How deaths during PM-JAY operation indicate systemic rot in Gujarat

The Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana (PM-JAY) suddenly finds itself facing the risk of a credibility crisis in Gujarat following the death of two beneficiaries who underwent angioplasty on November 11 – allegedly without their knowledge, permission or due diligence.

The procedure was performed by Ahmedabad-based Khyati Multi-Speciality Hospital on seven people after a check-up camp at their Borisana village in Kadi Taluka of Mehsana district, as per an application filed under PM-JAY.

Angioplasty is a medical intervention intended to improve blood flow in blocked coronary arteries. According to reports, the two victims – Mahesh Barot, 52, and Nagar Senma, 75 – had no history of heart disease.

The news of their deaths sparked outrage in the village and beyond and opened a veritable can of worms about systemic loopholes in Gujarat, leaving PM-JAY loans vulnerable to misuse by specialized private hospitals. PM-JAY is the flagship central health insurance scheme launched by Narendra Modi and entitles low-income families and all people above 70 years of age to free medical care. According to the National Health Authority Dashboard, 26.2 million Ayushman cards have been issued in Gujarat, of which 180,000 were issued in the last 30 days.

Sensing yet another case of municipal negligence that could cast a long shadow on governance in Gujarat, the health department suspended Khyati Hospital from the PM-JAY list and filed a case against Dr. Prashant Vazirani, who performed the ill-fated surgeries; hospital owner and chairman Kartik Patel, CEO Chirag Rajput, directors Rajshri Kothari, Dr. Sanjay Patolia and marketing specialist Milind Patel. The charges include culpable homicide, attempted culpable homicide, forgery, fraud and criminal conspiracy.

There were also mass arrests of Dr Vazirani, Milind Patel and Rahul Jain from the hospital management.

Kartik Patel is believed to have left for Australia in early November and several board members and staff have been reported absconding.

The state government also exempted six other hospitals under Chief Minister JAY. Two of them are in Ahmedabad and one each in Surat, Vadodara, Rajkot and Gir Somnath. The government found that these hospitals were violating PM-JAY norms.

Four doctors have been suspended – cardiologist Dr Vazirani, Dr Hiren Mashru (pediatrician, Nihit Hospital, Rajkot), Dr Ketan Kalariya (radiation oncologist based in Rajkot) and Dr Mihir Shah (surgical oncologist, Sunshine Hospital, Vadodara and Surat). The state government has received complaints against all suspended hospitals and doctors for allegedly falsifying reports and giving wrong treatment to patients to avail benefits under the PM-JAY scheme.

The investigation was quickly handed over to the police crime branch, which raided the offices and homes of the hospital’s owner and board members and even stepped in to freeze the assets of the hospital and its top management in order to trace the money allegedly derived from the fraud reported under PM-JAY.

The crime branch’s investigation revealed some sinister details. Sources said that in the last two years, Khyati Hospital has conducted 19 medical camps in villages in north Gujarat. Dozens of angioplasties have been performed recently, and at least six alleged suspects have come to light and are likely to be included in the probe.

Sources claimed that some village heads knew about the fraud and were bribed. Patients’ medical data collected during medical camps were allegedly traded.

Sources said the role of senior health department officials is also being investigated internally as it is known that this type of fraud could not have been committed without official patronage at some level. “These deaths have shed light on a well-planned fraud run by Khyati Hospital for years. “What is particularly disturbing is that through the sarpanch, they have identified and targeted backward and elderly people in the village to carry out these operations, recognizing their vulnerability and lack of understanding of their health complications,” Congress spokesperson Hiren Banker said.

Currently, there is a strong demand and resentment from the opposition on social media for action against hospitals suspected of irregularities related to PM-JAY and a speedy investigation against which complaints have been received. Under fire to defend the credibility of the Central Plan, the Gujarat government has indeed cracked the whip at Khyati Hospital, but it remains to be seen whether it will seize the opportunity to effectively address the systemic rot.

Subscribe to India Today magazine