It has now been uncovered that the PET-CT scan, which is supposed to be done at the cost of ₹7,200 per case, is being charged at ₹9,200.
Published Aug 26, 2023 | 8:00 AM ⚊ Updated Aug 26, 2023 | 8:00 AM
The Bone Marrow Transplant block at Kidwai. (South First)
Earlier in August, South First uncovered the reality faced by families needing critical paediatric bone marrow transplantations at the Kidwai Memorial Institute of Oncology (KMIO).
Following this, the Department of Medical Education (DME) took note of the various allegations against the cancer institute and is due to hold a meeting with the director of the hospital soon.
DME Director Dr Sujatha Rathod told South First: “We have taken note of all the allegations against Kidwai Hospital and also its director. This includes not performing bone marrow transplants (BMT) at the Bone Marrow Transplant Unit inside the hospital. It has come to the notice of Dr Sharan Prakash Patil, the medical education minister, too, and an explanation has already been sought from the director. A meeting in this regard will be held in the coming week.”
Close on the heels of an investigation by South First on how state-run KMIO in Bengaluru — despite its own state-of-the art BMT centre — is referring paediatric patients to costly private hospitals, more discrepancies are tumbling out of the closet.
It has now been uncovered that the Positron Emission Tomography and Computed Tomography (PET-CT) scan, which is supposed to be done at the cost of ₹7,200 per case and reduced by ₹400 for every 25 cases, is being charged at ₹9,200.
PET-CT is an important scan for cancer diagnosis, staging, and management of cancer. It costs in the range of a whopping ₹34,000 at private diagnostic centres.
“As per the agreement between Kidwai and the vendor, the diagnostic centre — Bangalore Medical Systems (BMS) — is allowed to charge ₹7,200 per scan for AB-ArK (Ayushman Bharat-Arogya Karnataka scheme) patients and ₹9,200 for outside patients. BMS must also reduce the charges by ₹400 for every patient after 25 cases in a day. However, this is also not happening,” explained a senior doctor at the hospital.
According to documents available with South First, a pre-dated work order had been issued for the development, operation, maintenance, and management of PET-CT under a Public Private Partnership (PPP) at the Kidwai Institute. This order, allegedly, was issued by the present director, V Lokesh, two months before he even assumed charge.
The order was allegedly signed by the director in the month of August last year, while he took charge only in October.
Explaining the issue in detail, a senior doctor told South First, “Tenders for the PET-CT were floated in December 2021, when the then-director C Ramachandra was in office. During this tender process, the Bangalore Medical System (BMS) was allotted the tender. Later, in July 2022, the agreement was signed between the then-director and the BMS.”
However, in October, Dr Ramachandra’s tenure ended and Dr Lokesh assumed charge. Interestingly, the document shows that Dr Lokesh issued the work order on 18 August, 2022, even before he took charge as director.
Speaking to South First, Director V Lokesh said that he would look into the BMT unit referrals, while categorically denying the allegations regarding the PET-CT order.
He said that he would give clear instructions to the doctors at the OPD to ensure that the patients are referred to the heads of departments and are not send back or orally referred to private hospitals unnecessarily.
“We have done nearly 40 BMTs in the last eight months. There is a problem with the shortage of hemato-oncologists, but we are in the process of hiring more doctors to perform the BMTs. These are very complicated procedures. We are also ensuring that the needy get free-of-cost BMT at our unit,” he said.
Meanwhile, regarding the PET-CT scan order, he said that a detailed report on the matter has already been submitted to the DME.
Explaining in detail to South First, Lokesh said that as a PET-CT scan is very expensive in private hospitals, a provision for it inside Kidwai would benefit the poor, and it is with this intention that the then-government in 2018 sanctioned ₹15 crore for a digital whole body PET-CT scan machine.
Of this, ₹10 crore was released on 12 March, 2018, which the then-director used to create the infrastructure needed for the PET-CT scan and other nuclear medicine facilities. However, due to the Covid-19 pandemic, the rest of the amount was not released and the CT machine was not procured.
“The cost of a digital PET-CT is ₹30 crore and an analog PET-CT will cost ₹12 crore. But the institute was not in a position to allocate the budget for procurement and, hence, they went in for the PPP model. This was approved in a Governing Council meeting held on 7 November, 2019, during C Ramachandra’s tenure. The finance committee meeting held on 2 December, 2020, approved the proposal and the tender was called. The lowest bidder, being BMS, won the tender and an agreement was drawn on 5 July, 2022,” explained Dr Lokesh.
The Atomic Energy Regulatory Board (AERB) also gave Kidwai approval on 9 December, 2022, to use the machine. The director stated that from 6 March, 2023, the PET-CT scans were being taken up at a cost of ₹7,200 for AB-ArK patients and ₹9,200 for outside cases. So far, 3,000 scans have been performed.
Regarding the notion that Lokesh signed official documents even before coming on board, he blamed Venugopal Reddy from the Finance Department, who, according to the director, on 30 June — the last day before his retirement — “mixed up the documents to the principal secretary, which gave an impression that the work orders were signed on 18 August, 2022, which is a total misrepresentation of facts,” said Director Lokesh.
He said that the work order dated 18 August, 2022, which was kept prepared after the receipt of agreement, was also present in the file to be sent to principal secretary and, hence, created this confusion.
“However, the fact of the matter is that the work order was signed by me on 9 December, 2022, and acknowledged too by the receiver. The unsigned draft work order copy dated 18 August, 2022, prepared by the previous director was attached to this and is being misrepresented. This is not true. I am ready to provide an explanation,” the director told South First.
