Powerful vested interests influence the selection process at AIIMS to help 39 undeserving candidates become senior faculty members.
IN an extraordinary case of blatant political interference in professional appointments, the Governing Body (GB) of the All India Institute of Medical Sciences (AIIMS), the country's premier medical institution, promoted to higher designations and grades all 39 candidates who had been found unsuitable for promotion by the nine-member Standing Selection Committee (SSC) appointed by the institute. The 39 candidates were among 251 persons who were considered by the SSC in November-December 2010 for promotion under an internal system called the Assessment Promotion Scheme (APS). The SSC's recommendations are only advisory and they need to be approved by the GB in accordance with Item 19 (ii) of Schedule-I of AIIMS Regulations 1999 (as amended). At its meeting of March 1, 2011, the GB approved the selection and, accordingly, the remaining 212 candidates were promoted. But, of the 39 who had been found unfit for promotion, 36 made representations to the President of the AIIMS, who, by the AIIMS Act of Parliament, is the Union Minister for Health and Family Welfare. The Minister, Ghulam Nabi Azad, in turn, ordered a review of the selection. More accurately, this review was ordered by the Ministry of Health and Family Welfare through its letters dated August 1 and 9, 2011. The AIIMS President approved this on November 28, 2011, on his own without recourse to the normal process of approval through a meeting of the Institute Body (IB). It may be noted that the AIIMS President is, by the Act, the Chairman of the GB as well. By ordering a review, the Minister was overruling a decision that he, as GB Chairman, had been party to.
The APS, it should be pointed out, is an irregular mechanism introduced by AIIMS as a sort of forced promotion system, which is not provided for in the rules of the AIIMS Act, and its validity has been questioned by Ministry officials in the past. Under this scheme, some of the faculty selected as assistant professors through the national selection process are promoted to higher designations as associate professors and professors, with attendant financial benefits of the respective higher grades, even if there are no sanctioned positions in these categories. Sanctioned posts can only be filled by inviting applications from all over the country and by a national selection panel.
Even if an assistant professor of AIIMS fails to make the grade in the national selection process, he or she can be considered for promotion under the APS. The difference appears to be only notional in the sense that people who have made it through the national selection process are called cadre associate professors and professors, while those who come through the APS are not. Interestingly, at present 99 positions of professors have been filled through the APS and some of them are heads of departments, even as several sanctioned positions, which should have been filled with better qualified professionals through the national selection, remain vacant.
As directed by the Minister, the present SSC reviewed the earlier selection on January 6. But for the new Director General of Health Services (DGHS), who is an ex-officio member of the SSC, the composition of the SSC was the same as that in 2010. As is customary, for the purpose of selection, the SSC invites two external experts/advisers in each discipline for evaluating the candidates. A note by the institute faculty cell had been provided to the SSC in addition to the 36 representations and other relevant documents. According to the minutes of the SSC meeting of January 6, after examining all the relevant facts, the committee reiterated its earlier decision of 2010 on the fitness or otherwise of the candidates.
Specifically, (a) there was universal agreement on the fitness for promotion of 212 candidates; (b) there was consensus on the unfitness of 26 (of the 39); (c) the majority of the members agreed on the unfitness of four (of the remaining 13) with two members disagreeing; and, (d) one member disagreed on the unfitness of the remaining nine (from the 13). However, the GB, in its meeting held on January 16, rejected the recommendations of the SSC and appointed all the 251 who had been considered for promotion. One senior faculty member pointed out that if at all any change was warranted, the benefit of the doubt could have been given to the 13 candidates on whose fitness there seemed to have been some disagreement, but not all the 39.
Besides the Minister as its Chairman, the GB comprises the following members: Jagdish Prasad, DGHS; R.K. Jain, Additional Secretary and Financial Adviser, Health Ministry; Sushma Swaraj, Lok Sabha member; Motilal Vora, Rajya Sabha member; P.K. Pradhan, Secretary, Health Ministry; Ms Vibha Puri Das, Secretary (Higher Education, Ministry of Human Resource Development); K.K. Talwar, Director, Post-Graduate Institute of Medical Education and Research (PGIMER), Chandigarh; R.A. Badwe, Director, Tata Memorial Hospital; and S.P. Agarwal, Secretary-General, Indian Red Cross Society. R.C. Deka, Director, AIIMS, is the Member-Secretary of the GB. It should be borne in mind that, as members of the current SSC, Prasad, Talwar, Badwe and Deka had reiterated the 2010 decision that found the 39 candidates unsuitable. Badwe, in fact, is the Chairman of the SSC. This is a clear indication of the powerful influence of politicians in decisions that affect the medical profession.
It should be pointed out that the 251 candidates considered under the APS included many who were, by earlier court directives, to be excluded for promotions as they had been appointed on an ad hoc basis in 1993-2003, and they would not have had the requisite four years of regular service at AIIMS to be eligible for being considered under the APS. This would make the promotions of not only the 39 doctors but also those of others among the remaining 212 doubly irregular. It is important, therefore, to go to the root of the issue, which is directly linked to the violation of the government's reservation policy for Scheduled Caste/Scheduled Tribe/Other Backward Classes candidates.
Between 1999 and 2003, AIIMS did not conduct its regular selection of faculty because of agitations and litigation against reservation in faculty selections. Entry-level posts of associate professors were filled on an ad hoc basis and 152 (out of the sanctioned 219) appointments were made. The regular selection process, by appointing a proper SSC, was resumed in 2003. Appropriate national advertisements were issued for 170 posts in March and August 2002. However, a large number (131) of ad hoc faculty were appointed in the vacant posts. Thus, the selection process had violated the rules of fair selection as well as the government's prescriptions under the reservation policy.
Not only that, nearly half (64) of these people were soon promoted to higher grades almost immediately after their selection under the APS; their years of service as ad hoc faculty were treated as regular service to make them eligible for the promotions. The Ministry received several representations pointing out these violations, which deprived many meritorious candidates of the opportunity of appointment. These representations argued that nearly the entire ad hoc faculty had got regularised in this manner. One faculty member, Sarnam Singh, also went to court arguing that the selection had affected the rights of candidates belonging to SC/ST/OBC categories. Following this, the Health Ministry appointed a five-member expert committee under Karan Singh Yadav, a Lok Sabha member, on January 23, 2007, to examine the process of selection by the SSC. The committee submitted its report in November 2007.
The Karan Singh Committee found that the ad hoc selections made in 1993-2003, as well as the process of the SSC selection in 2003, were characterised by a series of arbitrary in-house decisions and actions that violated proper procedures. It observed that pending court cases were not sufficient justification for holding regular selection in abeyance. But, even after the court dismissed the petition in 2001, no advertisements calling for appointment to various posts appeared for more than one year. As regards the 2003 selection for the advertised 170 positions, 762 persons had appeared for interview. They included 151 ad hoc faculty members of AIIMS and 611 external candidates, including 209 from the reserved categories.
From the selection details available for 162 posts (not for the 170 positions advertised), the committee found that 81 per cent (131) were filled by candidates from the ad hoc pool and only 19 per cent (28) were filled with candidates from the national pool of 611 persons interviewed. This implied that fewer than 5 per cent were selected from the national pool as compared with 87 per cent from the ad hoc pool. The committee also observed that if it had complete details of all the candidates, this latter proportion would, in all likelihood, be even higher. Further, it found that several highly qualified candidates, both in the reserved and in the general categories, were not selected. This gives credence to Sarman Singh's contention that this apparently proper selection process was actually designed to regularise the ad hoc appointments.
Indeed, the committee said: [T]here was a definite selection bias in favour of candidates from the ad hoc pool, and that the selection process of 2003 was primarily intended for selecting and regularising the services of as many as possible ad hoc assistant professors.
Another sequence of events, relating to legal proceedings and their outcomes, also suggests that this was the underlying objective of the 2003 selection. In September 1994, the Faculty Association of AIIMS (FAIIMS) filed a petition in the Delhi High Court challenging the reservation for SC/ST/OBC categories in faculty appointments and sought exemption for AIIMS. The ad hoc faculty too had filed a petition seeking regularisation of their services from the date of their initial ad hoc appointment. The court, however, upheld the reservation policy, stating that it saw no reason not to apply the reservation rule, and stayed any regularisation of the ad hoc faculty. It dismissed both the petitions on November 26, 2001.
In its order, the court said: [W]e fail to appreciate how petitioners could stake their claim for regularisation by-passing the conditions governing their ad hoc appointmenttheir appointment order stipulates that their appointment was subject to regular appointment to the post and that it would not bestow any claim on them for regular appointment, nor would it be counted for [the] purpose of any seniority, promotion or confirmation. If anything, they would have to sink and swim with the conditions of their appointment orders and there was no way to ignore these and regularise their services.
Immediately following this, the FAIIMS and the ad hoc faculty filed two special leave petitions (SLPs) in the Supreme Court. The Supreme Court passed two orders on the petition filed by the FAIIMS. The first interim order on February 11, 2002, said all further appointments would be temporary until further orders. The second one, on February 23, 2003, said due to its importance, the matter be heard by a larger Bench and be placed urgently before the Hon'ble Chief Justice of India.
As for the SLP filed by the ad hoc faculty, the apex court's interim order stated that the process of selection should be finalised and, before any appointments are made, the applications should be put up for consideration. At the time of the SSC review, the situation regarding both the SLPs had not moved any further in the Supreme Court, and no final decision had been taken by the court to confirm the appointments following the 2003 selection process. The situation continues to be the same today except for the recommendation of the GB on April 17, 2003, asking the ad hoc faculty to withdraw their SLP in order to facilitate regularisation. The SLP was withdrawn on June 4, 2003.
But, the committee expressed concern that the Supreme Court's orders were not taken into consideration before making the appointments in 2003. It said: [I]n the light of the Supreme Court's interim order, any other decision by any other body that sought to regularise the ad hoc assistant professors' services from the date of their initial appointment, and promote them on those grounds, could only be termed unlawful. This was all the more unacceptable as the High Court had already held that regularisation cannot be permitted. Withdrawal of the SLP in the Supreme Court alone cannot overturn either the High Court order or the Supreme Court order (emphasis added).
Stressing the need to obtain the Supreme Court's verdict without further delay, the committee concluded that all appointments made by the SSC in 2003 should perforce be treated as tentative or temporary. Since the court had not given any verdict on the case to date, this decision of the committee, appointed by the government, was equivalent to a government decision on the matter since the court or the government too had not issued any directive to the contrary and should continue to apply, a member of the committee said.
From the committee's findings, it is interesting to note that it was the IB and the GB that initiated the move to regularise the entire ad hoc faculty. In its meeting held on September 16, 2002, the IB (presided over by Shatrughan Sinha, Minister for Health under the Bharatiya Janata Party government) noted that if the ad hoc assistant professors were selected through a regular selection process, their period of ad hoc services would also be considered for promotion under the APS as a one-time measure. The GB, in turn, in its meeting on April 17, 2003, approved the IB's decision, although, as the committee noted, it was aware of the litigation pending in the Supreme Court on the issue of regularisation; it took the mistaken view that if the SLP was withdrawn all would be well. It was consequent to this GB decision that 64 of the 131 ad hoc faculty members selected by the SSC in 2003 became eligible for promotion and so were promoted as associate professors.
From the perspective of the AIIMS regulations, which the institute administration used to justify the regularisation, the committee noted that the GB might be the competent authority to make appointments to faculty posts, but not to regularise the services of ad hoc faculty and promote them by not implementing the court orders. It may be noted that at the time of the GB meeting, Sushma Swaraj had taken over as Health Minister under the BJP government. Once again, it was Sushma Swaraj who, as a member of the current GB, initiated the move to promote the 39 candidates under the APS despite the SSC finding them unfit, both in 2010 and in its recent review.One-time measure
According to the minutes of the GB meeting of January 16, following the SSC's review of January 6, which reiterated the unsuitability of the 39 candidates, Sushma Swaraj expressed concern over the status of the 39 members of the faculty and wanted that the issue be resolved. Stating that there was a significant shortage of doctors at the faculty level, she said that holding a full-fledged interview for them would take long and cause hardship. She, therefore, proposed that as a general amnesty to them, all the 39 found unfit by the SSC should be promoted.
However, Talwar and Deka opposed this, saying that such a move could have serious repercussions. Sushma Swaraj rejected their statement and said that this decision would be a one-time measure and not to be cited as a precedent. It may be recalled that the same phrase was used to regularise the appointments of the ad hoc faculty. Objecting to such a move to overrule the SSC decision, Deka said it would be better to replace the APS by promotions through the Departmental Promotion Committee (DPC).
But Sushma Swaraj's position was supported by another politician, Moti Lal Vora, who chaired the meeting in the absence of the Minister, and, interestingly, the DGHS, who was earlier party to the SSC decision. This time around, however, he seems to have succumbed to pressures from the political bosses. As a result, the GB decided to promote all the 39 candidates to their respective higher grades along with the statement that this would be a one-time relief measure and will not constitute a precedent. Incidentally, Madhu Vajpayee, the wife of Rasik Bihari Vajpayee, who happens to be the nephew of Atal Bihari Vajpayee, was one of the ad hoc assistant professors.
It is also pertinent to point out that the SSC itself is not always beyond politics as is evident from the 2003 selection process. According to some faculty members, even in the present case, there were some instances of undeserving candidates being promoted in the 2010 selection process.
In fact, the report of the four-member AIIMS review committee under M.S. Valiathan, constituted in July 2006, said: Instances have been brought to our notice when legislators and influential persons in the government contact senior faculty members for health problems, and the faculty members, in turn, take advantage of their contact to influence their own selections and promotions. On the SSC, it said: We are told that external experts who are invited to conduct the interview are asked to leave after giving their assessment of candidates, and the final recommendations are written in their absence and without their participation. It further noted with regard to the GB, the competent authority for appointments: The appropriateness of MPs taking part in the selection of faculty members needs re-appraisal as such a practice is unheard of in any institution of national importance or of higher education in India.
The GB decision, one member of the committee remarked, is unprecedented in the history of AIIMS and is a clear violation of the word and spirit of the AIIMS Act and undermines any aspiration for quality in medical education. The selection process, which was vitiated in 2003, continues to be trampled by powerful vested interests. According to him, many of the senior faculty of AIIMS have reached senior positions without proving their worth. We could be missing out on much better people in the country. Political interference, which is corruption, is at its highest in AIIMS, he added.
This is perhaps a pointer to what could happen with such power, now sought to be concentrated at the Centre in the draft of the National Council for Human Resources in Health (NCHRH) Bill, which is pending in Parliament, even though health happens to be a State subject. It has undergone several revisions in the past few years. The current draft is far from what was originally envisaged in the Yash Pal Committee Report. The new Bill proposes to give the Health Ministry an unfettered hand in dictating professional health education in the country.
According to the Bill, all positions and authorities in the new structure are to be appointed by Selection Committees appointed by the Union Health Ministry, undermining the autonomy of institutions of higher medical education and profession. That must be prevented.