The Print: New Delhi: Saturday,
05 September 2020.
Health
ministry RTI reply shows it invoked Disaster Management Act to act quickly, but
data is being shared with KPMG, Cisco & Boston Consulting.
Should a
government ministry’s response to an unprecedented health emergency go through
the loops of rules and bureaucracy? Even if it means the response could be
slowed down and risk lives?
Or
should a battle against the pandemic of the century cast standard norms aside,
step around guidelines, and just rush the system to act? Even if it means
working with select private players and giving them access to vast amounts of
valuable public health data?
These
were contentious questions that roiled the Union health ministry in the early
days of Covid in India, as it was putting together a ‘war room’ to compile and
analyse critical data from around the country to help combat coronavirus, and
needed to partner with seven private organisations.
The
argument was eventually settled in favour of urgency, government documents and
communication accessed by ThePrint under the RTI Act show.
The
health ministry, the documents show, went ahead and got the seven private
organisations on board without going through the standard process of inviting
expressions of interest from companies interested in doing the work and
evaluating them. This was done citing the state of “battle” and using the
“special provisions under the Disaster Management Act 2005”.
The
seven companies Cisco Systems India, KPMG Advisory Services, Red Swan Labs,
Urban Clap Technologies India, Boston Consulting Group, Primus Partners and
UChicago were picked from among several individuals and organisations who had
contacted the ministry and volunteered their services.
No
time to be clerical
The
Covid war room on the first floor of Nirman Bhawan in New Delhi is the nerve
centre of the analysis and projections being done on the daily, weekly and
monthly status of the pandemic in the country. It has access to state, district
and facility-level data, and results of its analyses are periodically shared
with states through written and oral communications — it was from here that
some of the lists of hotspot districts emanated in the early days.
A note,
moved by the under-secretary, e-health, on 23 April, spoke about getting the
seven companies to help with “latest tools and technologies for analytics,
visualisation, forecasting methodology and documentation”, and also laid down
the procedure that would need to be followed according to the General Financial
Rules.
The
rules state that once the health secretary has approved the move, a request for
expression of interest would have to be put out on the ministry website,
following which a committee formed for the purpose would evaluate the proposal.
Once the agencies had been finalised, contracts and non-disclosure agreements
etc. could be signed.
“The
committee may perhaps play the same role, which in normal circumstances would
have been done by committees doing EOI, pre-bid meetings, technical and financial
evaluations,” the note said.
However,
in this case, because of the pandemic, the emergency procurement and accounting
guidelines under the Disaster Management Act were invoked, to allow waiving of
standard procedure for inviting tenders. This was also done because of a
“no-cost liability” to the ministry for these services.
In his
notings on this document, health ministry joint secretary Lav Agarwal wrote
that this was no time to be ‘clerical’. “We are dealing with a battle here and
forming committees implies we are still working in a clerical mode & not
even understanding the magnitude of the battle we are dealing with. As already
directed, instead of wasting my time on these issues, please obtain signed
agreement from them and put up,” he wrote.
A senior
ministry official involved in the functioning of the war room, said on the
condition of anonymity: “Everything, the moving of the note, the deliberations,
happened subsequently. The war room was already functional because that was the
need of the hour at that point. If we didn’t do it right then, the health
ministry would have been talking out of thin air. We and they (in the war room)
worked past 1 am and were back in office at 6 am to get it up and going. And
they were doing all of this pro bono.”
Agarwal’s
notings too mentioned that the companies were working pro bono. “All
organisations are working pro bono and have already signed the nondisclosure
agreement. They are all providing valuable support already to Covid-19 support
in managing of control rooms, and attending to IT platform development,” he
wrote.
Concerns
over giving data to healthcare businesses
The war
room has access to data that can, among other things, help predict future
hotspots information that can be valuable for healthcare businesses looking to
expand.
According
to the note, the proposed committee would have worked at the same time as the
companies were helping out the war room, to prepare the guidelines for
data-sharing based on the National Data Sharing and Accessibility Policy, 2012.
The note
said: “After due approval of the competent authority and shortlisting of the
agencies, a nondisclosure agreement will be signed between the agency and MOHFW
with all the necessary terms and conditions to maintain confidentiality and
security of the patient data in accordance with all the relevant acts of
government. In addition, the committee so constituted for the examination of
proposals will also prepare the guidelines for data sharing based on the
National Data Sharing and Accessibility Policy (NDSAP) 2012.”
Agarwal’s
notings on the document in April clearly stated: “There is no data sharing with
any of the organisations.”
However,
the ministry’s RTI reply said the data related to the Covid app is being shared
with KPMG, CISCO and BCG, all of whom have already signed non-disclosure
agreements. It declined to share the agreements on the grounds that it is third
party information.
A
detailed questionnaire sent by ThePrint to the ministry remained unanswered for
a week, despite multiple reminders.
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