Cabinet approval granted to Elekta whose quoted price was 50 percent more than the market price
by Hafsa Sabry -The Sunday Leader
It has now been revealed how during the Rajapaksa regime an unsolicited contract to supply high quality radiotherapy with high energy radiation for cancer patients had been given to a local agent of a Swedish company for a higher price which has cost the country nearly Rs. 7.7 billion.
It has been revealed how the former regime had given this contract to Elekta which is the UK branch of a Swedish company. The local distributor is Siyol International (Pvt) Limited. Despite the fact that there were many reputed international manufacturers of medical linear accelerators, cabinet approval had been granted to the Elekta quoted price which was said to be 50 percent more than the market price.
It is alleged that the project directors had misused the tender deal for their personal benefit.
The total cost of this project is Rs. 7.7 billion of which Rs. 5.9 billion is for the supply and installation of the equipment, Rs.1.8 billion for the construction of radiation protective bunkers and associated buildings, 14 triple, dual and fixed energy linear accelerators, eight CT simulators and nine brachy therapy units to be installed in the ten identified oncology centres.
Health Ministry sources who wished to remain anonymous accused two main individuals, director of the project Asoka Jayawardane and Engineer S. A. J. Karunatilake of the Bio Medical Engineering Division of the Health Ministry of direct involvement in this scam.
According to government financial regulations, government procurement guidelines have to be followed when making purchases or in some instances proceeded by a pre-qualification process. “However in this instance, neither was the pre-qualification process followed nor tenders called. Instead, a decision had been made arbitrarily to make this massive purchase from Elekta. Despite, the fact that there were four international manufacturers of medical linear accelerators, violating tender procedure, Elekta was allowed to give their price and the Health Ministry agreed without any evaluation. The prices paid by the ministry exceeded the market price by more than 50 per cent raising questions as to who the beneficiaries of this largesse are,” sources added.
According to the sources, there are several requirements to be followed before a radiotherapy machine is installed because it has to be properly installed and monitored to prevent any health hazards and environmental effects by its radiation. First and foremost there should be a separate bunker with a minimum wall thickness of two metres and the bunker should be fully air-conditioned.
“Batticaloa, Jaffna, Karapitiya and Kandy are alleged to have failed to complete the constructions to the required standard although the bunker construction work has been completed in the Tellipalai Trail Cancer Hospital in Jaffna and at the Teaching Hospital Batticaloa,” sources alleged. The sources further said that although approval had been granted to purchase 15 radio machines during the previous regime only three had been imported so far, each costing around US $ 5 millionand three more machines will be coming into the country in the near future. “Since there are no properly constructed bunkers for the machines they have been lying in the storerooms of the respective hospitals over the past three months,” sources said.
However, of the three machines, one had been installed at the Maharagama Cancer Hospital in the existing bunker. “The country needs more radiotherapy machines as cancer is said to be the second highest cause of death in the country. Although the country has spent millions of rupees to purchase more radiotherapy machines, at this moment only two radiotherapy machines are in operation at the Cancer Institute, Maharagama and at the Ceylinco Healthcare Centre, Colombo to treat all cancer patients in the country,” sources claimed.
The sources meanwhile also alleged that most of the cancer treatment tri-energy machines at the Cancer Institute Maharagama suit bigger body structures which is not suitable for Sri Lankans.
“As a result of this, the machines produce excessive energy and power which damage the healthy tissues around the tumor which causes more danger to the sick,” sources added. According to the sources the reason why larger machines are imported is because of its high cost which will be beneficial for those who are receiving commissions from each purchase.
“The price is higher for larger machines and so is the public money that can be played out by those who are behind the purchasing scams. Without considering what the adverse impact could be on the innocent cancer patients who battle to get their disease cured, they buy these larger machines which make the patients even more sick,” sources alleged. The question remains as to who has given orders to subvert government procurement guidelines and awarded this enormous contract to a single supplier without calling for tenders.
“Such a decision can be taken only by the hierarchy,” sources claimed. Meanwhile it is learnt that the Project Director Asoka Jayawardene had been removed from his post as soon as Health Minister Dr. Rajitha Senaratne took over office but action is yet to be taken against Assistant Bio-Medical Engineer S.A.J. Karunatilake who too was involved in the deal. When The Sunday Leader contacted the Director, Teaching Hospital, Batticaloa to check on what has happened to the radiotherapy machine they have received and whether the bunker was constructed to the required standard, Dr. Ibra Lebbe said that the construction of the bunker is yet to be completed.
“The machine will be installed after the constructions are completed,” Dr. Lebbe said. However according to the Director of the Teaching Hospital, Karapitiya, Dr. Shelton Perera, the construction work is yet to be completed as the air-conditioners are yet to be installed. “We are yet to receive the air-conditioner. The installation of the machine is expected to be completed by November,” Dr. Perera said.
However, E. D. Piyathilake, Chairman of the Central Engineering Consultancy Bureau that constructed the bunkers in all hospitals, said that the bunkers in Jaffna and Batticaloa hospitals have been completed and the radiotherapy machines and the air-conditioning systems have to be fixed.
“We have only undertaken the civil constructions and our work will be completed in Kandy and Galle very soon as 70 percent of the construction work has already been completed. We have followed the specified requirements for the wall thickness in the construction,” Piyathilake added.
He further stated that the door for the bunker will be fixed only after the machine is installed.
Former Director Cancer Institute Maharagama and the former President Sri Lanka College of Oncologists Dr. Mahendra Perera said that whoever alleges about the machine and the radiation system should first be qualified to talk about it. “No one other than a qualified oncologist could speak about the radiation of the machine. These are blatant allegations against the doctors claiming that we play out public money”, Dr. Perera added.
According to Dr. Perera, there was only one radio therapy machine to treat the cancer patients in Sri Lanka ten years back and there was absolutely a need for new machines to be installed all over the country. Therefore the Sri Lanka College of Oncologists (SLCO), a cabinet approved college that represents all the 66 oncologist centers in the country and their members proposed the Ministry of Health to purchase these radio therapy machines in 2011.
“The college only requested for the necessary number machines and not for any particular brands. Nevertheless, there is only three manufacturers that manufacture these linear accelerator machines in the world – Philips, Varian and Elekta. “Varian was the machine that was initially bought and was breaking down very often from 2009. The Ministry of Health decided to purchase Elekta as Philips stopped manufacturing linear accelerator machines for a while and the hospital had a bitter experience with Varian as the machine failed to show the exact point where the radiation has to be aimed at. Moreover, the cost of Elekta comparing with Varian was cheaper as Varian was purchased for Rs. 450 million and Elekta costs only Rs.350 million,” Dr. Perera said.
Dr. Perera further stated that Elekta, a tri energy machine was installed with 5 years of warranty whereas Varian only had two energy systems with no warranty at all. “The Ministry would have selected Elekta for various reasons. Although the proposal was made by the SLCO to the ministry it had nothing to do with the brand selection or the tender dealings,” Dr. Perera claimed.