West Bengal Health Minister Sharadwat Mukhopadhyay has said the state health department wants to hand over its investigation into alleged large-scale irregularities in the Swasthya Sathi health insurance scheme to an agency specialising in financial fraud, subject to Chief Minister Shubhendu Adhikari’s approval. The minister said he had sought a meeting with the chief minister and that the department had prepared the relevant files.
Mukhopadhyay made the announcement at a press conference on Tuesday, according to Anandabazar. He said the department could not independently examine every dimension of the alleged financial irregularities because it lacked both the time and specialised expertise required for such an investigation. If the chief minister grants permission, records relating to what the minister described as 10 years of irregularities in Swasthya Sathi would be handed to an investigative agency.
The allegations concern a government health insurance programme used by beneficiaries to obtain treatment at enrolled hospitals and nursing homes. Mukhopadhyay had earlier said that a preliminary assessment indicated alleged fraud worth Rs 25,000 crore to Rs 30,000 crore. He described that figure as an initial estimate and said the department’s subsequent review had identified multiple participants and mechanisms that would require a wider investigation.
According to the minister, the department found instances in which cards belonging to deceased beneficiaries were allegedly used to generate bills. He cited a case in which a beneficiary died while receiving treatment, but records showed the person being admitted again three or four years later and undergoing surgery. The resulting bill was then allegedly sent to the health department for approval. Mukhopadhyay questioned how nursing homes could obtain and use the cards without the involvement of members of the beneficiary’s household.
The minister also alleged that third-party administrator companies, which were responsible for detecting suspicious bills, had helped approve some of them. He said the alleged irregularities involved officials at lower levels of the department, hospitals, beneficiaries, doctors and relatives of patients. These remain allegations presented by the health minister; the source report does not indicate that a specialised investigative agency has yet been appointed or that the claims have been established through a completed investigation.
The minister further said that the department had found evidence of alleged fraud involving false documents in the ambulance service operated under the Nishchay Yaan programme for pregnant women. The reported allegations therefore extend beyond hospital treatment claims and raise questions about controls across publicly funded health-service delivery.
The health department had previously issued advisories to nursing homes after several cases involving alleged unethical practices linked to Swasthya Sathi came to light, the report said. Those incidents had been presented by the Trinamool Congress-led health administration as isolated cases. The report also said that, despite concerns within the health department about the role of some nursing homes and doctors, action had not been taken against intermediary third-party administrator companies.
The proposed investigation would require approval from the chief minister, after which the files prepared by the health department could be submitted to an investigative agency. Trinamool Congress MLA Kunal Ghosh said that if irregularities had occurred, the administration would take action. He also cautioned that the process should not result in relatives of those involved receiving favourable postings, according to the report.
