DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEE164.100.47.5/newcommittee/reports/EnglishCommittees/Committee … · I, the Chairman of the Department-related Parliamentary Standing

Rajya Sabha Secretariat, New DelhiAugust, 2015/Sravana, 1937 (Saka)

PARLIAMENT OF INDIA

DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEE

RAJYA SABHA

ON HEALTH AND FAMILY WELFARE

REPORT NO.

87

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

The Functioning of All India Institute of

Medical Sciences (AIIMS)

(Department of Health and Family Welfare)

Ministry of Health and Family Welfare

EIGHTY SEVENTH REPORT

PARLIAMENT OF INDIARAJYA SABHA

DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEEON HEALTH AND FAMILY WELFARE

EIGHTY SEVENTH REPORT

The Functioning of All India Institute ofMedical Sciences (AIIMS)

(Department 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 DelhiAugust, 2015/Sravana, 1937 (Saka)

Hindi version of this publication is also available

Website : http://rajyasabha.nic.inE-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

(i)

COMPOSITION OF THE COMMITTEE(2014-15)

1 . Shri Satish Chandra Misra — Chairman

RAJYA SABHA2. Shri Ranjib Biswal3 . Shri Rajkumar Dhoot

%4. Shri Vijay Goel^5. Dr.Bhushan Lal Jangde6. Shrimati B. Jayashree7. Dr. R. Lakshmanan8. Shrimati Kahkashan Perween

&9. Dr. Vijaylaxmi Sadho10. Chaudhary Munvvar Saleem11. Dr. T.N. Seema

@12. Shri Jairam Ramesh

LOK SABHA13. Shri Thangso Baite14. Dr. Subhash Bhamre15. Shri Nandkumar Singh Chouhan (Nandu Bhaiya)16. Dr. Ratna De (Nag)17. Dr. Heena Vijaykumar Gavit18. Dr. Sanjay Jaiswal19. Dr. K. Kamaraj20. Shri Arjunlal Meena21. Shri J.J.T. Natterjee22. Shri Chirag Paswan23. Shri M.K. Raghavan24. Dr. Manoj Rajoriya25. Shri Alok Sanjar

#26. Dr. Mahesh Sharma27. Dr. Shrikant Eknath Shinde28. Shri Raj Kumar Singh29. Shri Kanwar Singh Tanwar30. Shrimati Rita Tarai31. Shri Manohar Untwal32. 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.

(ii)

**34. Dr. Pritam Gopinath MundeSECRETARIAT

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

(iii)

INTRODUCTION

I, the Chairman of the Department-related Parliamentary Standing Committee on Healthand Family Welfare, having been authorized by the Committee to present the Report on itsbehalf present this Eighty Seventh Report of the Committee on the Functioning of All IndiaInstitute of Medical Sciences (AIIMS).

2 . The Committee identified the subject ‘Functioning of All India Institute of MedicalSciences (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 toexamine the subject till 2013. The then Committee discussed threadbare a host of issues onthe subject and also heard experts/stakeholders. A Sub-Committee was also appointed in 2010-11and 2011-12. (List of composition of Committees year-wise that examined the subject is atAnnexure 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 oralevidence of representatives of the Ministry of Health and Family Welfare and the AIIMS. A listof official witnesses and experts/stakeholders heard is at Annexure II. In total, the previousCommittee 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 followingdocuments/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 Welfarealong 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 FamilyWelfare.

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

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

SATISH CHANDRA MISRANEW DELHI; Chairman,3rd August, 2015 Department-related Parliamentary StandingSravana 12, 1937 (Saka) Committee on Health and Family Welfare

Rajya Sabha

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

I T – 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 nationalimportance established in 1956 by an Act of Parliament to serve as a nucleus for nurturingexcellence 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 ProfessionalEducation, created to translate the recommendations of the Bhore Committee (1943) that laidthe foundation of the health sector policy and development in modern India. The AdvisoryCommittee, 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 theprovision of the most up-to-date hospital facilities for the education of medical graduates andopportunities for comprehensive research without which teaching and training must fail intheir object.’

3 . The Ministry further informed that the above resolve made at the cusp of ourIndependence, was translated into reality by the first Union Health Minister Rajkumari AmritKaur. The All India Institute of Medical Sciences (AIIMS) was brought into existence by theParliament through Act 26 of 1956. Moving the AIIMS Bill, she articulated the vision of AIIMSin her address to the Parliament on 18 February, 1956 wherein she stated, “It has been oneof my cherished dreams that for postgraduate study and for the maintenance of high standardsof medical education in our country, we should have an Institute of this nature in India whichwould enable our young men and women to have their post-graduate education in their owncountry, in their background with the necessary experience that we would like to give themto do research in the various spheres of medical education.” The Committee has been informedthat 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 laiddown in Clause 13 of the Act. Clause 14 of the Act lists the Functions of AIIMS for theattainment of the stated Objects.

The Functions re-affirm the Institute’s commitment to the broad spectrum of healthprofessional education as also to research and maintenance of well equipped hospitals. Over theyears, as the Institute evolved, it emerged as an apex level hospital, indeed, a benchmark inhealthcare. 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;

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4. Although AIIMS has consistently proved as a leader in advanced patient care, theunique and unparalleled role of the Institute has been to serve the nation as a fountainhead ofworld-class medical education and biomedical research, the core functions of a university.While addressing its problems, AIIMS should be seen as medical sciences university committedto excellence in research and education, to which is attached an apex referral hospital that isexpected 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 aimsand objectives of AIIMS:-

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

To bring together in one place educational facilities of the highest order for thetraining 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 theCommittee on 12th November, 2014 inter-alia submitted that ever since India Today beganranking medical institutions, AIIMS has been ranked number one consecutively for about 14years and quite often, it is number one in all parameters. Teaching and research is conductedin 52 disciplines. AIIMS is a leader in the field of medical research with over 1600 researchpublications by its faculty and researchers in a year. WHO fellows also undergo electivetraining in AIIMS. The Institute runs a comprehensive rural health centre at Ballabhgarh inHaryana and provides health cover to about 7.7 lakh people through the Centre for communitymedicine.

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 thefollowing members:

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

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

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The Director of the Institute, ex-officio;

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

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

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

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

10. From the information furnished to the Committee it is seen that the Minister of Healthand 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 andshall exercise such powers and discharge such functions as the Institute may, by regulationsmade in this behalf, confer or impose upon it. The Governing Body consists of the following11 members:

(a) President of the Institute;

(b) Director General of Health Services;

(c) Representative of the Ministry of Finance;

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

(e) Six members to be elected by the members of the Institute from amongstthemselves; 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.

(c) Standing Committees

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

Standing Finance Committee;

Academic Committee;

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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, 2014gave an overview of the roles of various committees and meetings of these Committees duringthe 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 CentralGovernment 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 modernmedicine and other allied sciences, including physical and biological sciences;

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

(c) Provide for the teaching of humanities in the under graduate course;

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

(e) Prescribe courses and curricula for both undergraduate and postgraduatestudies; 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 adepartment of preventive and social medicine sufficiently staffed andequipped to undertake not only undergraduate medical education but alsopost-graduate medical education in different subjects;

(ii) One or more well-equipped hospitals;

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

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

(v) Rural and urban health organizations which will form centers for thefield training of the medical, dental and nursing students of the Instituteas 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 techniciansof various kinds;

(g) Train teachers for the different medical colleges in India.

(h) Hold examinations and grant such degrees, diplomas and other academicdistinctions and titles in under graduate and post-graduate medical education asmay be laid down in regulations.

(i) Institute, and appoint persons to, professorships, readerships, lectureships andpost of any description in accordance with regulations.

(j) Receive grants from the Government and gifts donations, bequests and transfersof properties, both movable and immovable, from donors, benefactors, testatorsor transferors, as the case may be.

(k) Deal with any property belonging to, or vested in the Institute in any mannerwhich is considered necessary for promoting the objects specified in section 13.

(l) Demand and receive such fees and other charges as may be prescribed byregulations.

(m) Construct quarters for its staff and allot such quarters to the staff inaccordance with such regulations as may be made in this behalf.

(n) Borrow money with the prior approval of the Central Government on thesecurity of the property of the Institute.

(o) Do all such other acts and things as may be necessary to further the objectsspecified in Section 13.

Governing Body

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

Standing Finance Committee

17. The following matters shall be referred to the Standing Finance Committee which shallconsider them and make its recommendations thereon, namely:

(a) Annual accounts showing the receipts and expenditure of the Institute togetherwith the audit report thereon;

(b) Budget estimates showing the estimated receipts and expenditure of theInstitute;

(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.

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Standing Estate Committee

18. Standing Estate Committee is constituted for the purpose of considering additions andalterations to buildings belonging to the Institute and other questions relating to theirmaintenance 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 and12.05.2014

(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 andnursing. It also conducts super specialty courses in several disciplines.

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(b) Medical Research

26. As stated in the Status Note furnished by the Ministry of Health and FamilyWelfare, in the field of medical research AIIMS is the leader, having around 600 researchpublications by its faculty and researchers in a year. In fact many research projects arebeing carried out at AIIMS on topics which are of national importance. The AIIMS facultymembers get research funds from various governmental and international funding agencieslike 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.

(c) Patient Care Services

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 handlingcapacity. AIIMS continues to provide best possible medical care/treatment to all patientsattending 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 DependenceTreatment 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 byspecialized doctors at the level of Sr. Residents and consultants. These emergency servicesare equipped with all the diagnostic (including Ultrasound, CT. Scan etc.) and therapeuticfacilities.

(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 fromgrants of Government of India under the heads “Plan” and “Non Plan”. In addition, Plan grantsare also received for National Drug Dependence Treatment, VVIP care and College of Nursingetc. Besides, extramural grants are also received from various external funding agencies likeICMR, DST, CSIR, WHO, UNICEF, Department of Biotechnology (DBT) etc. for variousresearch projects. Plan and Non-Plan grants received from the Government of India and otheragencies are further allocated to Super-specialty Centers/Departments/Research Sections as pertheir 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 videletter dated 19th June, 2015 is as below:-

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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 Remarks2015-16

(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 ofCapital 1000.00 `142.00 crore for construction of National CancerAssets Institute at Jhajjar (`100.00 crore) and purchase of

Machinery and equipments by the Deptt. of NuclearMedicine.

TOTAL 2325.50

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

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

34. The Committee during the course of the examination of the functioning of AIIMSdeliberated 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 ofHealth and Family Welfare, AIIMS. The Committee also took note of the views expressed byexperts/witnesses on the functioning of AIIMS before the previous Committee. The same arediscussed in the succeeding paras.

V. Special Character of AIIMS

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

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

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

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

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

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

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

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

37. The Secretary, Department of Health and Family Welfare during the course ofdeliberations on AIIMS on 12th November, 2014 stated that the objectives of establishment ofAIIMS in the year 1956 were to develop patterns of teaching in undergraduate andpost-graduate medical education in all its branches, to bring together in one place educationalfacilities of the highest order for training of personnel in all important branches of healthactivity 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 theInstitute Body, the Governing Body and the five Standing Committees viz. Standing FinanceCommittee, Academic Committee, Standing Selection Committee, Estate Committee and theHospital Affairs Committee. The Director of the Institute is the Chief Executive Officer ofAIIMS. The Committee also sought the views of various stakeholders and experts on theworking of these entities. The Committee has been given to understand that there are severalshortcomings in the functioning of these entities which are mandated with the governance ofthe 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 ofpoor governance at AIIMS;

(ii) To manage huge faculty of AIIMS, there is need of trained administration tosupport 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 toresurrect the Institute;

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

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

(vii) There are cases of manipulating the AIIMS examinations and leakage of papersetc. Attempts of AIIMS to conduct an impartial and thorough review of itsexamination system, plug the leaks, and bring the culprits to book, lackedtransparency. There needs to be transparent system in this regard;

(viii) Contract appointments reduce the scope of independent opinion, which may bea short term convenience for some but causes long term damage to theindividual 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 theorganization, economically. The organization on the other hand has to bear thecost of repeated recruitment. Contract employment leads to career insecurity forthe individual and unstable workforce for the organization as the contractemployee has to search for new jobs constantly. Contract appointments shouldbe discouraged as they distort the system goals by negatively affecting securityand 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 entrustedwith recruitment and promotions of faculty and staff, respectively; and

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

39. The Secretary during evidence before the Committee on 12th November, 2014 submittedthat the main Institute bodies were being reconstituted after the General Elections for the 16thLok Sabha and all efforts will be made to notify the reconstitution of Institute bodies as soonas possible, The Director, AIIMS who was also present during evidence before the Committeeon 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 meetingsof 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 Committeehad called for the details of on-going probes into various corruption cases at AIIMS. As per

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the information furnished by the Department of Health and Family Welfare vide itscommunication dated 24th February, 2015 such corruption cases under investigation includedisproportionate asset cases, procurement of computers and peripherals without following dueprocedure, alleged financial irregularities in purchase of surgical gloves and medicines,construction of engineering works without approval of the statutory bodies, alleged temperingwith selection lists of operation theatre assistants, irregularities in appointment of officialsunder sports quota, irregular payments to contractors, irregularities in awarding developmentalworks etc.

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

(c) Need for decentralization

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

(i) Decentralisation of decision-making would provide greater time to the Directorfor 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 abetter approach;

(iv) There should be regular meetings of the Institute, Governing bodies and variousexisting 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 andsought action taken on the said report. The Ministry of Health and Family Welfare vide itscommunication dated 25th November, 2014 submitted that a High Powered Committeeconstituted for the purpose of implementation of Valiathan Committee recommendations hasclassified 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 toAIIMS for comments. AIIMS placed the report of High Powered Committee before theInstitute Body in its meeting held on 16/01/2012 wherein it was decided that the report of theHigh Powered Committee be considered on receipt of the report of Department related

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

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

46. The Committee has been given to understand that opinion of the medical world isdivided on the Valiathan Committee Report. Some of the stakeholders had expressedreservations 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 couldeasily have been used to manipulate opinion;

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

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

(iv) Financial dependence on the industry would perforce lead to shift inaccountability to grant providers rather than to the people/Government and thebasic character of the Institute as the highest level provider for equitabletraining, public-oriented research and public service would be lost. In handingover AIIMS to the industry on a platter, the Government would abdicate on itsresponsibility to the Nation;

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

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

(vii) Dr. Valiathan’s suggestions on conflict of interest management are quite atvariance 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 vacanciesin the Institute. The Committee sought details of vacancies in various categories in AIIMS. The

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Ministry of Health and Family Welfare vide its O.M. dated 05th November, 2014 gave anoverview of sanctioned/in-position doctors, nurses and supporting staff vis-a-vis requirementswhich is delineated below:

The details of sanctioned, in-position, vacant manpower and actual requirementsthereof, in respect of both faculty and Group A (non-faculty), B, C & D including technicalsupporting 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 facultymembers, apart from being appointed under the mode of direct recruitment, are alsobeing promoted to the next higher grade under Assessment Promotion Scheme withoutlinkage to vacancies by carrying the sanctioned post on which they have initially beenappointed.

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.

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48. Some of the residents keep on resigning off and on at regular intervals due to variousreasons and wherever waitlisted candidates are available, the vacant positions thus created arefilled from waitlisted candidates. Otherwise, these vacancies (where it is not possible to fillfrom 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 duringevidence before the Committee on 12th November, 2014 informed the Committee that sinceFebruary 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 forcreation for various areas of the hospital was placed before the Standing Finance Committeein its meeting held on 22/10/2014 and the SFC decided that creation of non-faculty posts isto be placed before the Sub-Committee. Apart from this, it was also informed that a totalnumber of 2235 non-faculty posts (1534 for creation and 701 for outsourcing) which wasapproved by the Standing Finance Committee and ratified by Governing Body of the Institutesubject 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

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

(iv) Contract appointments create distortions in the system since a person does nothave any security, any kind of idealism in his medical practice, and hence allthe appointments should be done on a permanent basis so that there is jobsecurity and career development ensuring whole hearted justice is done to thejob. AIIMS had repeatedly made attempts at making contract appointments offaculty members. (e.g. Neurosurgery, ENT and Medical Oncology) at timeseven when the selection process for regular appointments at AIIMS wasunderway;

(v) The reservation policy of the Government of India should be implemented inletter 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 ofAssistant Professors, reservation policy was not implemented as per theGovernment of India policy. When the reservation policy was accepted, it wasintroduced 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 ofPersonnel and Training (DoPT) should be set up and the reservation issuesshould be resolved once and for all and then a fresh beginning should be madeas per the policies of the Government of India; and

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

54. The Committee has been given to understand that shortcomings were noticed regardingnon-adherence of DoPT guidelines for filling up of posts and subsequent to that, a Committeewas constituted with the officials from the DoPT and also from the Ministry of Health whoafter examining the issue in detail gave its report. The Committee’s recommendations weretaken up in the Cabinet Secretariat. The Committee in its Report has stated that there was adifference between the shortfalls of vacancies and the backlog vacancies and that there wereno backlog vacancies in the grades of Associate Professors, Additional Professors and theProfessors in the year 2008. The instructions on reservation were not adhered to in theInstitute since the year 1994 which had resulted in substantive shortfall of reservation. Theloss caused to the reserved vacancies in the past may not be made good immediately as it wasnot possible to reserve more than 50 per cent of current vacancies.

55. The Additional Secretary during his evidence before the Committee on the 16thJanuary, 2015, informed that the norms and provisions, as laid down by the Government ofIndia regarding reservation of Scheduled Castes, Scheduled Tribes and OBCs in the

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appointment of doctors and staff are being followed strictly. He also submitted that therehave been many litigations in the Hon’ble High Court and Hon’ble Supreme Court on theissue 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

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pre-clinical and para-clinical departments. AIIMS also runs a 60-bedded hospital and theComprehensive Rural Health Centre (CRHC) at Ballabgarh in Haryana and provides health coverto about 7.7 lakh people through the Centre for Community Medicine.

60. The Committee has been informed that lately the services at AIIMS are overstretcheddue 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 timefor doctors to devote time to the patients; the waiting spaces for patients too areoverburdened. This compromises doctors’ efficiency besides reduced patients’ satisfactionlevels.

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 Committeethat the software known as VISTA is open source and has been put in use. AIIMS has alsomade its own modules and integrated the same with VISTA. The Director further informed thatAIIMS is working with Tata Consultancy Services (TCS) under Corporate Social Responsibilityand with the help of TCS, it aims to have a robust Electronic Medical Records in place. Onbeing asked about whether there was any plan to extend the EMR to Government hospitals allover India, the Secretary, Department of Health and Family Welfare replied that the Departmentof Health and Family Welfare was looking at greening of AIIMS and new AIIMS-likeinstitutions and the ultimate aim is to develop Electronic Health Records. But it will take timeas 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 theOPD. The last decade, in particular, has witnessed quantum jump in work load. So much sothat the present infrastructure and facilities have been rendered inadequate and is under severestrain. There has also been a waiting list of surgeries and other procedures in variousdepartments like Cardiology, CTVS, Neuro-surgery, Neurology and Cancer. There has also beenan increase in the number of under-graduate and post-graduate seats in all the departmentssubsequent to the implementation of Moily Committee’s recommendations which has also ledto the need of more space and resources for the various departments of the Institute. In viewof 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 AIIMScampus, hence need to look for additional land to cater to the emerging metropolitan needs fortertiary care services of Delhi in particular, and the country at large.

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

(c) Expansion Needs of AIIMS and Trauma Centre

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

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Trauma Care Services Centre would be a 750 bed hospital; other hospital facilities envisagedinclude:

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 fullydeveloped and catered to by AIIMS.

66. Efficient functioning of these facilities shall call for appropriate residentialaccommodation i.e, hostels for resident doctors and nurses as also type V & type-VI quartersand 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 theircompletion, their current status, estimated expenditure thereon and time and cost overruns, ifany, 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 Traumacentre and concomitant infrastructure is assessed at around 20 acres. This would be utilised

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largely for creating specialised patient care services and rehabilitation along with a focus onResearch Centre.

68. A plot of similar size exists adjoining the Trauma Centre, opposite to erstwhile KamalCinema. 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 underthe guidance of Secretary, Ministry of Urban Development, incorporating all the suggestions onthe line of New Moti Bagh campus.

70. In addition, the upcoming projects are those which have already been approved andin various stages of development and those which are on long term plan for the next decadeor 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 DirectorAIIMS, during evidence before the Committee on the 12th November, 2014, informed theCommittee that as per the existing arrangement only one rural health centre is attached with

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AIIMS. The new AIIMS-like Institutes will also have one rural health centre each attached withthem. Dwelling further on the issue, the Director explained that normally undergraduates andinterns are sent to the rural health centres, but the Comprehensive Rural Health ServicesProject (CRHSP), Ballabhgarh which is attached with AIIMS is different in the sense that theSenior Residents go to the rural health centre and provide patient care there. The faculty ofcommunity medicine is also stationed at Ballabhagarh, who implement the various healthprogrammes of Government of India.

72. The Committee has been informed that a plan to take over the JanakpuriSuper-specialty Hospital of the Government of NCT Delhi has been under discussion with theDelhi Government many times. If this plan comes through the immediate problem of the longwaiting 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. Thefollowing 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 thesedepartments.

75. There is no indoor facility available there.

76. Approximately, 300-350 patients daily visited AIIMS Outreach OPD, Jhajjar. Attendanceof 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

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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 futureand a crucible of excellence. It would emulate the ambience of world’s best universities, andwould be a symbol of India’s leadership in bio-medical and health sciences. The comfort ofpatients and their families would be at the heart of the design of its healthcare areas. Theneeds of the students, scholars, residents and scientists would be central to the academicinfrastructure and systems. Nurses, doctors, allied professionals, administrative staff andsupport workforce - all members of the Team AIIMS, shall have their respective space andopportunities.

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 ofPublic Health and initiate an interdepartmental outreach program for the community and,develop an interdisciplinary system and network for supporting the national programs andfacilities 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

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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 futureexpansion. There will be no partitioning of the land for individual centres out of the availableproperty.

81. In addition, following general facilities would be created:

— Housing, hostels, recreation areas, mini-market, schools, creches, communitycentre;

— Convention centre, auditoria, lecture theatres, seminar rooms, hotel, guesthouses, hostels for visiting fellows/trainees;

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— 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 needsof AIIMS. Work on all the centres/programs envisaged at this campus should start in the XIIPlan. Some of the tasks would be completed in the XII Plan period itself (e.g. National CancerCentre, General Purpose Hospital, Research Centres, Centre for Excellence in NursingEducation 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 Planperiod, while the rest carried over to the next Plan.

83. Shedding light on the development and expansion activities of AIIMS, the Secretaryduring evidence on the 12th November, 2014 informed that the Government had approvedestablishment 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 wasalso present during evidence before the Committee on the 12th November, 2014 informedthe Committee that construction of a Dharmashala has been started in the AIIMS TraumaCentre.

85. The Committee has been given to understand that the load of out-patients is about11,000 patients including main and all other centres. However, the bed Strength is only 2424which results in a big waiting list and a number of patients are turned away by AIIMS or aretold to come after a certain period. Every year, almost 35 lakh people visit AIIMS fortreatment. However, AIIMS is not able to provide medical facilities to so many people becauseinfrastructure and facilities have not been augmented over the years.

86. On being pointed out that there was lack of super-specialty centres in the countrywhich 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 submittedthat a few steps have been taken in this regard. For example, the six new AIIMS have comeup in various parts of the country though they are not fully functional yet. The Governmentis in the process of setting up more AIIMS, apart from these six new AIIMS. The Ministryof Health and Family Welfare is also going to upgrade 58 Government medical colleges in thecountry with super-specialty facilities. The upgradation of each Medical College would costaround ` 200.00 crore. It has also been decided that 58 district hospitals in those areas wherethere are no medical colleges would be upgraded as Government Medical Colleges. Aredevelopment plan is also being implemented in Safdarjung Hospital and Lady HardingeHospital where super-specialty facilities are coming up. The Ministry has also plans to bringup super-specialty facilities in Dr. RML Hospital.

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

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VIII. Academics

88. The Secretary, Department of Health and Family Welfare and Director, AIIMS informedthe 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 graduateand residency programmes in various disciplines, besides the undergraduate courses. TheInstitute also provides long term training to defence personnel and those sponsored by theGovernment Institutions besides short term training in various departments to Indian nationalsand trainees from oversees and elective training to foreign undergraduates from countries likeAustralia, Bangladesh, Canada, U.S.A to name a few.

89. The Committee has been given to understand that AIIMS has done enough to producehigh quality under-graduates that it could shift its focus to strengthen post-graduate educationalprogrammes across the country, assisting new AIIMS-like institutes under PMSSY. There canbe common pool of faculty and rotation of faculty among these Institutions where some of thepeople 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 qualitytertiary care in the country.AIIMS needs to grow out of a ‘Central elite institution’ mindset toengage much more with problems at the ground level in the States and to redesign itself fora much more national role in terms of education. For strengthening under-graduate educationacross the country, efforts should be made to utilize IT-enabled common classroom approachto teach many other colleges across the country. AIIMS and other institutions of nationalimportance should participate in training of faculty both through distance as well as throughperiodic contact programmes.

IX. Research

90. The Committee has been given to understand that significant research needs exclusivededication and a lot of reserved time. Most of the faculty in the Institute end up doing researchin the time left after seeing patients and completing their teaching responsibilities. This cannever be a “winning” model for research. The declining time for research among faculty alsoimplies that research mentorship for the trainees, Post-graduates and Ph.D scholars becomesa victim. The Research Administration also requires to be strengthened. Faculty who have anadditional responsibility to look after this aspect - are again hindered by the problem of limitedtime. There should be a well staffed research facilitation establishment. Besides, the salaryoffered to an MD level research officer at AIIMS is so low that very few are attracted towardsresearch 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 withinstitutions 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 strategictie-up with other institutions - more flexibility in appointing adjunct faculty/scientists toenhance the spirit of inter-disciplinary and inter-institutional collaboration - is perhaps the bestway forward for meaningful productive research.

91. The Committee has on record that the Institute was rated as the top institution inClinical Medicine Research in the country; top health institution in Bio-medical Research; itsBio-technology Research was classified as having a high impact and high collaboration index

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and the Institute had a higher research output as compared to other premier scientificinstitutions like IIT, IISc and TIFR. The Institute had conducted landmark research of nationalimportance on malnutrition, iodine deficiency, diarrheal diseases, liver diseases, lead poisoningin children, T.B., Genomic analysis of Malaria, Stem cell research, Vitamin D status in Indiancontext. The Institute research had influenced various National programmes like ICDS,Universal iodization of Salt, National Blindness Control programme, Flurosis Controlprogramme, Tobacco Control programme, National Programme on Health Care of Elderly. TheInstitute 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 1600Research Papers in high index Journals reputed all over the world. Professors participate invarious conferences, which are fully funded by AIIMS. Addl. Professor and AssociateProfessor can attend one international conference every two years.

93. The Committee further noted that in the Government funding plan, budgets are mainlyto augment clinical services and funds for research equipments and research, as such, wasonly ` 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 ofresearch in AIIMS, given by various stakeholders:

(i) There exists a lack of inter- disciplinarity as promotions are always made on thebasis of departmental vacancies and departmental positions. While allowingpeople to do a certain amount of investigation driven research to satisfy theirnatural interests, there should be identification of thrust areas of nationallyrelevant problems and setting up of a multi-disciplinary research groupaddressing important problems through an inter- disciplinary approach;

(ii) Even within AIIMS the possibility of cross- appointments between twodepartments does not exist which actually dampens some of the researchproductivity. The possibility of inter-institutional collaboration can be exploredwhich could include provision of visiting professorship which is absent atpresent in AIIMS;

(iii) Industry sponsored research like clinical trials should be discouraged in publicfunded institutions as they lead to distortion of priorities, conflict of interestand unethical practices. Government should ensure that AIIMS receives enoughgrants through Government sources to ensure that integrity of public healthgoals and public policy is observed;

(iv) There is problem with Research governance due to the manner in whichdecisions are taken at AIIMS;

(v) There should be collective decision with regard to the subject and it should bedone in a transparent and open manner so that people are not harassed by wayof pushing of files;

(vi) There should be a middle-level research cadre so that continuity is maintainedin research, non-monetary incentives should be given in the form of recognitionlike getting the research work published in journals, peer recognition, etc.

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provision of secretarial assistance should also be considered as a facilitationmeasure;

(vii) There is a need to strengthen research teams and resources and for centralizingresources;

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

(ix) Public funded institutions in India should not try to follow the West in goingexclusively for private grants, as Western institutions sustain themselves byselling their intellectual property; however in India that is not possible as weneed to focus on scholarship, patient care, education, research and publichealth;

(x) Provision of funds for research alone could not ensure a strong research basefor the country. A strong base of researchers needed to be set up, as thegestation period in the field of research to fructify is very long ranging from10 to 15 years. To ensure this, stability in value systems is not enough, thereis a strong urge to adapt to the changing times. In order to ensure cuttingedge research, there is a need to focus more on the biology of disease insteadof just focusing on studying the biology of cells. The concept of Doctor neednot 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 schooland 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 poolrequired for each type of research; (iii) formation of a separate eco- system;(iv) creation of centres which would support department structures whichcould be compartmentalized under four heads i.e. (a) Infectious diseasecentre; (b) Chronic disease centre; (c) Nutrition centre and (d) Health systemsResearch Centre; (v) need for Ministry to distinguish between HospitalMedical Centres and Academic Medical Centres; (vi) need for setting up‘Academic Medical Schools’ throughout the country; (vii) setting up ofcentralized research resources for each type of research; (viii) need formaking available financial resources for research not only from Governmentbut also from the Private Sector, etc;

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

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

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

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

(xiv) Till November, 2003, there were only 12 clauses in the guidelines for grant ofpermission to the members of the faculty to attend various scientificconferences and other assignments in India and abroad. In August, 2005, onemore clause was added which completely changed the spectrum of research inAIIMS. Clause 13 in the amended guidelines says that the faculty member mayalso be permitted to attend meeting related to the research project in India andabroad which may be funded by private research institutions, privatefoundations, private companies in which the concerned faculty member is eitherco-investigator or investigator. Then, there is a clause that the TA/DA will beprovided by the company;

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

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

(xvii) The quality of research at AIIMS is actually on the decline partly owing to lackof support system of research as the Research cell at AIIMS is very weak interms of understanding the needs of research and needs of collaborativeresearch wherein the Research cell does not allow appointments to be made inother 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 thecore character of the Institute as a medical university. It is impossible to deliver quality careand also to be academic and research institution, no matter how hard its highly committedfaculty tries day after day.

96. As against the original character envisaged, AIIMS is expected to provide care to anypatient walking into its portals, without the need for referral, for minor to the most complexailment. Thus it is not being allowed to function as a referral centre. As a result, waiting listsfor admissions/surgeries run into months, even years. AIIMS has thus been rendered as ageneral multi-specialty hospital rather a university hospital. Majority of the patients treated atAIIMS could have received treatment at other hospitals such as medical colleges andgovernment 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 secondarycare 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 secondarycare status, there can be no resolution of the problem. The services are over burdened by the

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patient care component leaving no time for introspection, forward planning and for that matterany constructive thinking. The Committee has been given to understand that according to astudy performed by Department of Hospital Administration, AIIMS in 2008, to assess thesatisfaction of patients, it was found that 87.5 % patients were satisfied with the behaviourof doctors, 57 % patients were satisfied with the behaviour of Nursing staff and 60% patientswere satisfied with the behaviour of Group D staff inspite of the various constraints beingfaced by the Institution.

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

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

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

Sl. Name of the Waiting TimeNo. Department

1 2 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 MonthsCategory -III ASAFC 6 months —Category-III Routine 16 months 6 months

5 . E.N.T. Ear Surgery 3 to 4 yearsHead & Neck Cancer One monthOther Benign Conditions 1 to 1½ yearCochlear implant surgery One year

6 . Orthopaedics Unit I Unit IIHand Cases 4-6 monthsSpine Cases 3-6 months 3½ - 6 monthsArthroscopy Cases 1-3 months 4-6 monthsArthroplasty Cases 3-6 months 3-6 months

Paediatric Surgery Cases 7-9 months

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Oncology Malignant -

3-6 monthsBenign: 5-7months

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-lifethreatening)

For emergency No waitingpatients (acute lifethreatening)

9 . Urology Emergency Same day

Semi emergency surgery 48 to 72 hrs.

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

Routine patients with 4-6 monthsbenign disease with noimmediate or lifethreatening complication

10. Nephrology Living renal transplant 3-4 months

11. Ophthalmology Routine 1 week

Squint Surgery 6 months

1 2 3 4 5

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The following are some of the suggestions made by some stakeholders on improving thepatient 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 orfrom outstations, at least for part of day’s OPD’s registration.

(ii) Despite all hype about IT, there is no computerization of patient records inAIIMS compared to other institutions.

(iii) Creation of a few tertiary care centres in Delhi and neighboring States wouldbe inadequate to decongest AIIMS. A health system perspective would call fora more detailed sector-wise development of primary, secondary and tertiary careservices all over India including the neighbouring States.

(iv) User charges are a barrier to accessing healthcare for most people andespecially for the poor. Further, user charges decrease access for the morevulnerable sections among the poor, such as women, children, and thescheduled castes and scheduled tribes in India. Studies also show that sickpeople are more likely to die when they had to pay user charges. In India, 1in 3 people who need hospitalization and have to pay out-of-pocket are forcedto borrow money or sell assets to cover the expenses. Over 20 million Indiansare pushed below the poverty line every year because of out-of-pocket spendingon healthcare.

(v) Revision of norms of the faculty as per patient load and creation of the postsfor recruitment of faculty was required; and operational flexibility whereinDirector could take people on contract to ensure effective patient care couldsolve the problem of long waiting time in AIIMS.

(vi) Essential medication should be provided free of cost as it will only marginallyincrease the overall budget of AIIMS and since there are only a few suchcentres in India, it would not burden the exchequer.

(vii) There is a need to improve the manpower, space and infrastructure (includingcomputerization) situation at AIIMS, and the need for centralized laboratoryservices as patients have to often go to external laboratories and radiologycentres, 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 andcentralization of laboratories, and to build in staff accountability and norms forclinical services.

(ix) In a poor country like India wherein, a person has to spend 84% of expenditureout of his pocket, the concept of user charges add to his medical expenditureburden. The Government should prepare an action plan to increase thebudgetary allocation of health sector from the present less than one per cent to2.5-3% 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 envisagedby founding fathers of the Institute, screening OPDs in the Institute is the need

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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

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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 areanomalies in pay scale, designations and promotional avenues of PR cadre. They demanded thattheir 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 thebasis of limited competitive departmental examination so that professionally qualified employeesmay 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 theCommittee stated that the physiotherapy services were started at AIIMS just after its inceptionand since then the physiotherapists were meticulously contributing in the patient care andmanagement. Their participation and contribution was very well recognized as almost everyclinical department had physiotherapists as its essential part. But they never got dueappreciation. New developments in technology and research in physiotherapy and health careled 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 tothem, the physiotherapists are being treated as mere technicians in spite of the fact that theireducation, skills and participation in the health care is no way comparable to any othertechnical service at AIIMS.

104. The Forum stated that the entry level qualification for physiotherapists at AIIMS isBachelor of Physiotherapy which is a four and a half year professional degree course and itincorporates even more than BDS in terms of syllabus and clinical responsibilities. Grade Payof `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 recruitedat AIIMS were post-graduates and they were working in super-specialty centres which signifytheir needs at AIIMS. Despite being involved in intense care management, they had been deniedvarious allowances like conveyance allowance, non-practicing allowance etc. Thepost-graduate qualifications were imparted by the National Institutes and the CentralUniversities and they are eligible for the post of Assistant Professors as per the UGCguidelines. The Forum therefore requested that at these super-specialty centres, the entry levelqualification should be post-graduate degree irrespective scheme for physiotherapy with theGrade Pay of `6600/-.

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

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

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

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

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

107. According to the Forum the Recruitment Rules for the Physiotherapists had not beenmodified for the last more than forty years, contrary to the DoPT Guidelines and also despitethe recommendations from various Departments/Bodies and Ministries as well. Globallyphysiotherapy profession is well established as autonomous and independent health careprofession.

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

(iii) Speech Pathology and Audiology

109. One of the important areas of the ENT is speech pathology and audiology. TheCommittee was given to understand that AIIMS used to run a bachelor’s programme in thisfield for more than two decades. Under this programme the Institute used to train professionalson issues related to communication disorders such as hearing impairment, mental retardation,voice, fluency and phonological and language disorders. Of late, the Committee has beeninformed 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, theCommittee observes that the meetings of some bodies/committees are not being heldregularly which gives a poor reflection on functioning of these important decisionmaking bodies. The Committee feels that such a state of affairs on the part of an apexinstitution like AIIMS which is a role model for all medical institutions in the countryshould not be allowed to persist. The Committee recommends that the Annual ActionPlan of AIIMS should prepare an itinerary at the beginning of the year itself to conductmeetings 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 strengthenedwith regular, pre-notified meetings of the Staff Council whose deliberations should beavailable to the Institute Body for review.

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

112. The Committee desires that the practice of ex post facto approval of the decisionsmade by Director and President of AIIMS for the matters needing approval of theInstitute Body/ Governing Body in its subsequent meetings should be done in veryexceptional cases only. A mechanism should be developed for immediate meetings in theemergent matters.

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

II. General administration

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

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115. The Committee recommends that standard Government of India (GOI) practicesregarding seniority between direct recruits to substantive posts and promotees should bestrictly 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 bereviewed 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 countryand it is imperative that all possible measures should be taken to attract, retain andnurture its talent.

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

III . Budgetary provisions

118. The Committee observes that availability of tertiary care services is skewedtowards private domain vis-a-vis public sector which leads to high health cost burden onpeople, especially the marginalized and poor sections of our society. AIIMS which is aninstitution of National Importance and eminence, has made substantial contribution tocorrecting the imbalances in availability of affordable and quality tertiary healthcare,especially to the most deprived and vulnerable sections of our society, which isacknowledged unequivocally by all. Therefore, it goes without saying that AIIMS needsto be supported and nurtured with the utmost gravitas and all its financial requirementsshould be met by the Government by way of budgetary support to allow it to flourishand excel further. The Committee is, therefore, constrained to observe that there is ahuge mismatch between the AIIMS’s projected demand of ` 2325.00 crore and allocationof ` 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 thelast five years, the Committee is unable to reconcile itself with the reduced quantumof plan funds for 2015-16. Since a large number of developmental activities arecurrently underway at AIIMS and inadequacy of Plan funds may prove to be big factorin limiting the progress in executing important initiatives like National CancerInstitute, Jhajjar, new OPD Block at Masjid Moth etc., the Committee lends its fullsupport for enhanced budgetary support to AIIMS and recommends that the, resourcegap should not be allowed to come in the way of speedy execution of developmentalprojects of AIIMS. The Committee simultaneously recommends that the Department ofHealth and Family Welfare should oversee the quality of development expenditure toensure strict adherence to canons of financial prudence and discipline and fulfillment ofall prescribed conditionalities.

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

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IV. Autonomy

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

121. The Committee is of the opinion that new policies should be designed forachieving more functional and financial autonomy in an effective manner. Keeping inmind that AIIMS is a public health institution funded by the Government, nocompromise on accountability front can be made.

V. Valiathan Committee Report

122. The Committee notes that the High Powered Committee has classified therecommendations 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 inAIIMS Act and the Rules and Regulations made thereunder. The Committee, however,takes note of the opinion both pro and against on Valiathan Committee Report. TheCommittee impresses upon the Department to closely scrutinize all the suggestionsgiven by the Valiathan Committee before implementing the recommendations further.

VI. Vacancies/Appointments

123. The Committee observes that the essential pre-requisite for quality health careservices is the availability of adequate manpower/specialists and other healthcareprofessionals. A cursory reading of the vacancy position vis-a-vis the sanctioned strengthreveals that there is more to it than meets the eye. What confounds this Committee isthe issue that inspite of providing ample budgetary support, in-position strength inrespect of faculty is 594 against sanctioned strength of 826, that of non-faculty is 201against 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, theCommittee has been informed of creation of 2235 non-faculty posts and furtherprojected 905 non-faculty posts for creation. It is more than evident that on the onehand the Institute has revealed grand plans for expansion but on the other, it has notbeen able to recruit even the sanctioned strength. The Committee, therefore, exhorts

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the Institute to streamline its recruitment policy so as to ensure that beforeapproaching the Government for creation of posts, the Institute should at least ensurethat the sanctioned posts are filled up within a targetted timeline. The Committee alsorecommends that the Institute should expedite the process of creation of a PersonnelDepartment to ensure streamlining of procedures and actual process of recruitment forfuture appointments.

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

125. The Committee also finds that the process of appointment of Director of theInstitute is done at the last moment in a hurry. The Committee is also of the view thatthere 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, recommendsthat in order to ensure timely filling up of the post of Director, the required processesshould be put in motion at least one year before the anticipated vacancies arose. On theissue of appointment of Head of Department, the Institute should ensure a codifiedpolicy 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 thepractice of appointing a serving IAS/IRS/IPS officer as Deputy Director ofAdministration who serves at the pleasure of the Health Minister and follows the diktatsof the Minister and Health Secretary, with no accountability to AIIMS as a bird ofpassage. This needs to be rectified if efficiency and integrity of the Administration hasto be ensured. The Committee therefore recommends that a management expert berecruited by the Institute Body through open selection, with a five year term which isopen to reappointment, subject to objectively conducted performance appraisal.

VII. Assessment Promotion Scheme

127. The Committee feels that the issue of Assessment Promotion Scheme(APS) hasraked its fair share of controversy. The Committee is of the view that the Instituteshould 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 theauthorities, concerned should take a realistic assessment of the scheme and frameguidelines to overcome the lacunae existing in the Assessment Promotion Scheme to putan end to the controversy the Scheme has generated. The Committee also recommendsthat till such guidelines are framed standard Government of India (GOI) practices inthis regard should be strictly followed.

VIII. Rotation of Headships

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

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

IX. Accommodation

129. The Committee has been given to understand that several doctors, senior facultymembers and other staff have not been provided suitable accommodation. TheCommittee 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, arenot getting accommodation and have to reside outside. The Committee recommendsthat 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. TheCommittee 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 healthinfrastructure across the country’s medical colleges, State hospitals, Community HealthCentres, Primary Health Centres, etc. This would improve the quality of health caredelivery in the country, thereby reducing the load on a tertiary care institution likeAIIMS. The Committee, therefore, recommends that the Ministry should urgently lookinto the issue of strengthening the health care infrastructure across the country so asto reduce the primary and secondary healthcare burden on the Institute.

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

132. The Committee notes from the information made available to it that of the fiveprojects (both completed and on-going) of Oversight Committee costing ` 615.87 crore,four projects have witnessed time overruns and cost escalations while the fifth projectconcerning the construction of Houses at A. V. Nagar is yet to be finally approved bySouth Delhi Municipal Corporation. Similarly, of the 23 other projects (both completedand on-going) most of the projects have lagged behind their set targets and thus havenot met time and cost deadlines. The Committee feels that this is a pathetic situationas such delay does not bode well for an institution of vital importance like AIIMS. TheCommittee is very much concerned with these delays and desires them to be addressedwith utmost gravitas and promptitude. The Committee, therefore, impresses uponvarious agencies involved in the expansion process of infrastructure in AIIMS to resolvethe clearance issues in a time bound manner as health infrastructure cannot be heldransom to technical issues like clearances and that too in the national capital of thecountry. The Committee also desires that the issue be taken up at the highest level inthe Ministry with counterpart Ministries dealing with agencies involved inimplementation of the infrastructure projects in AIIMS to ensure that there is nofurther delay in the schedule laid down for implementation and completion of various

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projects in AIIMS. The Committee also impresses upon the Ministry to ensure settingup of an Oversight Committee reporting directly to the Director of the Institute toensure strict vigil and monitoring of infrastructure projects to ensure adherence to timebound completion thereof. The Committee also recommends the Department to ensurethat there is no cost escalations of projects and the work of on-going projects isexecuted within the approved cost.

133. The Committee has been given to understand that AIIMS catered to 35 lakhpatients, which is a huge number by any standard. It is thus more than evident thatthere is very high burden of clinical services on AIIMS. Given the fact that aconsiderable number of patients availing health care facilities at AIIMS belong to thepoor and deprived sections of the society, it is all the more imperative that the healthcare infrastructure of AIIMS is augmented to keep the same commensurate with thehealth care requirement of the society. The Committee, therefore, endorses theexpansion plans of AIIMS. The Committee would, however recommend that an effectivemonitoring mechanism be put in place to ensure that the expansion plans are executedwithin 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 notmaterialized as yet. The Committee recommends the Department to expedite the processof 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 ofHealth and Family Welfare to ensure that the Development Project concerning AIIMSCampus II, Jhajjar, Haryana is executed within the initially estimated project costs andtime-frame in order to avoid any time-overruns and cost escalation of the project. TheCommittee further recommends that such satellite centers should also be set up inother parts of the NCR like Meerut, Greater Noida, Gurgaon, Ghaziabad, etc. so thatinflux 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 AIIMSis the lack of adequate and quality medical facilities in the neighboring States likeBihar, U.P. and Rajasthan etc. The Committee observes that the primary objective ofPradhan Mantri Swasthya Suraksha Yojana (PMMSY) which was launched in 2006, wasto correct the imbalances in availability of affordable, quality tertiary health care. TheCommittee takes note of the fact that the Government is setting up six AIIMS likeinstitutions. The Committee has been given to understand that desired progress has nottaken place in other AIIMS like Institutes. Infrastructure and faculty is not adequateto run the Institute. Therefore, the Committee recommends that an early action betaken to ensure that the six Institutes start functioning optimally. This would reduce

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the load on the AIIMS, Delhi to a large extent. The Committee is also of the view thatthe Government should consider setting up of more AIIMS like Institutions in thehealth care deficient States like Uttar Pradesh, Bihar and Madhya Pradesh.

137. The Committee observes that the expansion of tertiary care institutions isessential for catering to the healthcare needs of the growing population in the countryand setting up of AIIMS-like institutions and upgradation and strengthening of medicalinstitutions under PMSSY is a major step towards guaranteeing quality health care toall. 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 inavailability of affordable tertiary level health care in the country. However, thisobjective can only be realised if, besides setting up of AIIMS-like Institutions, moremedical institutions/colleges/districts hospitals in different parts of the Country areupgraded and strengthened through Centrally Sponsored Scheme for capacity expansion.The Committee, therefore, recommends that more medical institutions/Medical Collegesof underserved and un-served areas be included under PMSSY for upgradation andstrengthening of the District Hospitals without compromising the quality of servicesrendered. The Committee would also like to add that recruiting quality faculty for otherAIIMS-type institutions is already proving difficult. The need of the hour is to createan All-India cadre linking AIIMS-Delhi, PGIMER and JIPMER as hubs and the newAIIMSs 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 careersbetween their state cadre and central postings.

XIII. Referral Character

139. The Committee notes that apart from being a University by character, AIIMS hasan impeccable position as a tertiary hospital also. It is, therefore, imperative thathighest level of patient care is provided by the Institute. The Committee is howeverconstrained to note that over the years the tertiary referral status of the Institute hasbeen 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, asecondary 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 negativelyimpacts the patients who deserve tertiary care on priority but such a mammoth patientload with even minor ailments also adversely affects the functioning of the Institute andhampers its academic and research activities. The Committee, therefore, from thestandpoint of the Institute recommends immediate filling up of all the existing vacanciesand restructuring of staff and other resource requirements of the Institute based on theexisting patient load. It also desires immediate investment for creation of requisiteinfrastructure including expansion of departments, addition of operation theatres andother paraphernalia, improvement in the existing infrastructure, etc. The Committee isof the opinion that the decentralization of medical services is necessary to decongest themain Hospital by creation of screening OPDs, outreach centres. An efficient and promptreferral to other health facilities would also go a long way in improving the patient care

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in the Institute. Single patient friendly registration for all OPDs along withcomputerization of patients’ records and reports with sufficient safeguards for ensuringconfidentiality and centralized laboratories services with sample collection at multiplesites would also be a hugely patient friendly initiative.

140. The Committee would, however, like to add that AIIMS cannot be a tertiary careinstitution as long as UG courses are run UGs need exposure to primary and secondarycare too hence general OPDs etc. Either AIIMS discontinues UG programmes andfocuses only on PG plus programmes like PGIMER or transfers UG training to ancillarycentres linked to but not situated in the main campus. Since there are now many goodUG training medical colleges, unlike 1956 when AIIMS was set up, the former may bethe preferred option. On the other hand, if AIIMS has to be a role model-cum-technicalresource for new AIIMS-like institutions, the composite UG+PG character has to bemaintained. 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 reservationprovisions have been violated in AIIMS in the past. Though, the Committee takes noteof 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 nodeviation of even one per cent”, it nevertheless would like the Ministry to put in placean institutional mechanism to ensure that a robust database with multi-stage crossverifications is created for implementing the reservation policy in AIIMS. TheCommittee also recommends that the Ministry may also ensure that accountability ofthe AIIMS officials is fixed for potential violations of constitutional provisions onreservation. Action should also be taken against those responsible for violations of thereservation policy in the past.

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

XV. Procurement

143. The Committee finds that in spite of an elaborate procurement process forequipments, consumables, materials, medicines, etc, it has come to its notice thatthere are loopholes in the procurement process. The Committee, therefore, stronglyrecommends that the Department should build abundant safeguards in the procurementprocess 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

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Committee desires that adequate steps should be taken to re-start this programmewithout any further delay as there is a huge demand and shortage for speech therapistsand audiologists in the country.

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

XVII. Research and Development

146. The Committee notes with satisfaction that AIIMS has maintained its position asa top research Institution in the Country. With a view to ensure that the Institutecontinues to remain at the forefront of research and development in health sector notonly in the Country but also in the world, the Committee strongly recommends that theMinistry should ensure that all requirements of funds for R&D activities in theInstitute should be met on top priority. This would not only ensure that the integrityof public health goals and public policy is observed but would also eliminate industrysponsored research like clinical trials and a host of other such activities whichsometimes may lead to distortion of priorities, negligence of public good, conflict ofinterest and unethical practices. The Committee would also like to be informed of theevaluation of impact on national health programmes and innovations in clinical/publichealth service delivery that research at AIIMS contributed to.

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

148. The Committee is also of the opinion that for better command and control andmonitoring and for maximizing the research inputs, the research team should bemulti-disciplinary and all resources for research should be centralized. It would also beworthwhile to provide professional secretarial assistance along with non-monetaryincentives including peer recognition to the human resource involved in R&Dactivities.

149. The Committee also desires that the ‘research governance should invariablyinclude collective decision making and the protocols regarding research governanceand manpower development should also be given due consideration in careerprogression.

150. The Committee observes that the concept of Research with focus on NationallyRelevant Health Problems is a sine-qua-non. AIIMS being a premier Institute and beingexpected to play a visionary role to the other medical Institutions, there should bedefinite direction for the areas on which research undertaken would help in giving a

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proper perspective for solving Nationally Relevant Health Problems. There is an urgentneed to consider the Multi-disciplinary research. Besides, making available adequatetime to the faculty for pursuing research is equally important.

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

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

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

154. The Committee recommends that there is an urgent need to build a robuststructure which would facilitate Research activities which the Institute seems to lack atpresent. If need be, possibilities should be explored for encouraging collaborativeResearch between the Institute and other reputed medical institutions in the countryand abroad.

155. The Committee feels that though AIIMS has been able to carry out internationallycomparable research activities, yet a lot remains to be done in translating the researchoutcomes into health products. The research should be result oriented and the results

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should be implementable so that it does not remain confined to laboratory or only onpaper but ameliorates the lot of the common people.

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

XVIII. Patient Care

157. The Committee finds that the average waiting time for patients in getting datesfor surgeries, various processes and tests is too long. The Committee is aware of thefact 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 eachdepartment should be opened which would, depending on the severity of the disease, putin place a grading system under which patients having disease of severe nature can beoperated earlier and those who have a less serious complication can be operated lateras straitjacketing of surgeries on first-cum-first serve system does not do justice to thepatient having serious complications. The Committee recommends that the Instituteshould devise a screening wing for each Department which, the committee feels, wouldbe 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 accordedto the patients coming from outside Delhi as they come to the Institute only afterexhausting all the medical avenues and resources at their place of stay and their plightis the worst amongst all patients visiting the Institute.

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

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

XIX. Students’ Welfare

161. As in case of any university, the students are the backbone of AIIMS and theyhave contributed significantly to the reputation of the Institute with their selflessservice and dedication. Students Welfare, therefore, should be the top most priority ofAIIMS as it simultaneously ensures both a better academic environment and a betterpatient care. The Committee, therefore, recommends that the Government shouldensure that all facilities for academic pursuits, research activities, infrastructure andwelfare of students should be put in place on war footing. There should be reservation

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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 theentire duration of their study period. The Committee further desires that professionalcounseling and other sub measures should be put in place to help the students facingdifficulty with their syllabi.

XX. Innovations

162. The Committee notes that professional health education of the pioneering kindwas the fundamental reason for the establishment of the Institute. Several innovationsin education (e.g. rural internship, present phases of MBBS programme, 3 yearpostgraduate residency system, new DM/MCh courses) were pioneered at AIIMS beforethey became the national norm. Disappointingly, this is not the case now as theoverbearing intrusion by the “service” component of the job profile perhaps does notallow for time to think freely and come up with new and innovative strategies forteaching. The Committee is concerned to note that there has been no innovation,worth mentioning in the Institute for quite some time. The Committee feels thatinnovations should be made and adopted in teaching, learning and assessment. It isnecessary to be aware of the things going on in the rest of the world and alsoimportant to select things which are relevant to the country. Besides, the Instituteshould be able to come up with its own innovations in the medical field which were theprime objectives of AIIMS. The Committee would, therefore, like the Ministry to findout 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 anddeveloping 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 SelectionCommittee (iv) Estate Committee and (v) Hospital Affairs Committee and eachCommittee has been assigned a designated role. But from the information madeavailable 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 arenot held regularly, required details are not put in the agenda and sufficient time is notgiven and sometimes ex-post-facto approvals are taken. This suggests that theestablished structures do not seem to function as they should, which means there is atendency to squeeze the decision-making process. This results in lack of transparencyand accountability and that is why many violations occur. The Committee is convincedthat if regular processes, norms and procedures are observed transparently and if thereis adherence to norms, then a lot of irregularities can be avoided. Taking into accountall these factors, the Committee recommends that the maximum work should be donein the AIIMS Committees because collective decision-making is the best antidote tocorruption and nexus. The Committee also recommends that whenever there is aviolation of norms and processes, the violation must be discussed threadbare in theGoverning Body of AIIMS which is the executive body and swift remedial action taken.

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

164. The Committee would like to make it abundantly clear that though theCommittee is all for professional autonomy of AIIMS, autonomy should not meanautonomy 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, theCommittee had sought a status note on the probes initiated from 2011 to 2014. TheCommittee notes from the information furnished by the Ministry that myriad corruptioncases are under investigation involving AIIMS officials and doctors. The cases includedisproportionate asset cases, procurement of computers and peripherals withoutfollowing the purchase procedure, alleged financial irregularities in purchase of surgicalgloves and medicines, construction of engineering works without approval of thestatutory bodies, alleged tempering with selection lists of operation theatre assistants,irregularities in appointments of officials under sports quota, massive irregular paymentto contractors, irregularities in awarding the work of development of ward and alliedspaces for Department of Pulmonary Medicine, purchase of uniforms for employees, etc.The Committee is perturbed to note that despite unraveling of corruption cases atAIIMS at regular intervals, the Ministry has done away with the regular Chief VigilanceOfficer’s post at AIIMS and the role of anti-graft officer of AIIMS has been assignedto 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 tacklingsuch a large number of cases of corruption at AIIMS and recommends that the Ministryshould quickly move towards appointing a regular Chief Vigilance Officer ofunblemished credentials at AIIMS. Needless to emphasize that the Chief VigilanceOfficer is the only instrument available with the Ministry to monitor statutorycompliance of various prescribed procedures and norms. The Committee alsorecommends the Ministry to play a proactive role in ensuring expeditious investigationsinto all the corruption cases at AIIMS and furnish within three months from the dateof presentation of this Report, an up-to-date status note detailing therein various stagesof cases of investigation, involving corrupt practices and embezzlement of funds andsteps taken to check occurrence of such cases in future.

MINUTES

IFIRST MEETING

(2010-11)

The Sub-Committee met at 11.00 A.M. on Thursday the 30th June, 2011 in RoomNO.‘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 alsoinformed them that the Sub-Committee has been constituted to examine various aspects of thefunctioning of All India Institute Medical Sciences (AIIMS) which is a premier MedicalInstitute in the country. At the commencement of the meeting, the Convenor drew theirattention to Rule 294 (1) of the Rules of Procedure and Conduct of Business in the Councilof 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 declarethe nature of such interest notwithstanding any registration of his interests in theRegister, and shall not participate in any debate taking place in the Council or itsCommittees before making such declaration”.

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3. The Sub-Committee then discussed a number of issues pertaining to AIIMS, like-lowfrequency of meetings of the various Standing Committees of AIIMS; large scale migrationaffecting teaching as well as tertiary care; shortage of faculty; patient services being offeredespecially for the poor patients; faculty matters especially with regard to reservation, properman-power utilisation by entering into some kind of bond with doctors; adequacy ofinfrastructure in view of long waiting period for patients; status of implementation ofrecommendations of Valiathan Committee; need for amendments in the existing legislationpertaining to AIIMS, etc.

4 . The Sub-Committee thereafter discussed its further course of action. It decided tobegin with a briefing meeting with the Secretary, Department of Health and Family Welfarealong 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, Departmentof Health and Family Welfare along with Director, AIIMS at its next meeting scheduled to beheld on the 11th July, 2011.

5 . The Sub-Committee also directed the Secretariat to seek a detailed status note andreplies 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.

I I

SECOND MEETING(2010-11)

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

MEMBERS PRESENT

1. Shri Brajesh Pathak — Chairman

2. Shri Datta Meghe — Convenor

RAJYA SABHA





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




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 agendaof the meeting i.e. oral evidence of the Secretary, Department of Health and Family Welfareand Director, AIIMS on the functioning of All India Institute Medical Sciences.

3 . The Convenor also informed the Members that the Department of Health and FamilyWelfare had sought extension of time for three weeks i.e. upto 21st July, 2011 for furnishingthe replies to the questionnaire. The Sub-Committee discussed the same and acceded to theDepartment’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 requestfrom the Convenor chaired it.

5 . The Sub-Committee, thereafter, heard the views of Secretary, Department of Health andFamily Welfare & Director, AIIMS and other officers of the Institute on various aspect of thefunctioning of AIIMS. Dr Nikhil Tandon, Professor, AIIMS made a power point presentationon 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 presentload; (iv) cost to AIIMS; (v) patient satisfaction; (vi) Post Graduation & ResidencyProgrammes; (vii) holding of various types of training to defence personnel andcandidates sponsored by Government institutions, foreign undergraduates fromcountries like Australia, Bangladesh etc; (viii) landmark research of national importanceon malnutrition, iodine deficiency, liver diseases, lead poisoning in children,tuberculosis, genomic analysis of malaria, stem cell research, vitamin D status in Indiancontext.

6 . Prof. Tandon also informed the Committee that some National Programmes wereinfluenced by AIIMS research like Integrated Child Development Schemes (ICDS), universaliodization of salt, National blindness Control Programme, Fluorosis Control Programme,Tobacco Control Programme and National Programme on Health Care of Elderly and thatAIIMS 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 ofseniority; vacancies and implementation of reservation in faculty posts; autonomy of theInstitute; frequency of meetings of General Body and various Standing Committees of theInstitute; implementation of recommendations of Valiathan Committee; roaster system prevailingin the Institute; filling up of backlog of vacancies; creation of more posts in view of increasingdoctor-patient ratio; commercialisation of research at AIIMS; clinical trials being conducted in

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

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

9 . The Sub-Committee then decided to meet again on the 26th July, 2011 to hear the viewsof 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.

IIITHIRD MEETING

(2010-11)

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

MEMBERS PRESENT

1. Dr. Sanjay Jaiswal — In the Chair

RAJYA SABHA



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


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 thechair in absence of the Convenor. The Members were then apprised of the agenda of themeeting viz. hearing of views of experts on functioning of All India Institute of MedicalSciences.

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

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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 Directorin 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 regularbasis; lack of code of conduct for doctors; faculty development, implementation of AssessmentPromotion Scheme etc. She also informed the Committee that the problems inherent to theAIIMS were complex and a high powered Committee viz. Valiathan Committee gave its reporton the working of AIIMS in 2006. Another High powered Committee was formed on theimplementation of Valiathan Committee which gave its report in February, 2010. Two otherCommittees viz. Professor Maheswari Committee on Internal Governance and JavedChaudhary’s Committee on ‘How to retain faculty of AIIMS’ gave their report. She felt thatit seemed that even these have been gathering dust due to lack or willingness to implement thesame. With regard to patient care she was of the opinion that there should be a concept offiltering and screening OPD patients at AIIMS in view of the huge intake of OPD patients andtreatment of Common ailments may be addressed by peripheral units handled by general dutydoctors. She also felt that AIIMS should take measures to reduce the patient intake in theInstitute to focus on research aspect. She concluded by informing that in matters ofrecruitment, 25% seats should be reserved for direct lateral entry to promote fresh talent inthe Institute.

4 . Prof. S. K. Jindal from PGIMER, Chandigarh informed the Sub-Committee that therewas a gross mismatch between what was required for clinical research and what wasdelivered. 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 fordecentralization of Medical services through opening Kiosks at the peripheral limits of the cityso as to reduce the pressure of patients converging at a single hospital premises, therebyreducing pressure on doctors. On the issue of decision making, he was of the view that aGroup of faculty should be set up which could share responsibility of decision making therebydecreasing the burden of all decision making on the head of the Medical Institution. He wasin 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 onthe working of his Institute. He informed the Sub-Committee that he had the pleasure of beingthe 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 morefunds for Education, Research and Service component, which was not the case earlier. He wasof the view that for any Institute to function in a streamlined manner, there was a need forprovision of different experts, say, one for administering finance, one for administeringaccounts etc. so that the Director/Head of the Institute could focus on planning aspect. On theissue 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 couldfocus 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 theSub Committee that the Institute had been primarily set up for setting new standards and actingas a catalyst for medical education in the country. He felt that there was a need to set up

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AIIMS like Institutes to foster competition as well as reduce the pressure on AIIMS. He feltthat in order to provide uniformity in standards set by AIIMS, there should be rotation offaculty from various Medical Institutes to AIIMS and vice-versa so that the knowledge gainedin 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 optout 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 weaksupport structure; lack of collaboration in the field of research, red tapism etc. He was of theview that there was a need to identify thrust areas for National Interest, some of which canbe 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 outsidecountries in various disciplines so as to get feedback of experiences from foreign medicalprofessionals. On the issue of patient care, he was of the opinion that there was a need toset up a network of hospitals for reducing the burden on AIIMS. AIIMS should instead focuson secondary and tertiary care. There was also a need to undertake computerization andlinkage of patient records to access record of patient from all Departments of AIIMS. On theissue 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 politicalinterference and emphasis should be on the basis of direct lateral entry and not on the basisof entitlement.

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

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

9 . The Sub-Committee adjourned at 4.30 P.M.

IFIRST -MEETING

(2011-12)

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

MEMBERS PRESENT

1. Dr. Sanjay Jaiswal — Convenor

RAJYA SABHA



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





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 thereconstituted Sub-Committee and apprised them of the progress made with respect to theSub-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 meetingi.e. hearing the views of Ms. K. Sujatha Rao, former Secretary, Ministry of Health and FamilyWelfare and Prof. M.S. Valiathan, National Research Professor, Manipal on the subject.

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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 theSub-Committee inter-alia sharing her experience as a Secretary in the Ministry of Health andFamily Welfare especially with respect to various aspects of the functioning of AIIMS. Shestated that there has been a decline in overall working standards of AIIMS during the lasttwenty years. She observed that the main reasons behind this were - the large scaleinterference of the Ministry into its day-to-day functioning; large scale demoralization in theAIIMS 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 highlycentralised administrative structure; less autonomy and representation to internal governance;infrastructure constraints like delay in procurement of advanced/modern hi-tech instrumentslike 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 thein-patients; lack of realistic Budget for the Institute; and, lack of delegation of powers to theDirector of the Institute to appoint doctors/supporting staff on temporary/contractual basis toease out workload and carry out patient-care functions and for taking other decisions forbetterment 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 bedecentralization of powers and the Institute needs to be headed by a professional, notnecessarily a doctor. Such professional should have sound knowledge in Human Resources,hospital management and stock and inventory management. She also touched upon the ValiathanCommittee Report on the subject. During the presentation, Members raised some querieswhich were replied to by Ms. Rao.

4 . Thereafter, the Sub-Committee heard the views of Prof. MS. Valiathan, NationalResearch Professor, Manipal University, Manipal. During his presentation, he gave backgroundof the Valiathan Committee constituted under his Chairmanship in 2006 with three othermembers. He dwelt upon various issues related to Valia than Committee Report as well as theoverall functioning of the AIIMS, which included - the terms of reference of ValiathanCommittee; need to make AIIMS truly professional body oriented towards generatingknowledge and technology for which it was originally conceived; lack of personnel policy inAIIMS; preponderance of Government officers/Government-nominated members and lack ofrepresentatives from Faculty in the Institute Body/other Committees of the Institute; need forhigh quality public health oriented research in the Institute; fixing better criteria for nominationof members to various Committees/Bodies of the Institute; the need for fixing more rigorousnorms 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.

IISECOND MEETING

(2011-12)

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

MEMBERS PRESENT


RAJYA SABHA




LOK SABHA

5. Dr. Jyoti Mirdha


7 . Shrimati Harsimarat Kaur Badal


9 . Shri Radhe Mohan Singh (Ghazipur)

10. Shri Ashok Argal

SECRETARIAT





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 theagenda of the meeting i.e., to hear views of Prof. Subrata Sinha, Director, National BrainResearch Centre, Manesar, Haryana; Prof. Pratap Sharan, Departement of Psychiatry, AIIMS

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

3 . The Sub-Committee first heard views of Prof. Subrata Sinha. Prof. Sinha expostulatedhis views on the functioning of AIIMS in light of the Valiathan Committee Report and the HighPowered Committee Report of Ms. Sujatha Rao on the recommendations of the ValiathanCommittee Report which inter-alia also included a study undertaken by Prof. Sunil Maheswariof IIM, Ahmedabad. He was of the view that the Valiathan Committee Report was orientedmore towards making the Institute a revenue generating model. According to him, the mainissue concerning AIIMS was intellectual autonomy and corporatization of AIIMS would hit itsintellectual autonomy. He felt that the main problems plaguing the Institute was lack of FacultyDevelopment due to negative interpretation of rules thereby making the atmosphere restrictiveinstead of an enabling one. He was also of the view that the Director of the Institute shouldbe from amongst the faculty and political appointments for the post of Director should beavoided. He also shared his views on incentivisation, Government funding of AIIMS and itsimpact on the autonomy of AIIMS. The Members raised some queries which were replied toby the witnesses.

4 . The Committee then heard views of Prof. Pratap Sharan and Prof. Anoop Saraya. ProfSharan informed the Sub-Committee that the model of AIIMS based on the AIIMS Act passedby the Parliament in 1956 had worked well for more than 5 decades and was being replicatedto create six more AIIMS like Institutes in the country. Dr. Sharan shared his views on theValiathan Committee Report; structural changes in AIIMS as suggested by the ValiathanCommittee and grievance redressal mechanism in the Institute. Prof. Sharan stressed on theneed for maintaining a balance between Research and Patient care at AIIMS which could beachieved by increasing the number of faculty which would enable the faculty to devote timefor research activities in addition to meeting the needs of the patients. Besides, he also raisedissues like need for a separate Research Cadre for streamlining research; setting up of a corpusof National Research; need for integration of AIIMS with National Issues; doing away withAdhoc interpretation of Rules; need for doing away with Contractual Appointments;implementation of a rule based governance rather than ad-hocism; transparency in decisionmaking; increase in the component of research funding; not compromising the concept ofequity at any cost; the financing of care and education at AIIMS. Prof. Anoop Sarayaemphasized that all efforts for commercialization/corporatisation and outsourcing of clinicalcare should be stopped; rules and regulations of the institute should be in line with deemeduniversity status than as a Central Government department status as this would yield greateracademic and research autonomy and less bureaucratic interference; doing away withincentivization, need for screening OPD based on medical condition to filter out non-seriouspatients; need for the audit of AIIMS done by AGCR and CAG; need for strengthening of thePeripheral Health Institutes, reduction in bureaucratic red-tapism etc. Members sought somequeries 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.


IIITHIRD MEETING

(2011-12)

The Sub-Committee met at 3.00 P.M. on Wednesday the 7th December, 2011 in RoomNo. ‘63’, First Floor, Parliament House, New Delhi.

MEMBERS PRESENT


RAJYA SABHA

2. Shrimati Viplove Thakur


LOK SABHA

4. Dr. Jyoti Mirdha



SECRETARIAT





WITNESSES

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

2. Shri P.S. Krishnan, Former Member Secretary, National Commission for BackwardClasses

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

4 . Dr. Debjyoti Karmakar, President and Dr. Bhaumik Shah, Representative, ResidentDoctors’ 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 apprisedthem about the agenda of the meeting i.e., to hear views of the experts and representativesof various associations and the Ministry of Health and Family Welfare and AIIMS on (i) theimplementation of reservation policy in AIIMS; and (ii) the various aspects relating tofunctioning of AIIMS.

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

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

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

6 . Thereafter, the Sub-Committee heard the views of the representatives of ResidentDoctors Association, Students’ Union and Society of Young Scientists in AIIMS. Dr. Karmakar,highlighted the following points viz . lack of transparency in many matters dealt byadministration at AIIMS; absence of a vision charter, jmasterplan; loopholes in recruitmentprocedures and ambiguity in reservation in MBBS, MD; unimpressive leadership in areas ofvital concern like research; growing concern about mishandling of funds in respect toprocurement of equipments; non-percolation of benefit with regard to international collaborationto MBBS students and difficulty in getting scholarships; contractual appointments; need forcorrective measures to set right perceived corruption in examinations; need for streamlining thevarious components of lab and diagnostic services; need for establishment of screening OPDsto filter out critical ailments. Representatives from Student Union, AIIMS raised issues like lackof a proper procurement policy; need for regular interface between administration and students;

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installing CCTV cameras for security purposes and absence of proper reservation mechanismfor Students from AIIMS for Post Graduate seats. Besides, the issue of plagiarism and the roleof Medical Superintendent being made redundant also figured in the discussion.

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

8 . Members sought some queries which were answered by the witnesses. The Convenorasked the witnesses to furnish their further submissions, if any, in writing to enable theCommittee 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.

IVFOURTH MEETING

(2011-12)

The Sub-Committee met at 3.00 P.M. on Wednesday the 14th December, 2011 in RoomNo. ‘63’, First Floor, Parliament House, New Delhi.

MEMBERS PRESENT


RAJYA SABHA

2. Dr. Vijaylaxmi Sadho

3. Shri Derek O' Brien

LOK SABHA

4. Dr. Jyoti Mirdha

5. Shri Datta Meghe

SECRETARIAT





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 apprisedthem about the agenda of the meeting i.e., to hear the views of (i) Prof. P.K. Dave, FormerDirector, AIIMS; and (ii) Dr. Manoj Singh, President, Faculty Association, AIIMS along withhis colleagues.

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3. The Sub-Committee first heard the views of Prof. P.K. Dave on the administrativereforms in AIIMS, Prof. Dave shared his experiences on the working of the Institute. Hehighlighted the following points for improvement in the functioning of AIIMS viz. makingAIIMS a referral hospital as the same would reduce the patient load and help the faculty todevote more time for teaching and research work; need for according complete autonomy toAIIMS as envisaged in the Bill piloted by Smt. Rajkumari Amrit Kaur in 1956; need to identifythrust areas in the planned budget of the governing body at the beginning of each year whichwould result in increase in the clinical & research facilities and development aspects; properimplementation of envisioned development plan in various centres, convention centre and otherinfrastructural facilities; filling of all the vacant posts; regular holding of meetings of standingcommittee, internal meetings (faculty meeting and staff council), etc.

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

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


7 . The Sub-Committee was adjourned at 4.05 P.M.

VFIFTH MEETING

(2011-12)

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

MEMBERS PRESENT


RAJYA SABHA




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




WITNESSES

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

Ministry of Urban Development

Shri D. Diptivilasa, Additional Secretary


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 apprisedthem about the agenda of the meeting, i.e., to hear the views of (i) Sh. K. B. Saxena, FormerSecretary, Government of India, (ii) Sh. D. Diptivilasa, Additional Secretary, Ministry of UrbanDevelopment alongwith representatives of Department of Health and Family Welfare and AllIndia Institute of Medical Sciences (AIIMS) and (iiii) Dr. M. K. Bhan, Secretary, Departmentof Biotechnology, Ministry of Science and Technology, on the various aspects relating tofunctioning 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 managedaccording to good administrative practices. However, the deterioration of the Institute set inwhen a blind eye was turned to all the rules and recruitments in the institution were madein violation of all rules especially in matters of reservation in the Institute. To compoundthis, user charges were introduced on all and sundry irrespective of the economic well-beingof the patient who came to the Institute for treatment. He felt that even though the Institutewas still rated as a best institution, it suffered from basic governance problems. Hesubmitted that two major kind of problems were facing the Institute (a) poor PersonnelManagement and (b) irregular Financial Management. On the Personnel Management front, hewas of the view that the best way to avoid the mess created in the recruitments was to handover recruitment of medical doctors to an autonomous body like UPSC and those of medicalstaff to SSC, which could objectively handle the recruitments by ensuring filling of seats asper Government Rules. He was of the view that the established structure was not workingas per the expectations and was leading to lack of transparency and accountability. Withregard to Financial Management, he informed the Committee that in order to ensure properaccounting procedures, a Selection Committee should be put in place with impetus on welldefined procedures to ensure objective selection of the person who would head the FinanceDepartment of AIIMS, who could work independently without undue pressure or interferencefrom the Ministry of Finance or Ministry of Health and Family Welfare. He strongly favouredthe financial autonomy of the institute and objected to any proposal for drawing moneyoutside the Government for managing the Institute. The Convenor requested the witness tosend 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-Committeealso directed that a note on action taken against the persons involved in irregularities inAIIMS should be sought from the Department of Health and Family Welfare. Members raisedsome queries which were answered by the witness.

4 . Thereafter, the Sub-Committee heard the views of Shri D. Diptivilasa, AdditionalSecretary, 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 inorder to enable AIIMS to carry out its redevelopment plans. Shri Diptivilasa, AdditionalSecretary, informed that at a meeting held on 15th February, 2012, it was suggested that giventhe 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 bemoved 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 atMasjid Moth from ‘Residential’ to ‘Public’ and ‘Semi-Public’ (PS-1, Hospital) has been movedseparately and is under active consideration of the Ministry. The Sub-Committee felt that therehas been undue delay in the issue of land usage change, since the proposal was moved in 2005and nothing has happened till date. The Sub-Committee directed the Ministry to provideinformation on the reasons for delay and the names of the persons responsible for thisinord-inate delay along with (i) copies of correspondence between DDA and Ministry of UrbanDevelopment; (ii) Minutes of meetings of the Ministry held in this regard. The Sub- Committeealso sought to know, the other proposals for land use change passed by the Ministry of UrbanDevelopment during the period. The Sub-Committee directed the Ministry of UrbanDevelopment to expedite the matter. The representatives of the Department of Health andFamily Welfare informed that after the notification for land use change is received from theMinistry of Urban Development, the Department of Health and Family Welfare would moveforward to get the building plans approved from NDMC and construction of 3 new blockswould 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 takenby it to pursue the matter with the Ministry of Urban Development. Members made somequeries which were replied to by the witnesses. The Convenor directed the witnesses to sendfurther 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, andDepartment of Biotechnology on research aspects pertaining to AIIMS. Dr. Bhan made apower-point presentation on the importance of research in premier medical institutionsincluding AIIMS. He was of the view that provision of funds for research alone could notensure a strong research base for the country. He informed that a strong base of researchersneeded to be set up, as the gestation period in the field of research to fructify was very longranging from 10 to 15 years. To ensure this, stability in value systems was not enough, therewas a strong urge to adapt to the changing times. He dwelt at length on the importance ofresearch for medical schools. He was of the view that in order to ensure cutting edgeresearch, there was a need to focus more on the biology of disease instead of just focusingon studying the biology of cells. The concept of Doctor need not be seen just as a patienthealer but also as a health-economist, researcher etc. There was an urgent need to treathospital as one part of medical school and not as a be-all and end-all focus of a doctoremployed there. He further dwelt on the (i) need for division of research into Basic MedicalResearch, Clinical Research, Translational Research; (ii) need for diverse talent pool requiredfor each type of research; (iii) formation of a separate eco-system; (iv) creation of centreswhich would support department structures which could be compartmentalized under fourheads 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 HospitalMedical Centres and Academic Medical Centres; (vi) need for setting up ‘Academic MedicalSchools’ throughout the country; (vii) setting up of centralized research resources for each

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type of research; (viii) Financial Resources for research not only from Government but alsofrom the Private Sector etc. The Members then raised certain queries which were replied toby Dr. Bhan. The Convenor asked him to send further suggestions, if any, which he wouldlike 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 respectof major works being carried out in the AIIMS. The Sub-Committee directed the Secretariatto seek clarifications from the Ministry in the regard.

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


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


RAJYA SABHA


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


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 apprisedthem about the agenda of the meeting, i.e., to hear the views of (i) Shri Manoj Joshi, JointSecretary, Department of Personnel and Training, (ii) Shri Satish Chandra, Joint Secretary andLegal Advisor, Department of Legal Affairs, (iiii) Shri Keshav Desiraju, Special Secretary,Department of Health and Family Welfare along with representatives of the Department andAIIMS on the issue of implementation of reservation of SCs, STs and OBCs in the All IndiaInstitute of Medical Sciences(AIIMS).

3 . The Sub-Committee first heard the views of Manoj Joshi, Joint Secretary, Departmentof Personnel and Training on issue. Shri Joshi stated that the Cabinet Secretariat hadconstituted a Committee on 11.02.2009 to examine the matter regarding the special recruitmentdrive by AIIMS for SCs, STs and OBCs for filling up 92 vacancies in the Grades of AssistantProfessor, Associate Professor, Additional Professor and professor in the Year 2008 with therepresentatives from DOPT, Ministry of Health and Family Welfare and D/o Legal Affairs. TheReport of the said Committee had been forwarded to the Ministry of Health and Family Welfarein 2009, but there had been no communication from the Ministry Of Health and Family on theaction taken by the Ministry on the said Report. Members raised certain queries viz. thedifference between shortfall. vacancy and backlog reserved vacancies, what is floatingreservation, procedure for de-reserving a reserved post, applicability of DOPT guidelines toAIIMS in respect of reservation which were partly answered to by the witness. Thereafter, theSub-Committee heard the views of Shri Keshav Desiraju, Special Secretary, Department ofHealth 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 ofreservation, whether Deputy Director (Administration), AIIMS can hold the charge of ChiefVigilance Officer, period for which a joint secretary of the Ministry can remain on deputationetc. which were partly answered to by the witness. The Sub-Committee felt that the answersgiven by the witnesses of the Department of Personnel and Training and Ministry of Health andFamily Welfare were far from satisfactory. The Sub-Committee therefore decided to call theSecretaries 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 perspectiveon the issue of implementation of reservation in AIIMS.

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


VIISEVENTH MEETING

(2011-12)

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

MEMBERS PRESENT


LOK SABHA

2. Dr. Jyoti Mirdha


4 . Shrimati Harsimrat Kaur Badal



7. Shri Ratan Singh

SECRETARIAT



WITNESSES

Ministry of Personnel and Public Grievances and Pensions, (Department ofPersonnel and Training)

1 . Shri P.K. Misra, Secretary, Department of Personnel and Training

2. Shri Manoj Joshi, Joint Secretary, Department of Personnel and Training


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


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.

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7. Members raised some queries which were answered by witnesses. The Convenordirected the witnesses to send further suggestions, if any, which the witnesses wouldlike to share with the Sub-Committee for improving the functioning of AIIMS within aweek’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 the31st May, 2012.

VIIIEIGHTH MEETING

(2011-12)

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

MEMBERS PRESENT


RAJYA SABHA

2. Shri Janardhan Dwivedi

LOK SABHA

3. Dr. Jyoti Mirdha

4. Shri Ashok Argal



SECRETARIAT




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 apprisedthem about the agenda of the meeting, i.e., to hear the views of various witnesses on thefunctioning 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 ofambiguity in the interview procedures for different posts being held at AIIMS right now isthere. 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

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the interviews were conducted by the Selection Committee, AIIMS without consulting thegoverning body.

4 . Dr. Kameshwar Prasad, HOD, Neurology, AIIMS focused his presentation under fourheadings viz. governance, research, patient care and medical education. He suggested theimplementation of Central university model with inclusion of faculty members along withdirector in Governing body of an Institution, rotating headships with all perks and facilitiesaccording to government pay scales; conduct of nationally relevant research, balance betweencompany funded research and internal research done by faculty members; formulation ofstringent rules to accept the investigation reports done at AIIMS only to improvise patient care;introduction of innovative techniques in medical education system, appointment of thecompetent 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-aliahighlighting the importance of department of medicine in any medical college viz-a-viz the verypoor status of bed strength, faculty strength, lecture theatres in department of medicines atAIIMS. He also informed the Sub-Committee about the inordinate delay in considering theproposal for introduction of DM Pulmonary Medicine course in Department of Medicine,shifting of DOTS center away from the main Department in his absence without consultinghim, refusal for permission to attend Canadian International Health Research on T.B Research,various administrative issues and grievances, unequal and heavily biased criteria ofappointments of HoDs of various departments, difficulties in purchase of state-of-the artequipments for the department of medicine, issues related to infrastructure, laboratoryfacilities, security and parking issues at AIIMS etc.

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



IXNINTH MEETING

(2011-12)

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

MEMBERS PRESENT


LOK SABHA

2. Dr. Jyoti Mirdha

3. Dr. Sucharu Ranjan Haldar


5. Shri Ratan Singh

SECRETARIAT




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)

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

3 . The Sub-Committee first heard the views of Shri D. Diptivilasa. He informed theCommittee that the issue regarding conversion of land behind AIIMS from ‘residential’ topublic/hospital had been cleared by the Ministry of Urban Development on 15th May,2012 andthe 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, Departmentof Health and Family Welfare along with Director and Deputy Director(Admn.),AIIMS onvarious issues concerning the functioning of AIIMS viz.-delay in taking of charge by the newChief Vigilance Officer(CVO) and reasons therefore; steps taken for divesting of charge ofCVO from the present Deputy Director(Admn.); implementation of reservation policy in AIIMSand steps being taken to fill the backlog vacancies in view of opinion given by Department ofPersonnel to treat vacancies in the reserved category as backlog vacancies; allegation ofradiotherapy treatment of dog being conducted in AIIMS; Interviews for various faculty postsbeing conducted without the approval of General Body (G.B.) and appointment letters beingissued without G.B. approval; latest position with regard the scientific and technical posts inAIIMS; roadmap for appointment to all posts remaining vacant in AIIMS; criteria for selectionwhile conducting interviews to various posts; details of minutes/ agenda of meetings ofStanding Committees, General Body and Institute Body during the last five years; engagementof persons in contractual positions; allotment of out of turn Government accommodation whichwere partly answered to by the witnesses. Members also sought information from the Ministryon (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 thewitnesses would like to share with the Sub-Committee for improving the functioning of AIIMSalong with queries remaining unanswered within a week’s time.



IISECOND MEETING

(2014-15)

The Committee met at 2.30 P.M. on Thursday, the 18th September, 2014 in RoomNo. ‘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


8. Chaudhary Munvvar Saleem

9. Dr. T.N. Seema

LOK SABHA

10. Shri Thangso Baite

11. Dr. Ratna De (Nag)


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

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SECRETARIAT





WITNESSES

* * *

* * *

I . Opening Remarks

2. * *

3 . The Chairman sought the views of the Members of the Committee on the subjectsdeliberated in the last meeting. After some discussions, it was decided that the followingsubjects 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

VFIFTH MEETING

(2014-15)

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

MEMBERS PRESENT


RAJYA SABHA

2. Shri Ranjib Biswal

3 . Shri Vijay Goel

4 . Dr. R. Lakshmanan



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



15. Shri Alok Sanjar

16. Shrimati Rita Tarai

SECRETARIAT






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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 apprisedthem of the agenda of the meeting, i.e., to hear the Secretary, Department of Health andFamily Welfare on * * * and (ii) the functioning of All India Institute of MedicalScience (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 andFamily Welfare on the functioning of AIIMS. He inter alia submitted that the AIIMS, Delhi wasset up with the mission of providing medical education, research and patient care in thecountry. At present AIIMS has a total of 52 Departments out of which twenty-five are clinicaldepartments including six super-specialty centres that manage practically all types of diseaseconditions with support from pre-clinical and para-clinical departments. AIIMS also runs a 60bedded hospital and the Comprehensive Rural Health Centre at Ballabhgarh in Haryana. Dr. AmitGupta, Additional Professor, AIIMS made a power point presentation on AIIMS delineating thefollowing points viz. organizational structure of AIIMS; courses offered in undergraduate andpostgraduate level; training opportunities; Extramural Research and Intramural ResearchProjects (2014-15) being undertaken; landmark Research of National importance beingconducted in the field of malnutrition, Diarrhoeal & liver diseases etc.; National Programmesand Policies influenced by research done at AIIMS like Integrated Child Development Scheme,Universal iodization of Salt, Hepatitis vaccination Policy; main hospital, centres and outreach ofAIIMS; total Bed strength (2428 out which 2164 for general & 264 for private); increasingtrend of patient load creating difficulties; landmarks made by AIIMS; computerization and


85

digitisation of current facilties for increasing efficiency and bringing transparency in thefunction 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 andJodhpur; method of social and economic evaluation of person below poverty line who does nothave BPL card; list of medicines being supplied free in AIIMS; need for increasing budgetarysupport to AIIMS; quality of research; maintaining Electronic Health Record(EHR); need to setlimit for waiting time of patients; need to appoint patient counselors in the Institute on regularbasis; mortality rate including infant mortality rate in AIIMS; need to conduct regular meetingsof five Committees of AIIMS as well as AIIMS like institutions; lack of residentialaccommodation for faculty in AIIMS; reasons for large number of vacancies in faculty andnon-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 theCommittee.

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


9 . The Committee then adjourned at 4.10 P.M.

IXNINTH MEETING

(2014-15)

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

MEMBERS PRESENT


RAJYA SABHA

2. Dr. Bhushan Lal Jangde



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




14. Shri Raj Kumar Singh


16. Shri Manohar Untwal

17. Shri Akshay Yadav

18. Dr. Pritam Gopinath Munde

SECRETARIAT






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WITNESSES


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 apprisedthem 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 MedicalSciences (AIIMS); and * * * The Chairman then recalled that in the last meeting held onthe 22nd December, 2014, Members had sought more time to examine in greater detail thevarious issues concerning AIIMS before finalizing the Report. Similarly, subsequent to listeningto representatives of IMA on functioning of CGHS in the meeting of Committee held on 19thNovember, 2014, it was decided to hear the Ministry on the issues raised by the IMArepresentatives. Accordingly, the Health Secretary had been invited to depose before theCommittee on both the subjects. However, the Secretary had expressed his inability to appearbefore the Committee and sought exemption from personal appearance as he has beenscheduled to visit Barabanki District, Uttar Pradesh, during 14-16 January, 2015 as per thedirection of Hon’ble Prime Minister and requested to allow Shri Arun Kumar Panda, AdditionalSecretary along with Director (AIIMS) for presentation on AIIMS and * * * on his behalfwhich 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, AdditionalSecretary and representatives of AIIMS on the functioning of AIIMS. Shri Panda inter aliasubmitted that on the issue of reservation, the Government had constituted an Inter-Ministerial


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 thejudgment of the Hon’ble Supreme Court dated 16.1.2014, on the said issue, which would beimplemented by the Department of Personnel and Training (DOPT). On the issue ofAssessment Promotion Scheme, the Committee was informed that lateral entry had reduced. Onthe issue of Clinical Trials, it was submitted that all rules and regulations were being adheredto and regarding procurement, it was informed that all General Financial Rules were beingadhered to. On the issue of plagiarism, it was informed that the Institute was against plagiarismof any kind and lastly there was no deterioration in functioning of AIIMS and the Instituteadhered to highest standards of care. Dr. V. Srinivas, Deputy Director(Administration), AIIMSgave a brief history of the genesis and implementation of reservation in AIIMS and informedthat 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 thereserved categories since the last 16 years when the Institute has started implementation ofreservation 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 issueof long waiting period for surgeries; reports in media of devices purchased by the Institute butlying idle due to non-installation; procedure for selection of faculty; measures taken to curbovercrowding in the Institute and need to introduce more super-speciality centres; residentialfacilities for the faculty and staff; status of implementation of the Valiathan Committee Reportetc. 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 Committeeand assured to furnish written replies of those queries which remained unanswered within aweek’s time.

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


10 The Committee then adjourned at 4.00 P.M.

XXIVTWENTY-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


RAJYA SABHA

2. Dr. Bhushan Lal Jangde

3. Dr.R. Lakshmanan


5. Shri Jairam Ramesh

6. Dr. T.N. Seema

LOK SABHA

7. Dr. Heena Vijaykumar Gavit

8 . Dr. Sanjay Jaiswal

9 . Shri Arjunlal Meena


11. Shrimati Ranjanben Bhatt



SECRETARIAT


Shri Pradeep Chaturvedi, Director


Shri Dinesh Singh, Joint Director


1. Opening Remarks

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

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3. The Committee then considered and discussed the draft 87 th Report on theFunctioning of All India Institute of Medical Sciences. Few changes were suggested byMembers for incorporation in the Report. After some discussion, the Committee adopted thesaid Report with some modifications. The Committee, thereafter, decided that the Report maybe 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. HeenaVijay kumar Gavit and in her absence, Dr.Shrikant Eknath Shinde to lay the Report on theTable 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


4. Shri Mohd. Ali Khan

5. Dr. Prabhakar Kore

6. Dr. R. Lakshmanan

& 7. Shri Rasheed Masood

8. Shri Jagat Prakash Nadda


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


17. Mohd. Asrarul Haque



20. Shri Chowdhury Mohan Jatua


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.

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94

SECRETARIAT



Shrimati Arpana Mendiratta , Joint Director




(2012-13)


RAJYA SABHA


*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


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


18. Mohd. Asrarul Haque




22. Shri Mahabal Mishra

23. Shri Zafar Ali Naqvi


25. Shri Harin Pathak

26. Shri Ramkishun

27. Dr. Anup Kumar Saha


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.

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SECRETARIAT







(2011-12)


RAJYA SABHA

*2. Shri Janardhan Dwivedi%3. Shrimati Viplove Thakur

4 . Dr. Vijaylaxmi Sadho5. Shri Balbir Punj6 . Dr. Prabhakar Kore7. Shrimati Vasanthi Stanley

^8. Shri Rasheed Masood9. Shrimati B. Jayashree

10. Shri Derek O’Brien

LOK SABHA

11. Shri Ashok Argal&&12. Shrimati Harsimrat Kaur Badal

@13. Shri Vijay Bahuguna14. Shrimati Raj Kumari Chauhan15. Shrimati Bhavana Gawali16. Dr. Sucharu Ranjan Haldar17. Dr. Monazir Hassan18. Dr. Sanjay Jaiswal19. Shri S. R. Jeyadurai20. Shri P. Lingam21. Shri Datta Meghe22. Dr. Jyoti Mirdha

23. Dr. Chinta Mohan24. Shri Sidhant Mohapatra25. Shrimati Jayshreeben Patel26. Shri M. K. Raghavan27. Shri J. M. Aaron Rashid28. Dr. Arvind Kumar Sharma29. Shri Radhe Mohan Singh30. Shri Ratan Singh31. 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.

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SECRETARIAT






(2010-11)


RAJYA SABHA




5. Shri Balbir Punj

6 . Dr. Prabhakar Kore

7. Shrimati Vasanthi Stanley

8. Shri Rasheed Masood



LOK SABHA

11. Shri Ashok Argal

12. Shrimati Harsimrat Kaur Badal

13. Shri Vijay Bahuguna

14. Shrimati Raj Kumari Chauhan

15. Shrimati Bhavana Gawali




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


26. Shri M. K. Raghavan

27. Shri J. M. Aaron Rashid


29. Shri Radhe Mohan Singh

30. Shri Ratan Singh

31. Dr. Kirit Premjibhai Solanki

99

100

SECRETARIAT





SUB-COMMITTEE I ON AIIMS HEALTH AND FAMILY WELFARE

(2011-12)


RAJYA SABHA

*2. Shri Janardhan Dwivedi




LOK SABHA

6. Dr. Jyoti Mirdha

7. Shri Chinta Mohan

8. Shri Ashok Argal

9 . Shri Datta Meghe




13. Shri Radhe Mohan Singh (Ghazipur)

#14. Dr. Monazir Hassan

$15. Shri Ratan Singh

SECRETARIAT





*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



4 . Dr. VijayIaxmi Sadho



LOK SABHA

7. Dr. Jyoti Mirdha

8. Dr. Chinta Mohan

9. Shri Ashok Argal



12. Shri R. K. Singh Patel


14. Shri N. Kristappa

15. Dr. Tarun MandaI

SECRETARIAT





102

ANNEXURE-II

LIST OF WITNESSES

30th June, 2011


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 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 andTraining)

Shri Manoj Joshi, Joint Secretary, Department of Personnel and Training


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


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




21st May, 2012

Ministry of Personnel, Public Grievances and Pensions (Department of Personnel andTraining)

Shri P.K. Misra, Secretary, Department of Personnel and Training

Shri Manoj Joshi, Joint Secretary, Department of Personnel and Training


Dr. B.A. Agrawal, Secretary, Department of Legal Affairs

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

106





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 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


Dr. R.C. Deka, Director, AIIMS

Shri Vineet Chaudhary, Deputy Director (Admn.),

Shri Rakesh Yadav, Sub-Dean (AIIMS)

12th November, 2014


Shri Lov Verma, Secretary

Shri Arun Kumar Panda, Additional Secretary

107


Prof. M.C. Mishra, Director

Dr. D. K. Sharma, Medical Superintendent

Dr. Amit Gupta, Additional Professor

16th January, 2015Department 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 MATTERURGENT

COMMUNICATION FROM DEPARTMENT OF HEALTH AND FAMILY WELFARE.

H-11013/06/2015 ME-1Ministry of Health & Family Welfare

Government of India(ME- I Section)

Nirman Bhavan New DelhiDated 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 herewith50 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

The Institute gets grants under the Heads “Plan” and “Non-Plan”from the Govt. of India, Ministry of Health & family Welfare.Plan grants are also received for National Drug DependenceTreatment, separately. Besides, extramural grants are alsoreceived from various external funding agencies such as ICMR,DST, CSIR, WHO, UNICEF, DBT etc. for various researchprojects. Plan and Non-Plan grants received from theGovernment of India and other agencies are further allocated toSuper-specialties Centres/Departments/Research Section as pertheir projections/requirements”.

The Expenditure during the last five years Plan andNon-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

2012-13 474.00 470.00 420.32 650.00 788.70 899.63 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#

Reply to Questionnaire on functioning of AIIMS

Sr. Queries Reply thereon

1. Budgetary allocationsmade for AIIMS,B.E. and R.E. andactual expenditureduring each of thelast five yearsindicating thejustifications/reasonsfor under utilizations/overspending; if any,and the projects/schemes affectedthereby; and

2. The programmes/projects/schemesinitiated during the last 10 yearsindicating the date of initiation, thetargeted date for their completion,the estimated expenditure thereon,time/cost overruns, if any, thecurrent status thereof and the likelydate of their completion, in respectAIIMS.

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

#Tentative Expenditure, Accounts 2014-15 under compilation

109

Status and Expenditure done on differentprojects at AIIMS, New Delhi during last 10years are enclosed at Annexure- A

110

Status and expenditure done on different projects at AIIMS during last 10 years

SI. Name of Floors/Area Status/ Parking Agency Date of Date of Expected/ Payment PhysicalNo. Project Awarded Cost Start Completion Actual date made till Progress

of completion date work

1 2 3 4 5 6 7 8 9 10 11

Projects of Oversight Committee

1 Convergence G+l0+2 Awarded. All Nil Nice 30.07.13 1.11.13 December `58.89 cr CompletedBlock basements approvals Projects 2013 including

Area-15730 sq.mt. received. Pvt. ltd. consultancyBasement -2900 sq.mt. ` 50.85 crore. Thro’Total 18618 sq.mt. HSCC

2 Hostel Block G+l0+2 Awarded. All 128 M/s RBD, 2.04.12 1.12.13 One Block `51.27 cr 50%basements approvals Reality and completed including completedArea-8218 sq.mt. received Infrastruct February consultancy BalanceBasement - 4935 sq.mt. `72.84 crore. ure Ltd., 2015. work fromTotal 31161sq.mt. Thro’ HSCC Balance 5th floor to

March 2016 10th floorhas beenretendered

3 Dining Block G+2+2 Awarded. All 140 M/S Apex 1.03.12 2.04.12 October `13.74 cr 100%basements approvals Constructions 2013 including completedArea-2634 sq.mt. received Thro’ HSCC consultancyBasement -5672 sq.mt. `12.0 croreTotal 8306 sq.mts.

4 Surgical Block G+9+3 Awarded. DFS 82 M/S Apex Sep. 2013 April October `23.63 cr Work inbasements approval Constructions 2015 2015 including progressArea-12437 sq.mt. received. DUAC Thro’ HSCC consultancy 60%Basement -4404 sq.mt. has approved. completed

111

Total 16841 sq.mt. Plans yet notreleased. NDMCfinal approvalawaited.`50.18 crore

5 Construction G+l1 Plans `l.57 cr Master Planof Houses at Type IV-264 submitted to for of A.V.A.V. Nagar houses MCD. consultancy Nagar and

Type V-44 houses Forwarded to the TypeTypeVI- 44 DFS. Estimated designs arehouses. cost ` 430 to be finally

crore approx. approvedby SDMC.

— — — — — Tendersexpected tobe floatedand awardedby July 2015.30 monthstime periodthereafter.

Other Projects

1 Covering of Covering of 600 mtrs Approval M/s Rama March March Oct. 22.50 Crore CompletedNallha Phase-I of Nallah from received from Constructi 2005 2007 2008

South Ex to MCD on Co.Dental college

2 Construction M/s Kumar July 2012 Oct. 2012 24.11.12 12.50 Croreof out reach Infratech &OPD at Jhajjar Construction

Pvt. Ltd.

112

3 Construction Work had been All approvals CPWD March March March 4.40 Crore Completedof 8 NOs of got done on are in place 2005 2007 2010lifts for Ward deposit basisBlock

4 Construction Three level 450 Final 450 cars M/s V3S 1.11.11 31.10.12 30.10.12 Payment Completedof U.G. car parking completion Infratech made tillMultilevel car received from Ltd dateParking Area 23,129.00 sq.mtr. NOMC and `55.39 cr.

inaugurated including`55.00 cr. consultancycompletion cost

5 Out reach Single storied Awarded cost 50 cars M/s Kumar November Payment CompletedOPD at building of 4500 sq.mtr. 9.50 cr. Revised Infratech & 2012 made tillBadsha Jhajjar cost after deviation Construction date

`12.00 cr. Pvt. Ltd. `14.57 cr.

6 Renovation Single storied Awarded cost M/s Nice 2009 2010 2010 19.76 Crore Completedof RAK OPD building 15.84 Cr. Projects

developing of Revised cost Pvt. Ltd.sample after deviationCollection centre `19.76 cr.and EHS facility

7 Covering of Pier and slab Awarded. 350 cars M/S Rama June 2011 May 2012 August 2013 `27.33 cr. CompletedNallah Ph-II structure Approval of Constr. including

MCD obtained Pvt. Ltd. consultancyfor the covering. Thro’For `20.4 crore CPWD

ProjectConsultants

1 2 3 4 5 6 7 8 9 10 11

113

8 Tunnel Link Cut and cover Awarded. Nil M/S Nov. 2011 October May 2015. `39.00 cr. 98%between method and No statutory Valegha 2012 including completedAIIMS & partially on approvals Constructions consultancyJPNTC surface. required Thro’

except tree DMRCcutting which Projectwas obtaind. Consultants`38.89 crore

9 Renovation of Awarded cost — M/s Kumar 8.05.13 7.09.13 December `6.15 crore 100%CT-2 in CNC 4.00 Cr. Total Infratech & 2014 including completed

Project cost Construction consultancy and`9.00 cr. Pvt. Ltd. operational

10 Private Ward G+9+3 Basement All approval 180 cars Era Infra 19.01.15 18.01.17 18.01.17 1̀0.17 crore Excavation(Revised Area-1334 sq.mt. received Engg. Ltd. including andproposal) Basement -5059 sq.mt. Estimated cost consultancy shifting of

Total 18403 sq.mts. 100 crore. services isin progress.

11 Mother & G+8+3 Approval of 450 cars M/s 11.05.15 10.05.17 10.05.17 `14.04 cr. WorkChild Block Basements DFS obtained. Ahluwalia including awarded

Area-30771 sq.mt. Approval of Contracts consultancy andBasement -15176 sq.mt. DUAC granted. (India) mobilizationTotal 45947 sq.mts. Final Plans Ltd. started at

approved by site.NDMC.Estimated cost180 crore

12 OPD At G+8+3 basements. Approval of 958 cars M/s 11.05.15 10.05.17 10.05.17 `5.49 cr. WorkMasjid Moth DUAC granted. Ahluwalia for awarded

Final Plans Contracts consultancy and

114

approved by (India) mobilizationDFS & NDMC. Ltd. started atEstimated cost site.573 crore

13 Trauma G+7 Approval of — M/s 06.06.14 5th Jan. Jan. 2016 `16.68 cr. WorkExpansion Area-7000 Sqmt DFS obtained. Kumar 2016 including awarded

Approval of Infratech consultancy and 60 %DUAC granted. & workFinal Plans Construction completed.NDMC. Ltd.Agmt amount-`28.48 crore

14 Dharamshala LG+UG+l0 floors Approval of — M/s 04.08.14 March February ` 5.49 crore Work inAt Trauma 288 beds in DFS obtained. Kumar 2016 2016 including progress, 15Centre dormitory, 90 Approval of Infratech consultancy %. CSR

family suites and DUAC granted. & sponsored4 multipurpose Final Plans Construction project byhalls. approved by Pvt. Ltd. Power GridArea- 45886 Sqmts NDMC. for ` 29.0

Agmt. Amount crore.`23.46 crore

15 Cafeteria B+G+2 Approval of — M/s 17.02.15 16.05.16 16.05.16 NIL TendersDUAC granted. Lakshmi invited to beFinal approved Builders awarded inreceived from March 2015.NDMC. Time periodEstimated cost is 15 months.-12.66

16 Construction G+l Floor All approval are M/s S.S. 08.03.2014 07.03.2015 June 2015 17.05 Crore Workof OPD, Hostel in place Total Substantially

1 2 3 4 5 6 7 8 9 10 11

115

and Flats at Construction completedBallabgarh India

Pvt. Ltd.

17 Face uplifting Est. Cost M/s The 12.01.15 11.07.15 11.07.15 ̀1.50 crore Underof gate No.1 `4.00 crore Creators Progressimprove facadeof AIIMS

18 Hostel No.4 G+l0+2 basement. Drawing Tenders aresubmitted to proposed toNOMC, recall, beingapproved from single bidDUAC & DFS. receivedfinal approvalreceived fromNDMC19.10.14Est. Cost `25.00 crore

19 A/A in Guest Final approval UnderHouse received from tendering

NDMC on stage18.10.14

20 Geriatrics Final approval UnderBlock received from tender

NDMC on preparation19.10.14 stage,

approval ofHC recived.

21 Emergency G+l0 DUAC approval NDMCcum received 23rd approvaldiagnostic January 2015. underway.

116

block Detailedprojectreportunderpreparation.

22 National G+7 All approvals 710 ` 10.00 cr. TwoCancer received beds packagesInstitute except EIA under

clearance. EFC tendering.approved for Hospital`2035.00 crore package.

Likely to beawarded byJune 2015.To becompletedbySeptember2017.

23 Balance work 5th to 10th floor Awarded cost M/s Globe 11.05.15 10.04.16 10.04.16 Workof Hostel Block 32.85 Crore Civil awarded

Projects andPvt. Ltd. mobilization

started atsite.

1 2 3 4 5 6 7 8 9 10 11

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DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEE164.100.47.5/newcommittee/reports/EnglishCommittees/Committee … · I, the Chairman of the Department-related Parliamentary Standing