After suffering from a sore tongue for six months, Nuru Mia came to Faridpur Medical College and Hospital from a remote village for treatment and came to know that he had cancer.
When the doctors there advised him to take radiotherapy elsewhere as the hospital did not have radiotherapy facilities, after searching other government institutions, Nuru Mia came to know that he would have to wait 2-3 months to get the treatment.
He could not afford the therapy in a private hospital.
A recent report by the Ministry of Planning's Implementation Monitoring and Evaluation Department (IMED) has revealed this untoward incident regarding the treatment of poor Nuru Mia.
According to the report, linear accelerators, also known as linacs - devices used to treat cancer, were procured to provide radiotherapy services for the hospital, which was set up in 2018, but is yet to be operated due to a lack of manpower.
IMED found the equipment bought for about Tk15 crore locked in two wooden boxes.
It has not been possible to start all the advanced artificial respiratory ventilator (ARV) machines for the Intensive Care Centre (ICU) established through the Faridpur Medical College and Hospital project due to a lack of manpower.
A catheterisation laboratory to perform angiograms is yet to be set up in addition to the linear accelerator for radiotherapy.
IMED also said that due to the non-installation of several purchased equipment, it is not possible to provide full medical services to incoming patients.
The implementation of the Faridpur Medical College and Hospital project started in July 2011 to be completed in December 2013.
However, the implementation of the project was completed in June 2018 after five phase extensions.
The Department of Health has spent 51% more money than the initial budget while implementing the two-and-a-half-year project in seven years.
The work was supposed to be completed at a cost of Tk 314.82 crore, but in the end, Tk473.93 crore was spent.
IMED prepared the impact assessment report of the recently completed project through a private organisation.
According to the report, in Faridpur Medical College and Hospital establishment project, equipment was purchased at several times the market price.
IMED has claimed that there is a lack of initiative in the management of equipment, recruitment of manpower, appointment of doctors and overall management despite the huge interest shown in the purchase.
It said that several corruptions including violation of the Government Procurement Act have been resorted to in the project to purchase at a higher price than the market price.
Seven related audit objections at a cost of about Tk47 crore have also not been resolved.
Pointing out various anomalies in the implementation of the project, IMED said that the project was carried out on the verbal instructions of the former Minister of Expatriate Welfare and Foreign Labour.
IMED also said that many important documents, including the latest amendment document of the project, are missing from the Ministry of Health.
For the expansion of medical education in the country, the government decided to admit 50 students to each medical college by announcing the establishment of 5 new medical colleges in the financial year 1991-92.
Under this announcement, the operations Medical Assistant Training School (MATS) of Faridpur was stopped and Faridpur Medical College and Hospital was set up in its place.
Photo: BFirst
Starting from 1994, the 250-bed hospital was being used for the medical college.
When MATS resumed operations in 2008-09, the lack of a separate academic building and student accommodation for the medical college was evident.
Besides, as the number of students admitted to 100 in the financial year 2005-06, there is a need to increase the number of hospitals with 250 beds.
Taking all these considerations into consideration, the government adopted the scheme in 2011 to establish Faridpur Medical College and 500-bed Medical College Hospital.
Review of objectives
In addition to creating skilled doctors and medical human resources, the goal of providing relatively good medical services at an affordable price to the public has been achieved, IMED said.
According to the report, the number of students admitted to the medical college has increased from 50 to 250 every year.
As the 250-bed hospital has grown to 500 beds, the number of inpatients has increased by 67% and outpatients by 72% in the last five years.
However, despite the huge increase in the number of patients, 33% of the posts of doctors are vacant, and the operation theatres are less than required, so they are suffering to get services, IMED said.
IMED also said that due to the extra time it takes to get treatment, extra money is being spent on travel, waiting and accommodation of patient attendants.
Many complex diseases are being operated on in the operation theatre here.
On average, about 1300 patients are prescribed and treated daily in the outpatient department. In 2018, 241,688 people sought treatment in the outpatient department, and the number of patients at the hospital is increasing every year, IMED said.
As 350 beds in the hospital are covered by non-paying services, many poor patients can take non-paying bed services.
No sustainable plan
IMED felt that the detailed explanation or plan for service management after the completion of the project was not mentioned in the DPP.
According to the report, there is no significant direction in the DPP on what measures can be taken to manage and implement the project under the revenue budget after its completion.
After the completion of the project, it is currently running under the revenue budget, but there is a shortage of manpower in almost all posts.
Negligence in duty, irregularity in procurement process
IMED said that under the scheme, equipment was purchased for the hospital at a price up to four times higher than the price mentioned in the project document.
The approved DPP expenditure estimate is according to the rate schedule of 2008, but at the implementation stage, work orders have been given to follow the rate schedule of 2011 and 2014.
It is further stated that while issuing the work order, the approval of the proper authority was not taken regarding the omission of some items included in the original DPP, reduction of the approved volume and scope and changes in the design.
IMED also said that multiple works have been implemented according to the verbal instructions of the Minister of Expatriate Welfare and Foreign Employment at that time.
Unresolved audit objections
Several audits have been conducted but several objections have not been resolved, IMED said.
Tk46.74 crore in expenses incurred with such outstanding 7 objections.
As a project director, one has the power to contract a maximum of Tk50 lakhs, but the director of this project has contracted to buy goods up to Tk20 crore.
Besides, the audit objection of Tk10 crore of curtains at Tk38.25 lakh per set has also not been resolved.
