“The Health Ministry is the most corrupt state organization… Health Ministry officials are the most corrupt in the state sector.” A bold allegation, it may seem, but one that was levelled nonetheless by President Maithripala Sirisena when he addressed a meeting of the All Ceylon Nurses Association at the Maharagama Youth Centre on 10 February. “I was the Health Minister in the former government and I know how corrupt the ministry is”, he said. “The present Health Minister, Dr Rajitha Senaratne, [has] all the freedom he needs to do his job properly and I believe he has embraced the challenge of cleansing the Ministry of all corruption.”
To do that, however, Minister Senaratne will need a very big broom indeed. Just ten days previously, a senior regulatory official in his ministry had hosted a gala reception at Water’s Edge, one of Colombo’s most prestigious venues. To it were invited the private sector’s biggest purveyors of drugs and medical supplies. Incredibly (if not naively), the entire cost of the lavish extravaganza was met by the official, from his personal funds. No one seems to have stopped to ask why a government official should spend his personal money to host a party for Colombo’s drug moguls, or how it was that he had made so much money as to be able to squander it so freely. Invitees were told that the purpose of the function was to introduce them to the new minister, who would also be in attendance. Corruption in Sri Lanka’s health sector is not conducted furtively: it is done out in the open, for all to see, with complete impunity.
What was probably unknown to Dr Senaratne as he sipped and supped with the leading lights of the pharmaceuticals industry at Water’s Edge was that the very same official had, just a few weeks previously, hosted another reception for some 200 government health professionals at the Colombo Hilton’s Il Ponte poolside restaurant to urge them to support then president Mahinda Rajapaksa’s candidature at the election of 8 January. Again, it was the official, doubtless from the vast profits accumulated from hefty bribes, who footed the bill.
The Bibile Bill
Only last week, no doubt from the best of motives, parliament rushed through a bill to establish a National Medicine Regulatory Authority Bill before it could be subjected to any public scrutiny. Incredibly for a bill sponsored by none less than the president, less than one-third of MPs, 68 in all, voted on it: 157 legislators absented themselves from the vote. Many claim, however, that the mechanisms to make the new Authority’s workings transparent need further scrutiny.
The present pharmaceuticals regulatory body, the Cosmetics, Devices and Drugs Authority, which is under the Health Ministry, is one of the most notoriously corrupt institutions in the entire government. Indeed, the president’s remarks quoted above were probably aimed at it. Inexplicable delays by the Authority to grant licenses result in importers suffering enormous losses, and they readily pay millions in bribes to avoid such delays. “They held up my import permit for my 140-million shipment for more than three months,” one importer faced with this dilemma told Colombo Telegraph. “This was even though my product was fully registered and the customer was the Ministry of Health itself. Without their signature, the customs do not release the goods. Eventually I had no choice but to meet him and ask how to solve the problem. ‘You should know how’, he told me. After several demands I offered him Rs 2 million to sign the permit, but he chased me away saying that was not even worth considering. He told me, ‘Remember, I can bankrupt you!’” The question now is whether the new National Medicine Regulatory Authority set up under the Bibile Bill will be just another such corrupt, bribe-taking bureaucracy, or whether the Bill contains safeguards to ensure transparency.
The Elekta Scam
The problem with the Health Ministry is that some of the doctors in powerful positions have become brazenly corrupt. Often, the way this works is that they are called upon to treat important politicians or their families. This gives them intimate access, which they then exploit for their own gain.
On 22 February the Colombo Telegraph ran a comprehensively-documented exposé of one such case, where the Ministry, in an infamously shady deal, committed a staggering sum of Rs 7 billion (7,000 million) for the purchase of linear accelerators from a UK-based company named Elekta. No tenders were called, nor were competing bids invited. The deal was simply handed to Elekta on a plate, in a secret deal that reeks of corruption. Our exposé showed that the Health Ministry’s engineer on the procurement committee, S.A.J. Karunatilaka, had already been found guilty by the ministry’s own disciplinary process, of making no less than 15 illegal overseas trips. There has been no inquiry up to now as to whether any of these trips was funded by Elekta or its local agent, Siyol International, headed by businessman Sanath Perera. Indeed, Health Minister Rajitha Senaratne has up to now failed to launch an investigation into Karunatilaka’s illicit foreign trips, or to report this affair to the Bribery Commission or the police. Nevertheless, following our story, the National Cancer Institute’s deputy director, Dr Wasantha Dissanayake, announced that Dr Senaratne has ordered an inquiry into the Elekta scam. No announcement has been made, however, as to whether the deal has been suspended, or who is conducting the inquiry.
‘Totally free’ = Rs 7 billion
Here again, the problem is that the doctors who influence procurement are hand in glove with the vendors. Prior to publishing our story we contacted Dr Jayantha Balawardane, a senior oncologist at the National Cancer Institute, Maharagama, who was implicated by multiple sources as being a prime mover of the Elekta project. Dr Balawardane, however, distanced himself from the scam, telling us on 17 February that he “only helped the college of oncologists in this project. [The] Sri Lanka College of Oncologists is the founder of this project.” Asked specifically about any association with Elkta or Siyol, again Dr Balawardane shrugged us off, saying “We have not requested or specified any particular brands at any stage in our proposal”. Asked further about S.A.J. Karunatilaka’s illicit travels he told us “Any such matters are not applicable to me.”
It would seem from Dr Balawardane’s responses above that both he and Dr Mahendra Perera had acted purely in the context of their being members of the College of Oncologists, had no personal interest in this 7-billion rupee investment, were unfamiliar with S.A.J. Karunatilaka and had no involvement with Siyol International.
Asked by Colombo Telegraph of any personal interest he or Dr Mahendra Perera may have in this giant project, Dr Balawardane replied defensively, “Whoever your informant is, I fear is doing this with some malice to tarnish Dr Mahaendra Perera’s and my good names, or there are other parties with vested interests trying to sabotage this cancer project, which will provide totally free state of the art treatment for poor cancer patients in Sri Lanka , who otherwise would have to pay exorbitantly for this same treatment in the private sector.”
Despite Dr Balawardane’s ringing endorsement of Elekta’s technology as “state of the art”, insiders at the Maharagama Cancer Institute claim not only that the machines being imported are sub-standard but that they are over-priced by as much as 50%. “The only way to ensure the correct price and the best technology”, one of them told Colombo Telegraph, “is to call for open competitive tenders. Why did they not do so? And why is Dr Balawardane endorsing this corrupt process and inferior technology? And on what basis is he claiming that they are ‘state of the art’ if, as he says, he is not part of the procurement process? How can he know?”
Worse, in Dr Balawardane’s economic worldview, it seems that Rs 7 billion in public funds equates to “totally free”.
So we asked him that very question. “You state [the project] will ‘provide totally free, state of the art treatment for poor cancer patients in Sri Lanka’”, we said. “However, the Treasury states that Rs 7 billion has been allocated for the project. Could you please clarify then (a) in what way the treatment will be ‘totally free’; and (b) why no tenders were called for this massive procurement?”
Unable to answer these direct questions, however, Dr Balawardane stonewalled, saying only, “I believe I have nothing further to say on the said matter”.
The fact remains, however, that many doctors wielding influence in drug and equipment purchasing for the Health Ministry are uncomfortably cosy with certain vendors. Apart from other gratifications, it has become routine for such doctors to have their foreign travel sponsored by pharmaceuticals companies under the guise of “attending academic conferences”. Although such “sponsorship” is a bribe in terms of both the Penal Code and the Bribery Act, it is worryingly commonplace, with “academic conferences” taking influential doctors to unlikely destinations such as Kenya’s Masai Mara National Park or numerous world capitals in which, by lucky happenstance, they happen to have close family.
According to Dr Balawardane, for example, who admitted to Colombo Telegraph that he too has benefitted from such sponsorship, “Such academic conferences are mostly group sponsored by the pharmaceutical companies all over the world as routine”. The problem, however, is that they are nevertheless illegal and a direct conflict of interest when sponsored by companies whose sales the doctors can directly influence (Karunatilaka, for instance, faces dismissal and prosecution for doing much the same thing). A course of some of these drugs, such as Mabthera (Rituximab) manufactured by the multinational Hoffmann-La Roche, for example, cost patients up to Rs 1 million. And Mabthera’s local agent, A. Bauer & Co., is a regular sponsor of doctors to “academic conferences” in the world’s tourism hotspots.
On Saturday 21 February 2015, just one day prior to our exposé of the Elekta scam, Rajiv Nanayakkara, managing director of Markss HLC Ltd, one of the largest purveyors of cancer medicines in the country, hosted a gala festivity at his luxury residence on Bolgoda Lake. Present at this occasion were not only Drs Jayantha Balawardane and Mahendra Perera, but also the UNP’s deputy leader and Minster of Housing and Samurdi, Sajith Premadasa. The festivity, Dr Balawardane told Colombo Telegraph, was “hosted for the Hon Minister, Mr. Sajith Premadasa, to celebrate his victory”. Dr Balawardane, however, saw nothing strange in being entertained in the house of a businessman who benefits from millions of rupees worth of sales as a result of his (Balawardane’s) personal goodwill, the very definition of a conflict of interest.
What is more, he saw nothing strange in “celebrating the victory” of Sajith Premadasa given that until 8 January 2015 Balawardane made it abundantly public that he was among Mahinda and Shiranthi Rajapaksa’s closest buddies, boasting to anyone who would listen how he regularly dined at President’s House, had treated the First Lady’s ailing mother and attended on the president himself, when he had a cancer scare. Now, barely a month later, he was “celebrating” Sajith Premadasa’s “victory”. As it happens, Sajith Premadasa has not experienced a victory: he was not, after all, even a candidate in the election of 8 January. Instead, what Nanayakkara, Mahendra Perera and Jayantha Balawardane were celebrating was the ascent of Premadasa to the cabinet. They now have a friend in high office to provide patronage and cover to their future prosperity.
When President Sirisena says that he believes Rajitha Senaratne “has embraced the challenge of cleansing the Ministry of all corruption”, then, clearly the latter has his work cut out. As with all the other anti-corruption pledges of the new government, however, the public is yet to see anything more than words in the Yahapalanaya Government’s crusade against corruption. Unless substantial action comes before the general election, it will be the electorate who will be asking the government some very uncomfortable questions indeed.
© Colombo Telegraph- oooTiHa