The 30 Billion Dollar Medical Seats Scam

Guest article by Dr. Rita Pal.

Fury gripped the grass-roots medical fraternity today as they vented their anger on Twitter's hashtag #SaveNeetPG in relation to the “Cash for Medical Seats” scandal. On the 3^rd April 2013, the CNN-IBN admirable sting operation caught the following on camera in relation to “medical seats for sale”:-

• Medical colleges sell seats defying the Supreme Court order

• Officials demand Crores for Postgraduate medical  [PG] seats

• Money Trumps merit: Will Future Doctors be incompetent?

• Legitimate students paid lakhs to vacate PG seats

• How colleges hire docs to fudge medical inspections

• Find out why your child may not get admission to medical college

• Medical seats for sale: Are colleges producing dummy docs?

• CNN IBN uncovers black market for PG medical seats

India's medical fraternity have demanded that the government acts immediately over  this obvious corruption. One Indian doctor [ @DoctoAt Large] wrote

“You can't expect doctors paying 3 crores for PG seats to be ethical with patients. Start by eliminating corruption in admissions”

Following the sting operation, CNN-IBN submitted the film to the Medical Council of India [MCI]. Sadly, all authorities have been lethargic. The MCI's position on this issue is currently unknown.  There has been no robust statement of reassurance to the media or the public. This is entirely unacceptable. Despite this clear and present danger to the public, the MCI refused to have a plan or be pro-active in this issue. Are they out of their depth?

Indeed, the true extent of threat to public safety not yet known, considered or addressed. This is broadly an unacceptable and shocking situation. The government and the MCI appears relatively unconcerned about the potential threat to patient safety. Moreover, it is unknown how many doctors have “bought their way” through medical school. The true extent of medical incompetence is  also unknown. Moreover, this may have international implications as the number of doctors from this group may also be working abroad.

The current Health Minister appears relatively unconcerned about the potential for high mortality rate and threat to patient safety this may have led to or may indeed lead to. Moreover, this calls into question the number of competent students unlawfully rejected from medical school/post graduate education in favour of the elite who can pay their way through anything. The MCI and the current government' supine attitude to this serious problem raises the question as to whether they are implicated or complicit in these unlawful activities.

Buying a place in medical school is becoming a easy gateway to status, power and financial security. Long gone are ideas of patient safety and integrity. Clearly, the good doctors who have tirelessly worked hard against these serious obstacles will object to this unlawful behaviour that places the Indian medical fraternity under public scrutiny. How can the public now trust India's medical establishment with their lives? These activities will be causing an erosion in public confidence.

It is interesting that in April 2010, the President of the Medical Council of India [MCI] was arrested by the Central Bureau of Investigation for taking a Rs 2 crore bribe to recognise a medical college in Punjab. The CNN-IBN investigation had also demonstrated how a cartel led by this man flouted the normal procedures of the MCI with the intention of making money. Moreover, students lacking a background in science were given places on MBBS courses and colleges with no proper infrastructure were granted licenses. At that point, the government had apparently dissolved the MCI and replaced it with a board of governors, but the situation has not changed at all.

To demand some kind of accountability, CNN-IBN Live's Mr Rajdeep Sardesai swung into action from his usual cricket viewing and dog walking to take another bite at this story.  He  questioned former MoS Health Minister Dinesh Trivedi on this matter.

Mr Trivedi admitted that every year more than $30 billion was involved in “buying” medical seats. During the interview he claimed that 100 or so medical colleges were being controlled by politicians and were involved in selling their PG medical seats. “The “big money goes to 100 colleges”  Mr Trivedi said.

Trivedi blamed the conduct of the politicians saying

“It is the job of the government to create capacity whether in terms of hospitals or in terms of medical colleges, You just have many medical colleges, just like you've done for engineering colleges. Now there are no capitation fees. This is the gap that is created purposely kept”.

Former member of the Dental Council of India, Dr Usha Mohandas added

“It is a kind of well-established cartel. It is a beautiful network. The world can learn a lot from how strong this networking has been established for a wrong purpose. I would want the ministry to take absolute responsibility because the process of started and ending this is with the ministry, the other people in between are just via media. The ministry cannot wash its hands off and say that these are autonomous. If you ask the regulatory, they say we don't know anything you know, the minister asks us to do the same. This passing of the buck has to end.

All this is not new of of course. Over the last three years, CNN-IBN has been reporting on the corruption in the top most echelons of the Indian medical establishment with no action taken by the government.

The TV channel wrote

“CNN-IBN has also been showing how medical education regulators have been approving sub-standard medical and dental colleges and allowing them to flourish. The apathy, however, is leading to production of dummy doctors in the country”

Other incidences include as follows - In 2009, the Times of India reported that MBBS seats were being sold for Rs12 lakhs-40 lakhs by two private colleges in Chennai. At the time, the price of the seats were Rs 2 crore in radiology while Rs 1.5 crore for cardiology, gynaecology and orthopaedics. The hike in price was due to the reduced number of places available that year for the 32,000 graduates from medical school.

Times of India  wrote

“Another senior expert, who has held prestigious posts at the national level, says he has urged the UGC to hold centralized examinations like JEE for admissions to both MBBS and PG courses. ``It's a national shame to commercialize education. Besides, death of merit affects the quality of medical education. When money is paid, these colleges ensure that the exit is definite. The students pass, qualified or not,''

By 2011, the Central Bureau of Investigation arrested a doctor from Karnataka in the PGIMER  seat for sale scam. This was the sixth arrest at the time. The mastermind's main area of operation were Karnataka, Maharashtra, Madhya Pradesh, Punjab and Haryna -  where he along with his partners would text individuals for various examinations offering a seat for a certain price. The price of the seats ranged from Rs 20 lakh to Rs 80 lakh. Allegedly, seats were offered for AIIMS New Delhi as well.

In October 2011, Bangalore Police announced “A racket in sale of medical and dental seats for sums ranging from Rs 75 lakh to Rs 90 lakh has been busted in Karnataka with the arrest of 11 persons belonging to two gangs”. There were more complaints of medical seat fraud in Bhopal where a woman was arrested for allegedly taking money in exchange for medical seats.

By 2012, the CBI had been investigating more complicated allegations of medical school seat scam. This particular scam was elaborate involving a Tollywood producer.

The Indian Express wrote

“We are looking into the role of doctors in collusion with the accused and medical seat aspirants,’’ the sources said. Police suspect that the main accused collected huge amounts of money from the medical seat aspirants.  “With the tainted money the producer is planning to make more movies in the near future,’’ a source said.

Of course, these are the few stories that were reported. There must be thousands of incidents that have not made it to the public eye. It is clear that corruption is widespread in India's medical training system.  For now, we know that this is allegedly a $30 billion dollar scam, with the involvement of politicians who yet remain unnamed. While the current Health Minister passes the buck onto the MCI, it is interesting to note that he cleverly diverts the public gaze from the politicians who may well be ultimately responsible for this scandal. The MCI have no powers to hold politicians to account.  

Not only have they placed the public at risk but the government faces allegations of illegal discrimination on a mass scale.

We do not know how long this unlawful behaviour has been ongoing, nor do we know the extent of incompetent unqualified people who have been allowed into medical school and have been allowed to practise in India or abroad.

We do not know how many patients have died as a result, nor do we know the true scale of this scam. If individuals can “pay” their way into medical school, to what extent does this dishonesty extend? Is this dishonesty at dangerous levels now given the endless lists of health related scams in India. The current health minister had limply stated that there would be an audit on health related scams “We have to have audits in future to check health-related scams, including NRHM scam”.  So that would be the corrupt assessing the corrupt leading to a erroneous result then.

Lastly, how many innocent people are suffering because of the utterly shameful behaviour of the current government of India? The “Cash For Medical Seats” Scandal joins the endless list of Indian Scandals that the government has swept under the carpet by building a cosmetic façade of innocence.

The question is, how many people will die as a result?