

*** Relate to other matters V FIFTH MEETING (2014-15)

The Committee met at 2.00 P.M. on Wednesday, the 12th November, 2014 in Committee Room ‘A’, Ground Floor, Parliament House Annexe, New Delhi.

MEMBERS PRESENT 1. Shri Satish Chandra Misra — Chairman

RAJYA SABHA 2. Shri Ranjib Biswal 3. Shri Vijay Goel 4. Dr. R. Lakshmanan 5. Dr. Vijaylaxmi Sadho 6. Chaudhary Munvvar Saleem 7. Dr. T.N. Seema

LOK SABHA 8. Shri Thangso Baite 9. Dr. Ratna De (Nag) 10. Dr. K. Kamaraj 11. Shri Arjunlal Meena 12. Shri J.J.T. Natterjee 13. Shri Chirag Paswan 14. Dr. Manoj Rajoriya 15. Shri Alok Sanjar 16. Shrimati Rita Tarai

SECRETARIAT Shri P.P.K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Deputy Director Shri Pratap Shenoy, Committee Officer

83 84

WITNESSES

Department of Health and Family Welfare 1. Shri Lov Verma, Secretary 2. Shri Arun Kumar Panda, Additional Secretary * * *

Representatives from all India Institute of Medical Sciences (AIIMS) l. Prof. M. C. Mishra, Director 2. Dr. D. K. Sharma, Medical Superintendent 3. Dr. Amit Gupta, Additional Professor

I. Opening Remarks

2. The Chairman, at the outset, welcomed the Members of the Committee and apprised them of the agenda of the meeting, i.e., to hear the Secretary, Department of Health and Family Welfare on * * * and (ii) the functioning of All India Institute of Medical Science (AIIMS).

II. * * *

3. * * *

4. * * *

III. Oral evidence on the functioning of All India Institute of Medical Science (AIIMS)

5. Thereafter, the Committee heard the views of Secretary, Department of Health and Family Welfare on the functioning of AIIMS. He inter alia submitted that the AIIMS, Delhi was set up with the mission of providing medical education, research and patient care in the country. At present AIIMS has a total of 52 Departments out of which twenty-five are clinical departments including six super-specialty centres that manage practically all types of disease conditions with support from pre-clinical and para-clinical departments. AIIMS also runs a 60 bedded hospital and the Comprehensive Rural Health Centre at Ballabhgarh in Haryana. Dr. Amit Gupta, Additional Professor, AIIMS made a power point presentation on AIIMS delineating the following points viz. organizational structure of AIIMS; courses offered in undergraduate and postgraduate level; training opportunities; Extramural Research and Intramural Research Projects (2014-15) being undertaken; landmark Research of National importance being conducted in the field of malnutrition, Diarrhoeal & liver diseases etc.; National Programmes and Policies influenced by research done at AIIMS like Integrated Child Development Scheme, Universal iodization of Salt, Hepatitis vaccination Policy; main hospital, centres and outreach of AIIMS; total Bed strength (2428 out which 2164 for general & 264 for private); increasing trend of patient load creating difficulties; landmarks made by AIIMS; computerization and *** Relate to other matters 85 digitisation of current facilties for increasing efficiency and bringing transparency in the function of AIIMS; ongoing/sanctioned projects in AIIMS, etc.

6. Thereafter, Members raised certain queries namely, insufficient night shelters in AIIMS; need to expand the campus of AIIMS; lack of facilities at AIIMS like institutions in Bhopal and Jodhpur; method of social and economic evaluation of person below poverty line who does not have BPL card; list of medicines being supplied free in AIIMS; need for increasing budgetary support to AIIMS; quality of research; maintaining Electronic Health Record(EHR); need to set limit for waiting time of patients; need to appoint patient counselors in the Institute on regular basis; mortality rate including infant mortality rate in AIIMS; need to conduct regular meetings of five Committees of AIIMS as well as AIIMS like institutions; lack of residential accommodation for faculty in AIIMS; reasons for large number of vacancies in faculty and non-faculty posts in AIIMS, etc. The Secretary, Department of Health and Family Welfare, Director, AIIMS and other Officers replied to some of the queries raised by Members of the Committee.

7. The Chairman then raised certain questions regarding the functioning of AIIMS and sought detailed note thereon for consideration of the Committee within a week on the issues raised by him and other Members of the Committee which remained unanswered during the course of the meeting.

8. A verbatim record of the proceedings of the meeting was kept.

9. The Committee then adjourned at 4.10 P.M. IX NINTH MEETING (2014-15)

The Committee met at 2.30 P.M. on Friday, the 16th January, 2015 in Main Committee Room, Ground Floor, Parliament House Annexe, New Delhi.

MEMBERS PRESENT 1. Shri Satish Chandra Misra — Chairman

RAJYA SABHA 2. Dr. Bhushan Lal Jangde 3. Shrimati Kahkashan Perween 4. Chaudhary Munvvar Saleem 5. Dr. T.N. Seema

LOK SABHA 6. Dr. Ratna De (Nag) 7. Dr. Heena Vijaykumar Gavit 8. Dr. Sanjay Jaiswal 9. Dr. K. Kamaraj 10. Shri J.J.T. Natterjee 11. Shri Chirag Paswan 12. Dr. Manoj Rajoriya 13. Dr. Shrikant Eknath Shinde 14. Shri Raj Kumar Singh 15. Shri Kanwar Singh Tanwar 16. Shri Manohar Untwal 17. Shri Akshay Yadav 18. Dr. Pritam Gopinath Munde

SECRETARIAT Shri P.P.K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Deputy Director Shri Pratap Shenoy, Committee Officer

86 87

WITNESSES

Department of Health and Family Welfare

1. Shri Arun Kumar Panda, Additional Secretary

2. * * *

3. Shri Ali R. Rizvi, Joint Secretary

4. Prof. M. C. Mishra, Director, AIIMS

5. Shri V. Srinivas, Dy. Director (Admn.), AIIMS

6. Dr. D.K. Sharma, M.S, AIIMS

7. * * *

I. Opening Remarks

2. The Chairman, at the outset, welcomed the Members of the Committee and apprised them of the agenda of the meeting, i.e., to hear the concerned Additional Secretaries, Department of Health and Family Welfare on (i) the functioning of All India Institute of Medical Sciences (AIIMS); and * * * The Chairman then recalled that in the last meeting held on the 22nd December, 2014, Members had sought more time to examine in greater detail the various issues concerning AIIMS before finalizing the Report. Similarly, subsequent to listening to representatives of IMA on functioning of CGHS in the meeting of Committee held on 19th November, 2014, it was decided to hear the Ministry on the issues raised by the IMA representatives. Accordingly, the Health Secretary had been invited to depose before the Committee on both the subjects. However, the Secretary had expressed his inability to appear before the Committee and sought exemption from personal appearance as he has been scheduled to visit Barabanki District, Uttar Pradesh, during 14-16 January, 2015 as per the direction of Hon’ble Prime Minister and requested to allow Shri Arun Kumar Panda, Additional Secretary along with Director (AIIMS) for presentation on AIIMS and * * * on his behalf which had been acceded to. * *

II. * * *

3. * * *

4. * * *

5. * * *

III. Oral evidence on the functioning of All India Institute of Medical Sciences (AIIMS)

6. Thereafter, the Committee heard the views of Shri Arun Kumar Panda, Additional Secretary and representatives of AIIMS on the functioning of AIIMS. Shri Panda inter alia submitted that on the issue of reservation, the Government had constituted an Inter-Ministerial

*** Relate to other matters 88

Committee comprising of the representatives of Department of Health and Family Welfare, Department of Legal Affairs and Department of Personnel and Training to implement the judgment of the Hon’ble Supreme Court dated 16.1.2014, on the said issue, which would be implemented by the Department of Personnel and Training (DOPT). On the issue of Assessment Promotion Scheme, the Committee was informed that lateral entry had reduced. On the issue of Clinical Trials, it was submitted that all rules and regulations were being adhered to and regarding procurement, it was informed that all General Financial Rules were being adhered to. On the issue of plagiarism, it was informed that the Institute was against plagiarism of any kind and lastly there was no deterioration in functioning of AIIMS and the Institute adhered to highest standards of care. Dr. V. Srinivas, Deputy Director(Administration), AIIMS gave a brief history of the genesis and implementation of reservation in AIIMS and informed that since 2009-10, the reservation policy is being implemented in letter and spirit.

7. Thereafter, Members raised certain queries namely, the number of professors in the reserved categories since the last 16 years when the Institute has started implementation of reservation including the Other Backward Classes(OBCs); figures of backlog in reservation; updated status of corruption in the Institute; measures taken/being taken to address the issue of long waiting period for surgeries; reports in media of devices purchased by the Institute but lying idle due to non-installation; procedure for selection of faculty; measures taken to curb overcrowding in the Institute and need to introduce more super-speciality centres; residential facilities for the faculty and staff; status of implementation of the Valiathan Committee Report etc. Shri Panda, Additional Secretary, Department of Health and Family Welfare, Director, AIIMS and other Officers replied to some of the queries raised by Members of the Committee and assured to furnish written replies of those queries which remained unanswered within a week’s time.

8. The Chairman then raised certain questions regarding the functioning of AIIMS And sought detailed note thereon for consideration of the Committee by the first week of February, 2015.

9. A verbatim record of the proceedings of the meeting was kept.

10 The Committee then adjourned at 4.00 P.M. XXIV TWENTY-FOURTH MEETING (2014-15)

The Committee met at 3.00 P.M. on Monday the 3rd August, 2015 in Room No. ‘67’, First Floor, Parliament House, New Delhi.

MEMBERS PRESENT 1. Shri Satish Chandra Misra — Chairman

RAJYA SABHA 2. Dr. Bhushan Lal Jangde 3. Dr.R. Lakshmanan 4. Shrimati Kahkashan Perween 5. Shri Jairam Ramesh 6. Dr. T.N. Seema

LOK SABHA 7. Dr. Heena Vijaykumar Gavit 8. Dr. Sanjay Jaiswal 9. Shri Arjunlal Meena 10. Dr. Manoj Rajoriya 11. Shrimati Ranjanben Bhatt 12. Dr. Shrikant Eknath Shinde 13. Shri Kanwar Singh Tanwar

SECRETARIAT Shri P.P.K. Ramacharyulu, Joint Secretary Shri Pradeep Chaturvedi, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Joint Director Shri Pratap Shenoy, Committee Officer

1. Opening Remarks 2. At the outset, the Chairman welcomed Members of the Committee and briefed them about the agenda of the meeting i.e. to consider and adopt the draft 87th Report on the Functioning of All India Institute of Medical Sciences (AIIMS).

89 90

3. The Committee then considered and discussed the draft 87th Report on the Functioning of All India Institute of Medical Sciences. Few changes were suggested by Members for incorporation in the Report. After some discussion, the Committee adopted the said Report with some modifications. The Committee, thereafter, decided that the Report may be presented to the Rajya Sabha and laid on the Table of the Lok Sabha on a before Tuesday, the 11th August, 2015. The Committee authorized its Chairman and in his absence, Shri Jairam Ramesh and Dr. T.N. Seema to present the Report in Rajya Sabha, and Dr. Heena Vijay kumar Gavit and in her absence, Dr.Shrikant Eknath Shinde to lay the Report on the Table of the Lok Sabha.

4. * * *

5. The Committee then adjourned at 3.40 P.M.

*** Relate to other matters. ANNEXURES ANNEXURE-I COMPOSITION OF THE MAIN COMMITTEE (2013-14)

1. Shri Brajesh Pathak — Chairman RAJYA SABHA

2. Shri Rajkumar Dhoot 3. Shrimati B. Jayashree 4. Shri Mohd. Ali Khan 5. Dr. Prabhakar Kore 6. Dr. R. Lakshmanan

& 7. Shri Rasheed Masood 8. Shri Jagat Prakash Nadda 9. Dr. Vijaylaxmi Sadho 10. Shri Arvind Kumar Singh

LOK SABHA 11. Shri Kirti Azad 12. Shri Mohd. Azharuddin 13. Shrimati Sarika Devendra Singh Baghel 14. Shri Kuvarjibhai M. Bavalia 15. Shrimati Priya Dutt 16. Dr. Sucharu Ranjan Haldar 17. Mohd. Asrarul Haque 18. Dr. Monazir Hassan 19. Dr. Sanjay Jaiswal 20. Shri Chowdhury Mohan Jatua 21. Dr. Tarun Mandal 22. Shri Mahabal Mishra 23. Shri Zafar Ali Naqvi 24. Shrimati Jayshreeben Patel 25. Shri Harin Pathak 26. Shri Ramkishun 27. Dr. Anup Kumar Saha 28. Dr. Arvind Kumar Sharma 29. Dr. Raghuvansh Prasad Singh 30. Shri P. T. Thomas 31. Vacant

& Vacant vide disqualification as a member of the Council of States (Rajya Sabha) w.r.t. 19th September, 2013. 93 94

SECRETARIAT Shri P. P. K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Shrimati Arpana Mendiratta , Joint Director Shri Dinesh Singh, Deputy Director Shri Pratap Shenoy, Committee Officer COMPOSITION OF THE MAIN COMMITTEE (2012-13)

1. Shri Brajesh Pathak — Chairman RAJYA SABHA

2. Dr. Vijaylaxmi Sadho *3. Dr. K. Chiranjeevi 4. Shri Rasheed Masood 5. Dr. Prabhakar Kore 6. Shri Jagat Prakash Nadda 7. Shri Arvind Kumar Singh 8. Vacant 9. Shri H. K. Dua 10. Shrimati B. Jayashree LOK SABHA @11. Shri Ashok Argal 12. Shri Kirti Azad 13. Shri Mohd. Azharuddin 14. Shrimati Sarika Devendra Singh Baghel 15. Shri Kuvarjibhai M. Bavalia 16. Shrimati Priya Dutt 17. Dr. Sucharu Ranjan Haldar 18. Mohd. Asrarul Haque 19. Dr. Monazir Hassan 20. Dr. Sanjay Jaiswal 21. Dr. Tarun Mandal 22. Shri Mahabal Mishra 23. Shri Zafar Ali Naqvi 24. Shrimati Jayshreeben Patel 25. Shri Harin Pathak 26. Shri Ramkishun 27. Dr. Anup Kumar Saha 28. Dr. Arvind Kumar Sharma 29. Dr. Raghuvansh Prasad Singh 30. Shri P. T. Thomas #31. Shri Chowdhury Mohan Jatua * Ceased to be Member of the Committee w.e.f. 28th October, 2012. @ Ceased to be Member of the Committee w.e.f. 9th January, 2013. # Nominated as a Member to the Committee w.e.f. 14th December, 2012. 95 96

SECRETARIAT Shri P. P. K. Ramacharyulu, Joint Secretary Shri R. B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Deputy Director Shri Pratap Shenoy, Committee Officer COMPOSITION OF THE MAIN COMMITTEE (2011-12)

1. Shri Brajesh Pathak — Chairman

RAJYA SABHA

*2. Shri Janardhan Dwivedi %3. Shrimati Viplove Thakur 4. Dr. Vijaylaxmi Sadho 5. Shri Balbir Punj 6. Dr. Prabhakar Kore 7. Shrimati Vasanthi Stanley ^8. Shri Rasheed Masood 9. Shrimati B. Jayashree 10. Shri Derek O’Brien

LOK SABHA

11. Shri Ashok Argal &&12. Shrimati Harsimrat Kaur Badal @13. Shri Vijay Bahuguna 14. Shrimati Raj Kumari Chauhan 15. Shrimati Bhavana Gawali 16. Dr. Sucharu Ranjan Haldar 17. Dr. Monazir Hassan 18. Dr. Sanjay Jaiswal 19. Shri S. R. Jeyadurai 20. Shri P. Lingam 21. Shri Datta Meghe 22. Dr. Jyoti Mirdha 23. Dr. Chinta Mohan 24. Shri Sidhant Mohapatra 25. Shrimati Jayshreeben Patel 26. Shri M. K. Raghavan 27. Shri J. M. Aaron Rashid 28. Dr. Arvind Kumar Sharma 29. Shri Radhe Mohan Singh 30. Shri Ratan Singh 31. Dr. Kirit Premjibhai Solanki

* Ceased to be a Member w.e.f 27th January, 2012 and re-nominated to the Committee on 2nd February, 2012. % Vacant vide resignation w.e.f. 2nd April, 2012. ^ Vacant vide resignation w.e.f 9th March, 2012 and renominated as Member w.e.f. 04th May, 2012 and Member of Sub Committee II on CGHS w.e.f. 01st June, 2012. &&Ceased to be a member w.e.f 29th June, 20112. @ Vacant vide resignation w.e.f. 30th April, 2012. 97 98

SECRETARIAT Shri P. P. K. Ramacharyulu, Joint Secretary Shri R. B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Deputy Director COMPOSITION OF THE MAIN COMMITTEE (2010-11)

1. Shri Brajesh Pathak — Chairman

RAJYA SABHA 2. Shri Janardan Dwivedi 3. Shrimati Viplove Thakur 4. Dr. Vijaylaxmi Sadho 5. Shri Balbir Punj 6. Dr. Prabhakar Kore 7. Shrimati Vasanthi Stanley 8. Shri Rasheed Masood 9. Shrimati B. Jayashree 10. Shri Derek O’ Brien

LOK SABHA 11. Shri Ashok Argal 12. Shrimati Harsimrat Kaur Badal 13. Shri Vijay Bahuguna 14. Shrimati Raj Kumari Chauhan 15. Shrimati Bhavana Gawali 16. Dr. Sucharu Ranjan Haldar 17. Dr. Monazir Hassan 18. Dr. Sanjay Jaiswal 19. Shri S. R. Jeyadurai 20. Shri P. Lingam 21. Shri Datta Meghe 22. Dr. Jyoti Mirdha 23. Dr. Chinta Mohan 24. Shri Sidhant Mohapatra 25. Shrimati Jayshreeben Patel 26. Shri M. K. Raghavan 27. Shri J. M. Aaron Rashid 28. Dr. Arvind Kumar Sharma 29. Shri Radhe Mohan Singh 30. Shri Ratan Singh 31. Dr. Kirit Premjibhai Solanki

99 100

SECRETARIAT Shri P. P. K. Ramacharyulu, Joint Secretary Shri R. B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Assistant Director SUB-COMMITTEE I ON AIIMS HEALTH AND FAMILY WELFARE (2011-12)

1. Dr. Sanjay Jaiswal — Convenor

RAJYA SABHA *2. Shri Janardhan Dwivedi 3. Dr. Vijaylaxmi Sadho 4. Shri Derek O’ Brien 5. Shrimati B. Jayashree

LOK SABHA 6. Dr. Jyoti Mirdha 7. Shri Chinta Mohan 8. Shri Ashok Argal 9. Shri Datta Meghe 10. Shrimati Jayshreeben Patel 11. Shri S. R. Jeyadurai 12. Dr. Sucharu Ranjan Haldar 13. Shri Radhe Mohan Singh (Ghazipur)

#14. Dr. Monazir Hassan

$15. Shri Ratan Singh

SECRETARIAT Shri P. P. K. Ramacharyulu, Joint Secretary Shri R. B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Assistant Director

*Re-nominated w.e.f. 6th February, 2012. #Nominated w.e.f. 31st January, 2012. $Nominated w.e.f. 13th March, 2012.

101 SUB-COMMITTEE I ON AIIMS HEALTH AND FAMILY WELFARE (2010-11)

1. Shri Datta Meghe Convenor RAJYA SABHA 2. Shri Janardan Dwivedi 3. Shrimati Viplove Thakur 4. Dr. VijayIaxmi Sadho 5. Shrimati Brinda Karat 6. Shrimati B. Jayashree

LOK SABHA 7. Dr. Jyoti Mirdha 8. Dr. Chinta Mohan 9. Shri Ashok Argal 10. Dr. Sanjay Jaiswal 11. Shrimati Jayshreeben Patel 12. Shri R. K. Singh Patel 13. Shri S. R. Jeyadurai 14. Shri N. Kristappa 15. Dr. Tarun MandaI

SECRETARIAT Shri P. P. K. Ramacharyulu, Joint Secretary Shri R.B. Gupta, Director Shrimati Arpana Mendiratta, Joint Director Shri Dinesh Singh, Assistant Director

102 ANNEXURE-II

LIST OF WITNESSES

30th June, 2011

Department of Health and Family Welfare

Dr. M. K. Bhan, Secretary, Department of Biotechnology, Ministry of Science and Technology

Dr. K. Srinath Reddy,President, Public Health Foundation of India.

Dr. L. M. Nath, Former Dean, AIIMS

Dr. Ranjit Roy Chaudhury, Former Member Board of Governor, MCI

Dr. M. S. Valiathan, Former Director, Sree Chitra Tirunai Institute of Medical Sciences and Technology, Thiruvananthapuram

Ms. K. Sujatha Rao, Former Secretary, Ministry of Health and Family Welfare

Prof. Sunil Maheshwari, IIM, Ahemdabad

11th July, 2011

Representatives from the Department of Health and Family Welfare

Shri K. Chandramouli, Secretary

Shri Keshav Desiraju, Addl. Secretary

Shri Debashish Panda, Joint Secretary

Representatives from the All India Institute of Medical Sciences

Shri R. C. Deka, Director

Shri Vineet Chawdhry, Dy. Director

Dr. Nikhil Tandon, Professor, AIIMS

26th July, 2011

Dr. Sneh Bhargava, Former Director, All India Institute of Medical Sciences

Prof. S. K. Jindal, PGIMER, Chandigarh

Dr. K. S. V. K. Subba Rao, Director, JIPMER, Puducherry

Dr. K. Srinath Reddy,President, Public Health Foundation of India, New Delhi.

103 104

30th September, 2011

Ms. K. Sujatha Rao, Former Secretary, Ministry of Health and Family Welfare

Prof. M.S. Valiathan, National Research Professor, Manipal University, Manipal

13th October, 2011

Prof. Subrata Sinha, Director, National Brain Research Centre (NBRC)

Prof. Pratap Sharan, Department of Psychiatry, AIIMS

Prof. Anoop Saraya, Department of Gastro- enterology, AIIMS

7th December, 2011

Prof. Sukhdeo Thorat, Chairman, Indian Council for Social Science Research

Shri P. S. Krishnan, Former Member Secretary, National Commission for Backward Classes

Dr L. R. Murmu, Additional Professor, Forum for Rights and Equality, AIIMS

Dr. Debjyoti Karmakar, President & Dr. Bhaumik Shah, Representative, Resident Doctors’ Association, AIIMS

Shri Harshit Garg, Finance Secretary; Shri Himanshu Kanwat, General Secretary, Students Union and Ms. Komal Parmar, Student, AIIMS

Shri Rupesh Kumar Tyagi, Chairman and Shri Sanjay Kumar, General Secretary, Society of Young Scientists, AIIMS

Representatives from Ministry of Health and Family Welfare and AIIMS

Shri Debasis Panda, Joint Secretary

Dr. G. K. Rath, Chief of IRCS, AIIMS

Dr. Rakesh Yadav, Sub-Dean, AIIMS

14th December, 2011

Prof. P. K. Dave, Former Director, AIIMS

Representatives from Faculty Association, AIIMS

Dr. Manoj Singh, President

Dr. Lalit Dar, General Secretary

Dr. B. K. Khaitan, Past President

Dr. Vijay Sharma, Joint Secretary 105

28th February, 2012 Shri K. B. Saxena, Former Secretary, Government of India

Ministry of Urban Development Shri D. Diptivilasa, Additional Secretary

Ministry of Health and Family Welfare Shri Vineet Chawdhary, Deputy Director(AIIMS) Shri Debashish Panda, Joint Secretary

Ministry of Science and Technology Dr. M. K. Bhan, Secretary, Department of Biotechnology

10th May, 2012

Ministry of Personnel, Public Grievances and Pensions (Department of Personnel and Training) Shri Manoj Joshi, Joint Secretary, Department of Personnel and Training

Ministry of Law and Justice (Department of Legal Affairs) Shri Satish Chandra, Joint Secretary and Legal Advisor, Department of Legal Affairs

Ministry of Health and Family Welfare (Department of Health and Family Welfare) Shri Keshav Desiraju, Special Secretary, Department of Health and Family Welfare Dr. Vishwas Mehta, Joint Secretary, Department of Health and Family Welfare

All India Institute of Medical Sciences (AIIMS) Shri Rakesh Yadav, Sub-Dean, AIIMS

21st May, 2012

Ministry of Personnel, Public Grievances and Pensions (Department of Personnel and Training) Shri P.K. Misra, Secretary, Department of Personnel and Training Shri Manoj Joshi, Joint Secretary, Department of Personnel and Training

Ministry of Law and Justice (Department of Legal Affairs) Dr. B.A. Agrawal, Secretary, Department of Legal Affairs Shri Satish Chandra, Joint Secretary and Legal Advisor, Department of Legal Affairs 106

Ministry of Health and Family Welfare (Department of Health and Family Welfare) Dr. Vishwas Mehta, Joint Secretary, Department of Health and Family Welfare

All India Institute of Medical Sciences (AIIMS)

Shri Rakesh Yadav, Sub-Dean, AIIMS

31st May, 2012

Dr. Seema Rao, Ex-Assistant Professor, Pathology, MAMC

Dr. Kameshwar Prasad, HOD, Neurology, AIIMS

Dr. S.K Sharma, HOD, Medicine, AIIMS

Dr. H.H. Dash, HOD, Neuro-anaesthesia, AIIMS

08th June, 2012 Representatives from Ministry of Urban Development

Shri D. Diptivilasa, Additional Secretary

Shri G. S. Patnaik, Vice-Chancellor -DDA

Shri Ashok Kumar, Commissioner (Plg.), DDA

Representatives from Ministry of Health and Family Welfare

Shri P. K. Pradhan, Secretary

Shri Keshav Desiraju, Special Secretary, Health and Family Welfare

Dr. Vishwas Mehta, Joint Secretary

Representatives from All India Institute of Medical Sciences (AIIMS)

Dr. R.C. Deka, Director, AIIMS

Shri Vineet Chaudhary, Deputy Director (Admn.),

Shri Rakesh Yadav, Sub-Dean (AIIMS)

12th November, 2014 Department of Health and Family Welfare

Shri Lov Verma, Secretary

Shri Arun Kumar Panda, Additional Secretary 107

Representatives from All India Institute of Medical Sciences (AIIMS)

Prof. M.C. Mishra, Director

Dr. D. K. Sharma, Medical Superintendent

Dr. Amit Gupta, Additional Professor

16th January, 2015 Department of Health and Family Welfare

Shri Arun Kumar Panda, Additional Secretary

Shri Ali R. Rizvi, Joint Secretary

Prof. M. C. Mishra, Director, AIIMS

Shri V. Srinivas, Dy. Director (Admn.), AIIMS

Dr. D. K. Sharma, M. S., AIIMS Annexure-III

PARLIAMENT MATTER URGENT COMMUNICATION FROM DEPARTMENT OF HEALTH AND FAMILY WELFARE. H-11013/06/2015 ME-1 Ministry of Health & Family Welfare Government of India (ME- I Section)

Nirman Bhavan New Delhi Dated 19 June, 2015

OFFICE MEMORANDUM

Subject: - Functioning of All India Institute of Medical Sciences (AIIMS)-reg.

The undersigned is directed to refer to Rajya Sabha Secretariat OM No. RS 2/2(iii)/ 2011-Com (H&FW) dated 29.04.2015 on the above mentioned subject and to enclose herewith 50 copies of the requisite information in English. Hindi version will follow.

(S. N. Sharma) Under Secretary to Govt. of India Te1.23061883

Encl:- As above.

Joint Director,

(Ms. Arpana Mendiratta) Rajya Sabha Secretariat, Parliament House/Annexe, New Delhi - 110001

108 Reply to Questionnaire on functioning of AIIMS

Sr. Queries Reply thereon 1. Budgetary allocations The Institute gets grants under the Heads “Plan” and “Non-Plan” made for AIIMS, from the Govt. of India, Ministry of Health & family Welfare. B.E. and R.E. and Plan grants are also received for National Drug Dependence actual expenditure Treatment, separately. Besides, extramural grants are also during each of the received from various external funding agencies such as ICMR, last five years DST, CSIR, WHO, UNICEF, DBT etc. for various research indicating the projects. Plan and Non-Plan grants received from the justifications/reasons Government of India and other agencies are further allocated to for under utilizations/ Super-specialties Centres/Departments/Research Section as per overspending; if any, their projections/requirements”. and the projects/ The Expenditure during the last five years Plan and schemes affected Non-Plan is as under:- thereby; and (` in Crore) Year Plan Non-Plan Total B.E. R.E. Expdr. B.E. R.E Expdr. Budget Expdr.

2010-11 400.00 380.00 381.62 400.00 605.00 681.10 985.00 1062.72

2011-12 412.35 412.35 415.79 610.00 650.00 744.80 1062.35 1160.59

2012-13 474.00 470.00 420.32 650.00 788.70 899.63 1258.70 1320.00

2013-14 550.00 485.00 494.45 790.00 870.00 974.66 1355.00 1469.11

2014-15 550.00 621.00 669.82 815.00 1001.00 1099.08 1622.00 1768.90#

Note:- Excess expenditure adjusted from balances of previous year/out of revenue generation. #Tentative Expenditure, Accounts 2014-15 under compilation

2. The programmes/projects/schemes Status and Expenditure done on different initiated during the last 10 years projects at AIIMS, New Delhi during last 10 indicating the date of initiation, the years are enclosed at Annexure- A targeted date for their completion, the estimated expenditure thereon, time/cost overruns, if any, the current status thereof and the likely date of their completion, in respect AIIMS.

109 110 floor th floor to ork in th work Balance has been retendered Physical Progress Completed 100% progress completed luding completed luding luding 23.63 cr W 58.89 cr 51.27 cr 50% 13.74 cr ` consultancy date ` ` consultancy ` made till consultancy consultancy 60% mpleted including completed October 2015 inc 2015. work from of completion December 2013 inc BalanceMarch 2016October 10 5 Actual date 1.11.13 Completion Sep. 2013 April 30.07.13 1.03.12 2.04.12 Date of Date of Expected/ Payment Constructions 2015 Thro’ HSCC ure Ltd., Nice M/s RBD, 2.04.12 1.12.13Thro’ HSCC One Block Projects HSCC Agency Reality and co Constructions 2013 inc Thro’ HSCC Parking warded. DFS 82 M/S Apex warded. All Nil warded. All 128 warded. All 140 M/S Apex warded Cost Start 12.0 crore 50.85 crore. Thro’ 72.84 crore. received ` ` approvals ` received Infrastruct February Status/ received. Pvt. ltd. received. DUAC has approved. Status and expenditure done on different projects at AIIMS during last 10 years AIIMS at projects expenditure done on different and Status basements approval Area-2634 sq.mt. Total 8306 sq.mts. Total G+9+3 A Basement -5672 sq.mt. Basement - 4935 sq.mt. 31161sq.mt. Total G+l0+2 A G+2+2 A Total 18618 sq.mt. Total G+l0+2 A Basement -2900 sq.mt. basementsArea-8218 sq.mt. approvals basements approvals Floors/Area Area-15730 sq.mt. Area-12437 sq.mt. Basement -4404 sq.mt. Block basements 4 Surgical Block 1 2Projects of Oversight Committee 1 3 Convergence 4 53 6 Dining Block 7 8 9 10 11 2 Hostel Block SI. of Name No. Project A 111 Nagar and the Type Completed Master Plan designs are to be finally approved by SDMC. expected to be floated and awarded by July 2015. 30 months time period thereafter. l.57 cr 12.50 Crore ` consultancy 22.50 Crore 24.11.12 Oct. 2005 2007July 2012 Oct. 2012 2008 Constructi M/s Kumar Infratech & Construction Pvt. Ltd. M/s Rama March March — — — — — Tenders 430 ` 50.18 crore released. NDMC final approval awaited. ` DFS. Estimated received from crore approx. submitted toMCD. forA.V. of cost Approval Nallah from ype IV-264 Total 16841 sq.mt.Total Plans yet not G+l1 houses V-44 Type 44 TypeVI- to Forwarded Plans South Ex toDental college MCD on Co. houses houses. Nallha Phase-I of of out reach OPD at Jhajjar of Houses at T Nagar A.V. 5 Construction 2 Construction Other Projects 1 Covering of Covering of 600 mtrs 112 Completed Completed Completed luding 55.39 cr. 14.57 cr. 27.33 cr. Paymentmade till Completed date ` made till 4.40 Crore consultancy date ` ` consultancy 19.76 Crore 2012 August 2013 31.10.12 30.10.12 May 2012 2005 20071.11.11 2010 March March March 2009 2010 2010 M/s V3S Infratech Infratech & CPWD Pvt. Ltd. M/S Rama June 2011 Project Consultants Construction Projects M/s Nice cars M/s Kumar November Payment Completed 450 cars 350 cars Revised 20.4 crore CPWD after deviation ` warded. 55.00 cr. 12.00 cr. 19.76 cr. Final received fromNOMC and Ltd inaugurated inc All approvals 9.50 cr. ` completion cost ` after deviation ` for the covering.For Thro’ 15.84 Cr. Approval ofMCD obtained Constr.Ltd. Pvt. including 23,129.00 sq.mtr. parking completion ork had been Three level 450 developing ofsample Collection centre and EHS facility Revised costLtd. Pvt. building structure Single storied Awarded cost of 8 NOs ofWard got lifts for done on deposit basis Block U.G.of are in place Multilevel car Parking car Area Badsha Jhajjar cost OPD at building of 4500 sq.mtr. of RAK OPD Nallah Ph-II 4 Construction 123 3 Construction W 4 5 6 7 8 9 10 11 5 Out reachstoried Single Awarded cost 50 7of Covering Pier and slab A 6 Renovation 113 mobilization started at site. shifting of Excavation services is in progress. 100% luding completed luding awarded luding completed 5.49 cr. Work 14.04 cr. Work 39.00 cr. 98% 6.15 crore 10.17 crore ` consultancy and consultancy and consultancy consultancy consultancy and ` ` ` ` 2014 inc May 2015. December 2012 inc . 2011. October 11.05.15 10.05.17 10.05.17 8.05.13 7.09.13 uwalia inc luwalia for awarded alegha (India) Contracts Contracts Engg. Ltd. including and Pvt. Ltd. operational Constructions DMRC Project Consultants Infratech & Construction M/s Kumar cars M/s 11.05.15 10.05.17 10.05.17 958 cars M/s 180 cars Era Infra 19.01.15 18.01.17 18.01.17 Plans Ltd. warded. Nil M/S Nov warded cost — 9.00 cr. 38.89 crore approved by NDMC. Estimated cost 180 crore Approval of Final Plans DUAC granted. Approval of approvals 100 crore. received Estimated cost All approval Approval of 450 Project cost ` requiredexcept tree cutting which was obtaind. ` Thro’ DFS obtained. Ahl sq.mts. basements. and cover A Basement -15176 sq.mt. 45947 sq.mts.Total Final Area-30771 sq.mt. partially on Total 18403 Total Area-1334 sq.mt. Basement -5059 sq.mt. G+9+3 Basement G+8+3 Basements method and No statutory V Masjid Mothgranted. DUAC Ah AIIMS & (Revised proposal) JPNTC surface. CNC in CT-2 Total 4.00 Cr. Child Block between 12 OPD At G+8+3 10 Private Ward 11 Mother & 9 Renovation of A 8 Tunnel Link Cut 114 by 29.0 ` ork in enders and 60 % work completed. progress, 15 sponsored Power Grid for crore. invited to be March 2015. Time period is 15 months. mobilization started at site. luding luding awarded 16.68 cr. Work 5.49 crore W ` ` consultancy consultancy CSR %. 17.05 Crore Work June 2015 Jan.2016 Jan. th March2016 February 2016 inc 2016 inc 04.08.14 17.02.15 16.05.16 16.05.16 NIL08.03.2014 07.03.2015 T 06.06.14 5 umar umar Construction Ltd. Infratech ConstructionPvt. Ltd. project Infratech Lakshmi (India) Ltd. place Total Substantially 28.48 crore 23.46 crore ` DUAC granted.Final Plans NDMC. & Agmt amount - Approval of — M/s NDMC. Approval of Agmt. Amount ` Approval ofFinal approved —received from NDMC. M/s Estimated cost -12.66 BuildersAll approval are M/s S.S. in awarded DFS obtained. K DUAC granted. approved by DFS & NDMC. Estimated cost 573 crore Approval of — M/s 90 of Approval Floor LG+UG+l0 floors family suites and4 multipurposehalls. DUAC granted.Area- 45886 Sqmts Plans Final & approved by Area-7000 Sqmt At TraumaCentre 288 beds in dormitory, DFS obtained. K Expansion of OPD, Hostel in 14 Dharamshala 15 Cafeteria B+G+2 16 Construction G+l 12 3 4 5 6 7 8 9 10 11 13 Trauma G+7 115 leted Under tendering stage Under tender preparation stage, approval of HC recived. Progress are Tenders proposed to recall, being single bid received NDMC approval underway. 1.50 crore Under ` 12.01.15 11.07.15 11.07.15 ConstructionPvt. Ltd. Creators comp rd ` 4.00 crore NDMC on 18.10.14 Final approval NDMC on 19.10.14 received from DUAC approval submitted to NOMC, approved from DUAC & DFS. final approval received from NDMC 19.10.14 Est. Cost ` Drawing 25.00 crore January 2015. G+l0 G+l0+2 basement. HouseBlock received from and Flats at Ballabgarhof gate No.1 improve facade of AIIMS India cum received 23 diagnostic 20 Geriatrics 21 Emergency 17 Face uplifting18 Hostel No.4 Est. Cost M/s The 19 A/A in Guestapproval Final 116 Detailed project report under preparation. packages under tendering. Hospital package. Likely to be awarded by June 2015. To be completed by September 2017. awarded mobilization started at site. 10.00 cr. Two ` 11.05.15 10.04.16 10.04.16 Work ProjectsPvt. Ltd. and beds 2035.00 crore clearance. EFC approved for ` received except EIA floor Awarded cost M/s Globe th to 10 th block Cancer Institute of Hostel BlockCrore 32.85 Civil 22 National G+7 All approvals 710 23 Balance work 5 12 3 4 5 6 7 8 9 10 11 Printed at : Bengal Offset Works, 335 Khajoor Road, Karol Bagh, New Delhi-110005.