CAG raps health ministry for underutilisation of funds, shortage of doctors
New Delhi: Underutilisation of funds, uncontrolled circulation of expired and sub-standard medicines at government hospitals and acute shortage of doctors and paramedical staff, certainly does not go with government’s ambitious “Health for All”campaign, but it has emerged as a reality with the Comptroller and Auditor General (CAG) latest report released on Friday.
Coming heavily on the government for improper implementation of National Rural Health Mission (NHRM), the CAG report said that the financial management at both central and state levels was “not satisfactory”. In 27 states, the unspent amount increased from Rs7,375 crore in 2011-12 to Rs9,509 crore in 2015-16, the report pointed out.
The report has rapped the Union health ministry for shortage of basic medicines in the government hospitals and for its inability of quality control.
“In at least eight states, essential medicines and consumables such as vitamin-A, contraceptive pills, ORS packets, essential obstetric kits, etc., were not available in selected health facilities. In 14 states, medicines were issued to patients without ensuring the prescribed quality checks and without observing the expiry period of drugs, thus exposing the patients to health risks,” the report said. The 14 states include Assam, Bihar, Haryana, Jharkhand, Karnataka, Kerala, Maharashtra, Manipur, Odisha, Punjab, Telangana, Tripura, Uttar Pradesh and West Bengal.
“Every ASHA (Accredited Social Health Activist) is to be provided with a drug kit containing a set of drugs, equipment and products. The kit enables her to provide basic level care to the community. At least 3,588 ASHAs in 29 States/UT were surveyed and the findings revealed that at least 83% ASHAs didn’t have disposable delivery kits and 81% didn’t have blood pressure monitor.
The report found that despite having the financial assistance and availability of the medical equipment, the services aren’t being rendered due to lack of manpower. The shortfall in the availability of sub-centres (SCs), primary health centres (PHCs) and community health centres (CHCs) in the 28 states/ union territories (UT), ranged between 24-38%. The shortfall was more than 50% in five states including Bihar, Jharkhand, Sikkim, Uttarakhand and West Bengal.
Shortage of doctors and paramedical staff were observed in almost all selected facilities, compromising the quality of health care being administered to the intended beneficiaries. In the selected CHCs of 27 states, the average shortfall of five types of specialists (general surgeon, general physician, obstetrician/gynaecologist, paediatrician and anaesthetist) ranged between 77-87%.
“There was limited availability of medicines and equipments in 17 states, while 428 equipment (ultrasound, X-ray, ECG, cardiac monitors, auto-analyser, incinerator, OT equipment, blood storage unit etc.) costing Rs30.39 crore were lying idle/unutilised due to non-availability of doctors and trained manpower to operate the equipment, lack of adequate space for their installation. In 13 states at least 67 PHCs were functioning without any doctor,” the CAG report pointed out.
The CAG has rapped the government for not providing proper services under reproductive and child health (RCH) program. The CAG report has noticed shortfalls in administration of iron and folic acid tablets in all the 28 states. In 20 out of 28 states, non-maintenance of records of administration of antenatal checkups (ANCs) of pregnant women was noticed. Deficiencies were seen in Janani Suraksha Yojana that included non-payment of incentive to beneficiaries, delayed payment to beneficiaries, payment to 12,723 excess number of beneficiaries etc.” the report said.
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