Medical aid fund has been abused for select few – Goolsarran, Ram

In the wake of the exposing of a secret medical fund for senior government officials and others, former Auditor General Anand Goolsarran and commentator Chris Ram have branded the scheme as an abuse of taxpayers’ funds and called for reforms.

The report in the February 27th edition of Stabroek News on the fund has triggered widespread concerns particularly at large amounts for dental work for two ministers.

The 2012-13 list includes over $116M spent in one year on cancer treatment for now deceased presidential advisor Navin Chandarpal.

The report for the 2012-2013 period which lists 942 persons from Regions 1 to 10 who received subsidized and full financial assistance for medical treatment, was seen by Stabroek News and had an overall total of $361.4M. Chandarpal’s expenses topped the amount given to a patient with cancer as similar patients, diagnosed with the same disease and who requested varying amounts were only given a fraction for their treatment. This ranged from $400,000 to $5M of over $116M sought by the patients.

Of ten cheques given for dental work, which totalled $4.2M, nine were for Minister of Amerindian Affairs Pauline Sukhai $2.1M, Minister of Human Services Jennifer Webster $1.3M, Prime Minister Sam Hinds $28,240 and his wife Yvonne $788,880. A total of $25,160 was paid for the other person who benefitted from dental assistance.

Attorney General Anil Nandlall racked up some $4.9M in medical expenses in September 2012 in the United States. The cheque for the 42-year-old Nandlall lists “medical support” as the diagnosis.

Minister in the Ministry of Agriculture Ali Baksh received medical assistance for a coronary artery bypass at a cost of $12.2M. This is in addition to $249,600 for his airfare.

In his column in yesterday’s Stabroek News, Goolsarran averred that senior public officials, including Ministers of the Government and their families, are not expected to benefit from the programme.

“Ministers enjoy decent monthly salaries of $580,000 each while the Attorney General and the Prime Minister receive $1.6 million and $1.5 million respectively. They are also in receipt of a range of benefits including: duty-free concessions on one motor vehicle every three years; house allowance of $25,000 per month or official residence; 24-hour guard service; chauffeur allowance of $107,000 per month; free electricity, telephone and maid and handyman/gardener services; vacation allowance of $420,000; and generous per diems while on overseas travel.”, he stated

Since the early 1990s, Goolsarran said that the Georgetown Hospital, a public corporation with its own board, has received significant funding from Central Government as well as from the Inter-American Development Bank by way of loans and grants to upgrade its operations. He said that one would therefore expect that the beneficiaries would have first sought the services of this institution and if the specified treatment was not available, the next alternative was to seek to access the services of private hospitals. He said that it was only when these two options were exhausted that overseas treatment should be considered.

Adverting to the several high dental bills, Goolsarran said that these amounts must be viewed in the context of the prevailing costs of various services, such as tooth extraction ($3,000 – $3,500), general cleaning ($6,000- $8,500), filling ($5,500), root canal ($30,000), available at local dental institutions. The Cheddi Jagan Dental Centre charges nominal fees of $100 for extraction and $300 for cleaning and for filling, he added.

Noting that the Ministry of Health had accused the media of being unethical in the disclosures, Goolsarran said that since the resources of the taxpaying are involved, citizens have every right to reasonable access to information about who the beneficiaries are, the amounts expended, and the general nature of the medical condition that necessitated State intervention. He said that had it not been for disclosures by the media, such access would not have been forthcoming.

Pointing to conflicting government statements on the parameters of the fund, Goolsarran said that the widespread use of discretionary powers poses significant risks for abuse of authority and misuse of public resources, particularly for partisan interests.

“Why would one discard a rule-based system with all its merits in favour of one based on discretion? “, he asked. Referring to Head of the Presidential Secretariat Dr Roger Luncheon’s statement that the medical assistance programme was a condition of service, Goolsarran said that “I was a senior public servant from 1985 to 2004, and more specifically Auditor General from 1990 onwards. I, however, never came across a single case where medical assistance was a condition of service of any public servant regardless of his or her position!”

Goolsarran also pilloried the response of the present Auditor General, Deodat Sharma on the matter. Sharma had told Stabroek News that he found no discrepancy in relation to the medical assistance programme and that audit sampling procedures were used. He also referred to the risk-based approach that the Audit Office adopts in its audits and the materiality of the amounts involved.

Goolsarran said that if the Auditor General had asked for the list of beneficiaries, the most casual inspection of it would have been a revelation for him. He noted that the sad part was that Sharma’s number two, Gitanjali Singh, wife of Finance Minister Dr Ashni Singh is one of the beneficiaries of the secret scheme.

“State Audit is far more rigorous and requires the Auditor General to be     the watchdog of public accountability and the eyes and ears of the taxpaying public. Instead of the stout defender of the public interest, the Audit Office has become the pliant, malleable and cosmetic oversight outfit serving the interest of the political directorate.  How unfortunate!” Goolsarran declared.

He said that an urgent review of the programme is therefore necessary, and a forensic audit should be undertaken to ascertain whether any irregularities have occurred. He said that those who have benefitted from dental work undertaken at the expense of the State should, at a minimum, refund the related amounts to the Treasury.

Ram in a Stabroek News letter of March 8 said that while he believed that the government has a duty to provide medical service to its employees, the Consolidated Fund is not a contrived pool of insurance for ministers, their families, friends and others.

He praised the media for exposing the scheme.

“The publication of the information is a triumph of the people versus the state. That bit of enterprise is worth more that the entire budget of the Office of the Commissioner of Information. Predictably, the PPP/C assumed the role of victim when the information was revealed by our more enterprising media. Happily, what the PPP/C did of course was to confirm the veracity of the information and plead then patient confidentiality to justify their rape of the public purse”, Ram stated.

He noted that in July last year he had written a letter to the press questioning the role of Cabinet in adjudicating over the health issues of citizens. He said that his letter was prompted by the death of a family member, 57-year old Basdeo Gobin, who passed away while his application for assistance languished among Cabi-net’s papers.

Ram said that the same Cabinet that failed to respond to a request for a contribution to the cost of a heart operation which might have saved the life of a poor man, approved payment for all sorts of vanity expenditure for ministers and senior party members.

“Despite all the questions asked, no one has put in the public domain the rules and the procedures for the government medical assistance scheme and indeed the relationship between that scheme and the medical scheme offered by the National Insurance Scheme”, Ram lamented.

Reflecting on the fact that Justice B S Roy was one of the beneficiaries of the scheme, Ram said that he was aware of the convention that judges do not engage in public exchanges and he respected that. “But I believe that when a sitting judge seeks out discretionary benefits from the executive, whether in the form of medical assistance or other facilities, they run the serious and real risk of compromising not just themselves but the entire judiciary.

“My question to Justice B S Roy is whether he considered the implications of accepting discretionary benefits from the Cabinet of Guyana”, Ram added.

He said that he would ask the same question of Mrs Singh, the Deputy Auditor General in the Audit Office, who he said the public believes is already compromised by remaining with the Audit Office while her husband is the Minister of Finance.

Additional questions he said that he would have for Singh are whether a) she is aware of any documentation to regulate the operation of the scheme; b) the specific source of the funds; c) the specific bank account from which the payment is made; d) confirmation that it is not one of the many slush funds operated out of the Office of the President; and e) whether she can give the public a single instance of the annual report of the Audit Office commenting on this scheme.

He also asked Attorney General Nandlall whether he had paid back the $4 million he received from the scheme.