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From a building with no doors and windows to one where stairs are missing; projects whose finances are under a cloud; where construction work is abandoned because the agency has lost interest. These are some of the key reasons why more than 200 community health centres (CHCs) and primary health centres (PHCs) in 52 Uttar Pradesh districts are stuck, some from as far back as 2005, information accessed by The Indian Express under the Right to Information Act shows.
Indeed, most of these centres are languishing from before the Yogi Adityanath government came to power in 2017, and the UP government’s health department has flagged alleged financial irregularities, ongoing internal inquiry, or the need for a probe by a Special Investigative Team in around 90 such centres (see interview below).
According to information available until August 2023, 86 CHCs and 132 PHCs commissioned between 2005 and 2023 are pending completion. The state has a total of 970 CHCs and 3,976 PHCs across 75 districts. As many as 178 or 81.6% of the centres were commissioned before the Yogi government came to power.
The health department has also highlighted the extent of completion of each project (table 1), and the year in which they were commissioned (table 2).
A PHC is the first point of contact between the village community and the medical officer, meant to provide curative and preventive healthcare to the rural population. They are established and maintained by state governments under the Minimum Needs Programme or Basic Minimum Services Programme, and are supposed to be manned by a medical officer supported by paramedical and other staff.
CHCs are a step higher, serving as referral centres for four PHCs and providing facilities for obstetric care and specialist consultations. A CHC is required to be staffed by four medical specialists – surgeon, physician, obstetrician/gynaecologist and paediatrician – supported by paramedical and other staff. It typically has 30 beds with one OT, X-ray, labour room and laboratory facilities.
Information accessed under RTI by The Indian Express reveals the key reasons behind the stalling of 218 PHCs and CHCs:
👉🏽 In around 90 unfinished projects, the health department has highlighted alleged “financial irregularities”, ongoing internal inquiry, or an SIT (Special Investigation Team) probe. In all these cases, more than 90 percent of the amount that was allocated for construction has been spent. While internal inquiries are ongoing, one of the seven agencies tasked with the construction – the Rajkiya Nirman Nigam – has recommended an SIT probe.
👉🏽 In one instance, the health department notes: “The building has no doors, windows and the floor is incomplete.” This particular CHC was commissioned in 2006-07 in Ervakatra in eastern Uttar Pradesh. A total of Rs 2.24 crore was allotted, which has been spent, and the government has already rejected the revised estimate.
👉🏽 On the status of a CHC in Raniganj Kaithola of Pratapgarh, commissioned in 2014-15, the department notes: “The building does not have stairs or ramp to go from the first floor to the second floor.” While 94 percent of the allocated money has been spent, 60 percent of progress has been made.
👉🏽 “Affected by financial irregularities. The doors, windows, electric fixer in the buildings are partially complete,” notes the health department on the status of a CHC in Azamgarh’s Mohammadpur, commissioned in 2007-08. A total of Rs 3.02 crore was released, and despite over 96 percent of the funds being spent, only the first floor of the main building has been finished, records show.
👉🏽 On the status of a CHC in Dapsaura of Fatehpur, which was alloted in 2014-15 and passed its completion deadline in June 2021, the department notes: “Due to high expenditure by the construction unit, internal investigation is ongoing. Work stalled. OHT (overhead tank) is incomplete, there are no nets/glasses in the windows of the main building and MO’s (medical officer) residence.”
👉🏽 “Due to non-completion of work even after the entire amount has been spent, the process of filing chargesheet against the responsible officers is going on at the executing agency level,” notes the department on the status of one of the oldest commissioned projects from 2006-07 in Paras, Gonda district.
👉🏽 “On-site inspection was conducted on 06.07.2023. The work of medical officer and category-2 residence septic tanks and soak pits is still in progress. Apart from this, minor defects are being rectified,” notes the department on the status of a PHC in Amaujaspur in Sultanpur district, commissioned in 2018-19, which was declared complete.
👉🏽 “The doors installed have to be replaced. The approach road has to be repaired. The floor of the overhead tank is broken,” notes the department on the status of two PHCs in Bijnor district, commissioned in 2018-19.
👉🏽 On the status of a CHC in Sultanpur, the department notes: “An FIR has been lodged by the executing agency against its JE (junior engineer) and AE (assistant engineer) on 20.03.2015. The work is stalled.” The project was commissioned in 2008-09.
👉🏽 “The construction/executing agency is not taking interest in completing the work. The balance amount of Rs 70.26 lakh was released on 22.11.2022,” notes the department on the status of a PHC in Bhadari, Pratapgarh district, commissioned in 2007-08. Despite spending about 50 percent of the allocated money, the project is still at the level of foundation work.
👉🏽 “Almost the allocated cost for the medical officer’s residence has been spent and the construction work has been done only up to the chair level. Report has been sought from the construction unit,” noted the health department on the status of a PHC in Kudarcoat in Auraiya district, commissioned in 2005-06.
👉🏽 Other reasons cited by the health department for the delay include incomplete wiring; no water supply; unavailability of land; no mesh/glass in windows, etc. Records also show that even in the case of some “completed” works, irregularities were found during on-site inspection.
Seven government agencies were tasked with the construction – UP Rajkiya Nirman Nigam, UP Housing & Development Board, Construction & Design Services of UP Jal Nigam, Uttar Pradesh Rajya Nirman Sahkari Sangh Ltd, UP Projects Corporation Limited, UP State Construction And Infrastructure Development Corporation Limited, and UP Rural Engineering Department.
The maximum number of projects are being constructed by the Rajkiya Nirman Nigam (63 CHCs and 66 PHCs), followed by the Housing & Development Board (36 projects) and the Rajya Nirman Sahkari Sangh Ltd (28 projects).
In total, of the Rs 393.80 crore allocated for the construction of CHCs, Rs 353.36 crore has already been released until August 2023, and Rs 305.30 crore spent by construction agencies. In the case of PHCs, of the Rs 166.75 crore allocated for construction, Rs 160.55 crore has been released and Rs 129.80 crore spent.
Uttar Pradesh Deputy Chief Minister Brajesh Pathak, who also holds the health portfolio, told The Indian Express that the state government is cognizant of alleged financial irregularities in some under-construction PHCs and CHCs, and action has already been initiated.
In response to a questionnaire, Pathak said, “SIT investigation has been ordered by the current government against officials of the executing agency concerned, UP Rajkiya Nirman Nigam Limited. Based on the findings of the SIT investigation, UP Rajkiya Nirman Nigam Limited is taking action against the guilty officials at their own level.”
UP Rajkiya Nirman Nigam Limited is handling 63 CHCs and 66 PHCs that are yet to be completed.
Explaining the plan to complete projects that are stuck, Pathak said, “It has been decided by the Cabinet that some of the financial burden will be borne by the Rajkiya Nirman Nigam Limited and some by the Health Department, so that work can be completed in a time-bound manner. Action is being taken accordingly.”
The unfinished projects include 40 commissioned under the current BJP government in the state. On that, Pathak said, “The works which are currently under construction are being closely monitored and action is being taken to complete them on time so they can be made operational to the public soon.”
“To complete the projects on time, administrative and financial approvals are being issued in a timely manner and funds are being allocated accordingly. The projects are being continuously monitored by the government,” said Pathak, adding that this is to ensure financial irregularities do not happen in the future and projects are finished on time.
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