Fake NOC racket: Report silent on lack of internal committee in pvt hosps

Jaipur: The investigation report submitted by the medical education department to the health minister on the fake NoC for organ transplant scam has failed to highlight why the state govt could not compel private hospitals to establish their own competent authorisation committee or internal committee, despite them conducting more than 25 transplants every year.

According to the Transplantation of Human Organ Act 1994, hospitals that conduct more than 25 transplants annually have to constitute their own committees. However, these hospitals preferred to obtain NoC for organ transplant from SMS Medical College, possibly to evade their own accountability. Now, as the NoC scam has come to light, the state govt has suspended the licenses of three private hospitals, preventing them from performing organ transplants until further notice.

The notification issued by the Ministry of Health and Family Welfare on July 31, 2008, states, “The authorisation committee should be hospital-based in metro and big cities if the number of transplants exceeds 25 in a year at respective transplantation centers.” THOA 1994 says that it is the responsibility of the state govt to constitute hospital-based authorisation committees.

According to the notification, the composition of hospital-based authorisation committees, which will be constituted by the state govt and in the case of Union Territory by the Centre, includes the senior-most person officiating as medical director or medical superintendent of the hospital, two senior medical practitioners from the same hospital who are not part of the transplant team, two members being persons of high integrity, social standing, and credibility, who have served in high-ranking government positions, such as in the higher judiciary, senior cadre of police service, or who have served as a reader or professor in a university approved by the University Grants Commission, or are self-employed professionals of repute such as lawyers, chartered accountants, and doctors, secretary (health) or nominee, and director health services or nominee.

While the state govt failed to ensure that private hospitals established their own internal committees for NoC, the private hospitals are now taking the plea that it was difficult to doubt the authenticity of the entire process before the disclosure of the case that the documents submitted for kidney transplants and the verification process (NoCs issued by SMS hospital’s state authorisation committee) were fraudulent.

They argue that the hospital administration was completely unaware of this unlawful act, not only for international patients but also for Indian patients procuring NoCs. “The hospital administration was unaware that NoCs were being used without committee meetings by the state authorisation committee at SMS Hospital,” said an official of one of the private hospitals.

According to THOTA 1994, the state govt has to ensure regular inspection of registered transplant or retrieval hospitals by the state appropriate authority, to conduct onsite monitoring of their activities, quality of transplantation, post-operative follow-up of the donor and recipient, and outcomes of transplantation. However, that, too, has not been done in the state.

Private hospitals are now holding the state authorisation committee responsible for the scam, saying that the committee is required to verify all documents required for organ transplantation, whether for patients within India or from other countries. They said that neither the private hospital administration nor the organ transplant coordinators appointed by them have been mandated to verify the documents submitted by patients and donors.