211 Closure of World Bank
funded health care project
Punjab Govt Commission for
closure of World Bank funded health care project
-- By Vineeta Gupta,
General Secretary, Insaaf International
Al PUCL Bulletin, September
2002
so see, Improved Services
or Abetting Deaths
The State Public Sector
Disinvestment Commission has recommended to the
State Government to wind up World Bank Funded
Punjab Health Systems Corporation (PHSC). It
vindicates the stand of Insaaf International
since the beginning of this project that PHSC
was created by domestic rulers to engulf the
funds taken as loan from the World Bank. Agenda
of the World Bank was to heap the debt without
going into viability and impact of this project
on the poor people especially women, to serve
its hidden agenda of socio-economic subjugation.
In my meeting with World Bank official in 1998
in Washington DC, I had pointed out that the
setup and system including the officials to
manage the PHSC remain the same as the previous
state health sector which was projected as
failure necessitating formation of PHSC, clearly
indicating that the target of neither World Bank
nor the State Government was to improve health
care system.
Now when the loan
installments are almost over and corrupt
officials and rulers have pocketed the money,
the PHSC is recommended for winding up. People
have ended up with more debt and worsened health
services. Insaaf International will soon launch
a campaign for accountability of the failure of
the project and fixing of responsibility at
state and World Bank level. Insaaf international
time and again brought the malfunctioning and
adverse effects of PHSC on health care services
but the visiting World Bank Team always showed
its 'satisfaction', covered in the media.
Recently, the World Bank extended the loan as
result of its 'happiness' over progress of PHSC.
Insaaf International in
coordination with World Bank Bond Boycott
(Center For Economic Justice, Washington DC) had
released a report " World bank Funded Health
Care- A Death certificate for Poor" in September
2001 exposing the functioning of PHSC.
Background
Through a project called
India-State Health Systems Development Project
II, in which the World Bank lent US$106.1
million to India for health sector reforms in
Punjab, the Punjab Health Systems Corporation
(PHSC), a Para-state health organization, was
created to replace the existing public health
system.
The stated goal for the
PHSC project was to improve the performance of
the health care system through increased quality
and effectiveness as the state health services
were projected as failure. The ultimate goal of
the project was to improve the health status of
the people, especially women and the poor. What
it has done is exactly the opposite, mainly
because of the changes required by the World
Bank in the structure of "user fees" charged for
health services.
PHSC resulted in increased
corruption, enhanced user charges adversely
affecting poor and women, lack of transparency
and accountability and increased debt burden on
the people. Unable to afford private medical
care and decreased access to state health
services, the poor were pushed towards quacks
and superstitious methods of treating their
medical problem, adding to morbidity, mortality,
spread of communicable diseases like AIDS,
Hepatitis-B, and increased drug resistance etc.
The Times of India dated
4.6.02 reported that Punjab Health Systems
Corporation (PHSC), Punjab Financial Corporation
(PFC), Sugarfed, PAIC, Punsup and PRTC have been
recommended to be wound up. In case of other
major corporations like Markfed, Milkfed, PSEB
and PSCB and others, which are to be retained,
the commission has recommended that these be
restructured by right sizing through a Voluntary
Retirement Scheme (VRS) or retrenchment of
excess staff.
In case of procurement
agencies like Markfed and Punjab State
Warehousing Corporation (PSWC) the allocation of
mandis for procurement, which are reshuffled
every season, and allotment of rice mills in
case of paddy, are to be made permanent to curb
misappropriation of paddy, a serious problem in
the state. Two other state procurement agencies,
Punjab Agro Industries Corporation and Punjab
State Civil Supplies Corporation (Punsup) have
been recommended for winding up.
In case of Punsup all its
assets are to be handed over to the food and
civil supplies department. In case of PAIC the
commission has recommended that it stop
procurement activities pending its closure. The
commission has recommended the restructuring of
the Punjab Infrastructure Development Board
(PIDB) into a trust to administer the Punjab
Infrastructure Development Fund (PIDF) and the
Punjab Infrastructure Initiative Fund (PIIF).
The renamed and reoriented Punjab State
Industrial Development Corporation (PSIDC) is to
function as the secretariat of the trust. PSIDC
is to be renamed as Punjab State Infrastructure
and Industrial Development Corporation (PSIIDC).
In case of Punjab Health
Systems Corporation (PHSC) the commission has
recommended that it be wound up when the funds
of the project stand utilised. Gains of the
project to be consolidated by the taking over of
PHSC assets and liabilities by the directorate
of health services and family welfare.
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