Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH)

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Irregular Construction of a Pharmaceutical Factory in Kerala
(CAG of India, 18-06-2018) CAG of India
Government of Kerala irregularly assigned land falling under ‘residential zone’ for construction of a pharmaceutical factory resulting in denial of mandatory clearances from local body and consequent idle investment and locking up of funds to the tune of INR 3.76 crore.
Loss of Revenue Due to Not Charging Fees for Panchkarma Therapies in Haryana
(CAG of India, 16-03-2021) CAG of India
Shri Krishna Government Ayurvedic College, Kurukshetra did not comply with instructions of the State Government for charging fee for Panchkarma therapies which resulted into loss of revenue of INR 82.48 lakh.
Performance Audit of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH 2000-2005)
(CAG of India, 2005) CAG of India
Government of India established the Department of Indian Systems of Medicine and Homoeopathy (renamed AYUSH from November 2003) in March 1995 with the main objectives of promoting good health, expanding the outreach of AYUSH healthcare through preventive, promotive, mitigating and curative interventions, improving the quality of teachers and clinicians, ensuring affordable and efficacious AYUSH services and drugs and integrating AYUSH in healthcare delivery system and National Health Programmes. This report of the Comptroller and Auditor General of India contains performance appraisal of Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH), Ministry of Health and Family Welfare. The performance audit covering the period 2000-01 to 2004-05 was conducted through test check of records of the Department of AYUSH including its subordinate offices and implementing agencies in 29 States and Union Territories. Audit examination revealed that the Department attempted to implement a large number of schemes without adequate budgetary support, which resulted in dissipation of much of the efforts as well as lack of proper focus in the implementation of the schemes. The Ministry did not raise the budgetary allocation to the promised level of 10 percent of the total health plan. There were problems of management like lack of coordination between the Ministry and the regulatory and research bodies, absence of an effective monitoring and evaluation system and failure to remove different kinds of procedural hurdles. Educational institutions, hospitals and the apex research bodies suffered from poor infrastructural facilities including serious shortage of manpower even decades after they were set up. The regulatory bodies did not exercise their autonomy judiciously resulting in the Ministry curtailing their delegated authority in some cases. The quality control activities did not make any impact as the Pharmacopoeia Committees failed to finalise pharmacopoeial standards in respect of any of the compound formulations in the Ayurveda and Unani systems. Research activities undertaken by the Research Councils had not been taken up under any fixed parameters and within any specified time frame nor had research findings been disseminated for the benefit of stakeholders. Various promotional and contractual farming schemes were undertaken for increasing production of medicinal plants without any authentic database on the demand and supply position of prioritised medicinal plants. Poor supervision, monitoring and coordination among the functionaries only compounded the problems, as there was no perceptible impact on the production of medicinal plants. The Ministry did not succeed in achieving the objective of expanding the outreach of health care under AYUSH.
Performance Audit of AYUSH Department in Uttarakhand (2011-2016)
(CAG of India, 02-05-2017) CAG of India
A performance audit on Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) covering the period 2006-07 to 2010-11 was included in the Audit Report (Civil) for the year ended 31 March 2011. The Report was placed before the State Legislative Assembly in December 2012. This follow up audit was conducted with the objective of assessing the implementation of recommendations made in the earlier Audit Report and other important audit findings. The follow-up audit was conducted from April to May 2016 through test-check of records of the offices of the Director, Ayurvedic and Unani Services, the Director, Homoeopathy, the Principal cum Superintendent, Rishikul Post Graduate Medical College and Hospital, Haridwar, the Superintendent, Government State Pharmacy, Haridwar and two out of four district level offices (Haridwar and Pauri) of Ayurveda and Homoeopathy audited earlier. The period covered in audit was from 2011-12 to 2015-16. The audit was conducted with reference to the four recommendations accepted by the Government in the exit conference (March 2012) against 27 observations included in the Audit Report 2011.
Performance Audit of Indian System of Medicines and Homeopathy in Bihar (1999-2004)
(CAG of India, 2005) CAG of India
The Government established the department of Indian System of Medicine and Homoeopathy (ISM&H) for making available doctors practising these systems of medicine and providing medical and health care services to the masses at an affordable price. The Department failed to provide adequate educational and research facilities in Indian System of Medicine and Homoeopathy (ISM&H). Medical and health care services were also poor in the State. Following are the main audit findings: 1. Ayurvedic, Unani and Homoeopathic Medical Colleges and hospitals did not fulfill the required standard prescribed by the Central Council of Indian Medicine and the Central Council of Homeopathy New Delhi in respect of deployment of teaching, non-teaching, medical and para medical staff. 2. In the Government Homoeopathic Medical College and Hospital, Muzaffarpur considerable number of students dropped out every year. 3. Functioning of the Ayurvedic College-cum-Hospital, Begusarai and the Government Tibbi College, Patna suffered due to lack of basic infrastructure facilities. 4. No patient was admitted in paediatric emergency and research department of Government Ayurvedic College hospital, Patna during 1999-2003. 5. Out of Rs 1.25 crore released by the GOI for strengthening of infrastructure in Ayurvedic & Unani Colleges / Pharmacies, expenditure of Rs 73.22 lakh incurred on the facilities was rendered unfruitful. 6. The ISM&H department had not established any monitoring mechanism for evaluating the functioning of Ayurvedic, Homoeopathic and Unani colleges, hospitals and dispensaries.
Performance Audit of Indian System of Medicines and Homeopathy in Chhattisgarh (2000-2004)
(CAG of India, 2005) CAG of India
In Chhattisgarh, the Directorate of Indian System of Medicine and Homeopathy (ISM&H) has the responsibility of providing medical treatment through the systems of Ayurveda, Unani, Homeopathy, Yoga and Naturopathy. Poor infrastructure, high establishment cost and negligible expenditure on medical facilities were observed in this performance audit covering the period 2000-2004. Financial and operational management of the Department were deficient. Thirteen to 58 per cent of funds allocated for purchase of medicines were not utilised. Pharmacy was not modernised and quality control of medicines was not ensured. Due to lack of infrastructural facilities, adequate health care facility was not being made available. Main audit findings are summarised below: 1. Thirty bedded hospital at Ambikapur was not functional even after 25 years of sanction. 2. Sixty one of the 63 buildings sanctioned in 2002 were incomplete till date. 3. One hundred and forty eight dispensaries in six districts were running without doctors, and an unfruitful expenditure of Rs. 4.73 crore was incurred on pay and allowances of para medical staff. 4. The cost of medicines, produced during the period 2000-04 ranged from a meagre 17 per cent to 54 per cent of the overall running cost of the pharmacy. 5. Pharmacy machinery worth Rs.80.21 lakh was either not received or not installed hampering strengthening and modernisation of the pharmacy. 6. Quality of teaching was adversely affected in Government Ayurvedic Medical College due to non-posting of eight professors, nine readers and 12 lecturers as required under the Central Council of Indian Medicine (CCIM) norms.
Performance Audit of Indian System of Medicines and Homeopathy in Delhi (2000-2005)
(CAG of India, 2006) CAG of India
The Directorate of Indian Systems of Medicine and Homoeopathy is entrusted with implementation of the various programmes and policies of the Government of NCT of Delhi relating to Indian systems of medicine and homoeopathy. The performance audit of the functioning of the directorate revealed non-utilization of available resources and shortfall in setting up of homoeopathic, ayurvedic and unani dispensaries and health facilities. The spread and availability of treatment facility under Indian systems of medicine and homoeopathy fell far short of targets envisaged in the State health policy announced in 2001. Only 18 ayurvedic, nine unani and 31 homoeopathic dispensaries could be set up as of March 2005 against a target of 135 ayurvedic, 45 unani and 90 homoeopathic dispensaries during the Ninth Plan and the first three years of the Tenth Plan. Administrative laxity and lack of effective pursuance resulted in the utilization of only Rs.19 lakh (seven per cent) out of the grants-in-aid of Rs.2.67 crore made available by the Government of India during 2000-01 to 2004-05 for implementation of six centrally sponsored plan schemes while a drug testing laboratory was not set up for over three years despite availability of funds.
Performance Audit of Indian System of Medicines and Homeopathy in Madhya Pradesh
(CAG of India, 2005) CAG of India
The Directorate of Indian System of Medicines and Homoeopathy in Madhya Pradesh was established to implement various programmes and schemes of delivery of health services, imparting education, production of medicines etc. in the systems of Ayurveda, Homoeopathy & Unani with the assistance of District Ayurveda Officers, Principals of colleges and Superintendents of pharmacies in the State. It functioned under the Medical Education Department of Madhya Pradesh Government. There was an audit observation with regard to the Directorate of Indian System of Medicines and Homeopathy in Madhya Pradesh in Audit Paragraph 3.20 of the Report of the Comptroller and Auditor General of India on Madhya Pradesh for the year ended 31 March 1998. This performance audit covers the period 1999-2000 to 2003-04 and it was conducted through examination of records at the Directorate of Indian System of Medicines and Homeopathy, District Ayurveda Officers in 11 districts out of 45, two pharmacies (Bhopal and Gwalior) and four colleges out of nine (Ayurveda - Bhopal and Gwalior, Unani and Homeopathy - Bhopal). Main audit objectives of this performance audit were to assess: 1. Whether health care services under State programmes and Centrally Sponsored Schemes pertaining to ISM&H were properly delivered in rural and urban areas, 2. Adequacy and utilisation of facilities and infrastructure for education and training in these systems of medicines, 3. The economy and the efficiency in production and procurement of medicines and 4. The monitoring and evaluation mechanism, for administering the ISM&H activities in the State.
Performance Audit of Indian System of Medicines and Homeopathy in Odisha (2000-2005)
(CAG of India, 2005) CAG of India
This performance audit of Indian System of Medicines and Homeopathy (ISM&H) in Odisha covering the period 2000-2005 revealed that the poor infrastructure in hospitals and dispensaries, non revision of norms of medicine and diet, shortage of staff in dispensaries, inadequate supply of medicines and equipment to dispensaries stood in the way of providing quality health care services through ISMH. Vacancy in the teaching staff of the medical colleges affected the standard of education imparted under the systems. In the absence of Drugs Testing Laboratory in the State for testing of homoeopathy and ayurvedic medicines, the quality and standard of ISMH drugs in circulation in the State could not be ensured. Maintenance of herbal gardens was not effective and thus uneconomical.
Performance Audit of Indian System of Medicines and Homeopathy in Punjab (1999-2004)
(CAG of India, 2005) CAG of India
This performance audit shows that in Punjab, the Indian Systems of Medicine and Homoeopathy (ISM&H) could not be made effective. The major percentage of expenditure was on salaries and negligible expenditure was incurred on medicines. Although sufficient infrastructure had been created in Government Ayurvedic Pharmacy, Patiala for manufacture of Ayurvedic drugs, only negligible expenditure was incurred on purchase of raw herbs to be used for preparation of Ayurvedic drugs. As a result, no medicine could be provided to the hospitals/dispensaries and there were no indoor patients in 10-bedded Ayurvedic Hospital, Ludhiana and seven Ayurvedic Swasth Kendras. This led to unfruitful expenditure on pay and allowances of idle staff. Main audit findings are summarised below: 1. More than 98 per cent expenditure was incurred on salaries and negligible expenditure was incurred on medicines etc. Per patient expenditure on medicines decreased from 76 paise in 1999-2000 to 22 paise in 2003-04 (ISM) and ranged between 3 paise and Rs 1.20 (Homoeopathy) during 1999-2004. 2. Rupees 1.91 crore for Ayurveda released by Government of India were either not released by State Government or released only at the end of the year. 3. Rupees 0.19 crore for Homoeopathy released by Government of India could not be utilised due to late sanctioning of scheme by the State Government. 4. The department not only failed to fully utilise the funds received from Government of India for Government Ayurvedic Pharmacy Patiala but also incurred ungainful expenditure of Rs 36.98 lakh on purchase of machinery. 5. As no indoor patients were admitted in hospitals/Swasth Kendras, unfruitful expenditure of Rs 1.19 crore was incurred on account of pay and allowances of idle staff. 6. Response to the proposal to surrender 32 posts which could have saved Rs 40 lakh per year sent to Director, Research and Medical Education in November 1999 has not been received so far.
Performance Audit of Indian System of Medicines and Homeopathy in Tamil Nadu (1999-2004)
(CAG of India, 2005) CAG of India
The Government of Tamil Nadu took initiatives to encourage Indian Systems of Medicine with the objective of popularising them and to bring out their benefits. However, the Indian Medicine and Homoeopathy Department did not maintain any statistics to prove their effectiveness in treatment of diseases. The vacancies in the posts of Assistant Medical Officers resulted in shortfall in providing services. Against 9604 in-patients admitted in Arignar Anna Government Hospital of Indian Medicines, Chennai, during 1999-2004, 4465 (46 per cent) patients either abandoned the treatment or got discharged against medical advice. Four Research Units established in the above hospital for cancer and AIDS, diabetes, infertility and fracture did not carry out any research activities due to lack of modern machineries/ equipments and staff. Grants from Government of India for procurement of equipments for Drug Testing Laboratory was utilised only partially. Main audit findings are summarised below: 1. Out of Rs 60 lakh released by Government of India as grant for procurement of equipments for Drug Testing Laboratory Rs 27.88 lakh were not utilised. 2. The statistical data available with the Department only indicated the number of visits by patients and no data was available to prove the effectiveness of the Indian Systems of Medicines in treating diseases. 3. Out of 9604 patients admitted in the in-patient ward in Arignar Anna Government Hospital of Indian Medicines, Chennai, during 1999-2004, 4465 patients either abandoned the treatment or got discharged against medical advice. 4. The attendance of Assistant Medical Officers was less than 15 days in a month in 56 per cent and 68 per cent of the months in Thiruvannamalai and Nagapattinam Districts respectively during the five years from 1999 to 2003. 5. The four Research Units established in Arignar Anna Government Hospital of Indian Medicines, Chennai, did not carry out any research activity due to lack of modern equipments and staff. 6. A Regional Pharmacy (at Thirumayam, Pudukottai District) was defunct from April 2002 but Rs 11.59 lakh was spent towards staff of the defunct pharmacy.
Performance Audit of Indian System of Medicines and Homeopathy in Tamil Nadu (2013-2018)
(CAG of India, 24-06-2021) CAG of India
The policy of the Government is to provide holistic health care by bringing Indian Systems of Medicine (ISM) into the mainstream. Government seeks to achieve its objectives by expanding the existing network of ISM institutions, improving the quality of medical education, etc. The present Performance Audit revealed near absence of a system for management of project funds provided by the Central and the State Governments, chronic shortage of physical and human infrastructure in medical institutions and lack of efforts to further research and development in ISM. Main audit findings are summarised below: 1. Delays in procurement of equipment resulted in huge sums lying in the bank accounts of Tamil Nadu Medicinal Plant Farms and Herbal Medicine Corporation Ltd., (TAMPCOL) and State AYUSH Society. The Department parked unutilised funds with TAMPCOL. 2. The shortage of manpower across various posts ranged from 10 to 38 per cent in regular ISM wings, 48 per cent in ISM wings created under National Rural Health Mission and up to 100 per cent in ISM wings created under AYUSH. 3. Out of 297 ISM wings in the sampled districts, 31 stopped functioning and 25 functioned for four days or less per week due to shortage of medical personnel. 4. TAMPCOL, the PSU which manufactures and supplies medicines to ISM wings supplied only 47 and 50 per cent of the total quantity of medicines indented by the hospitals/wings during 2016-17 and 2017-18 respectively due to inadequate provision of funds and short production. No medicines were supplied to Unani wings during 2016-17. 5. During 2013-18, 82 drugs found to be ‘Not of Standard Quality’ could not be frozen or recalled immediately from distribution due to delay in drug testing on account of shortage of staff in drug testing laboratory. 6. Ayurveda, Unani and Homoeopathy colleges of the Government did not offer Post Graduate courses, hampering expansion of the reach of ISM. 7. The Research and Development wing sanctioned by the Government in 2013 at a cost of Rs 12 crore did not start functioning even as of August 2018 and the assets created were lying idle due to lack of coordinated action in procuring equipment and recruiting staff.
Performance Audit of Indian System of Medicines and Homeopathy in Tripura (1999-2004)
(CAG of India, 2005) CAG of India
This performance audit report on functioning of Indian System of Medicines and Homeopathy in Tripura covering the period 1999-2004 revealed that lack of planning, poor infrastructure, shortage of staff, poor manpower management, absence of adequate support system and opening of dispensaries without any feasibility study making many of the dispensaries dysfunctional – all in combination had a deleterious effect on working of the systems of Ayurveda and Homoeopathy to cater to the needs of public health care in the State. Main audit findings are summarised below: 1. Dispensaries were opened without feasibility study. This resulted in non-functioning of 17 Homoeopathic dispensaries for want of patients and wasteful expenditure of Rs. 22.10 lakh. 2. Neither Medical Officers nor Pharmacists were provided in five Homoeopathic dispensaries. This made these five Homoeopathic dispensaries dysfunctional. 3. Bed capacity of the Homoeopathic Hospital at Agartala remained heavily under-utilised due to non-supply of meals to the patients, poor pathology and radiography services and even non-availability of ambulance. 4. An amount of Rupees eight lakh spent on a project for development and cultivation of medicinal plants at Kamalpur proved wasteful as the infrastructure created by July 1999 remained abandoned since then.
Performance Audit of Indian System of Medicines and Homeopathy in West Bengal (1999-2004)
(CAG of India, 2005) CAG of India
The policy of the Government of India was to develop Indian System of Medicine and Homoeopathy (ISM&H) to provide better and economic health care to every citizen. This performance review of ISM&H in West Bengal covering the period 1999-2004 revealed that proper treatment through ISM&H could not be provided to the population due to low budgetary provision and failure of the institutions to avail of GOI assistance for infrastructure development, inadequate infrastructural facilities in state hospitals, non-deployment of medical officers in dispensaries and absence of homoeo dispensaries at panchayat level. In the absence of monitoring and supervision, the performance of the ISM&H institutions, laboratory and pharmacy and the utilisation of existing infrastructures for education, treatment and production of medicines were not satisfactory. Only 20 per cent of the gram panchayats were provided with dispensaries. State homoeopathic hospitals were set up only in Kolkata and two districts out of 19 districts. Fifty one dispensaries remained non-functional upto seven years for want of MOs. In the absence of essential indoor departments and requisite instruments in ISM&H institutions, patients were deprived of medical care and the students did not receive appropriate training. The existing capacity of the Integrated Drug Production and Testing Centre at Kalyani in drug testing and production of medicines and raw materials was badly underutilised. Modernisation of the Centre was stalled for want of infrastructure. Absence of supervision and monitoring on the part of the administration on utilisation of available infrastructure for education, treatment, production of medicine and supply of quality drugs adversely affected the quality of services under ISM&H.
Performance Audit on Efforts to Popularise and Strengthen Ayurveda in Rajasthan (2012-2017)
(CAG of India, 05-09-2018) CAG of India
Indian Systems of Medicine comprise Ayurveda, Unani, Siddha, Yoga and Naturopathy, of which Ayurveda is widely practiced in Rajasthan. The Ayurveda Department (Department) has an extensive network of 118 hospitals and 3,577 dispensaries in the State and during 2012-17, Government of Rajasthan (GoR) incurred INR 2,655.89 crore for Ayurveda Healthcare Services and Ayurveda Education. Though the Department prepared State Public Health Standards for standardization of facilities in Ayurveda dispensaries and hospitals in May 2014, they were still pending approval of GoR as of October 2017. The Department’s decision in September 1994 to establish a dispensary for minimum population of 2,000 persons was not followed and there was imbalanced distribution of dispensaries in rural areas. Further, in absence of an effective awareness programme, the utilisation of the vast network of Ayurveda healthcare facilities could not be ensured in the State. Even the specialty clinics for key diseases had not been established. Basic infrastructural facilities were inadequate as electricity was not available in 46.88 per cent and drinking water in 74.17 per cent of the Ayurveda healthcare centers. Further, in seven test checked districts, toilets were not available in 75.38 per cent healthcare centers and most healthcare centers did not have all essential equipment. There was shortage of manpower at all levels and disproportionate deployment of Medical Officers and Nurse/Compounders was also noticed. Further, efforts for filling up the vacant posts on contractual basis were also not initiated. There was no significant growth in number of Ayurveda patients during last decade in spite of the fact that Department had inflated the number of beneficiary patients. The number of hospitals having nil bed occupancy increased from 60 in 2012-13 to 79 in 2016-17 and no patient was admitted consecutively for five years in 40 hospitals, four years in 48 hospitals and three years in 49 hospitals. In spite of this trend, no review to reduce/relocate the staff was conducted. The performance of the departmental pharmacies was dismal as the achievement in drug production vis-à-vis targets during 2012-17 was only 39.12 per cent. Further, the cost of drugs manufactured by the departmental pharmacies was 1.23 to 3.92 times higher the price of Indian Medicines Pharmaceutical Corporation Limited. Distribution of drugs was done without ascertaining demand and there were instances of delay in distribution of drugs, distribution of expired drugs to the patients and failure to distribute drugs in small hygienic packaging. The quality of drugs produced was also not tested adequately to maintain standards. No new Post Graduate courses could be started in Government Ayurveda College, Udaipur after 1986 due to non-availability of qualified teachers. Further, practical training in Surgery and Gynecology was not being provided to the students as the Ayurveda colleges did not have facilities for delivery and surgery cases. The financial management was also weak as the Department failed to monitor the delays in submission of UCs resulting in the deprival of central assistance of ` 52.96 crore. As 91.78 per cent of total available funds during 2012-17 were spent on pay and allowances, a very small percentage of funds was available for strengthening and upgradation of healthcare facilities, which adversely impacted the quality of healthcare services provided in the State. The Department thus was not able to provide effective and quality Ayurveda healthcare services to the public despite having the largest number of Ayurveda dispensaries/hospitals in the country. Considering the existence of large number of professionals, dispensaries and hospitals in the State, there is an urgent need for GoR to review and improve the prevalent deficiencies in the Ayurveda healthcare services by adopting a suitable policy and standards.
Performance Audit on Functioning of AYUSH in Gujarat (2014-2019)
(CAG of India, 25-09-2020) CAG of India
Audit observed that the test-checked teaching Government Ayurved Hospitals (GAHs) and Government Homoeopath Hospital (GHH) had provided Out Patient Department (OPD) and In-Patient Department (IPD) services to more number of patients annually as against the minimum number of patients prescribed in the Regulations of Central Council for Indian Medicine (CCIM) and Central Council for Homoeopathy (CCH). However, following deficiencies were noticed during the course of Audit - 1. National Health Mission (NHM) and National AYUSH Mission (NAM) envisaged for mainstreaming of AYUSH by allocating AYUSH services at Primary Health Centres (PHCs), Community Health Centres (CHCs) and District Hospitals (DHs) however, Health and Family Welfare Department (H&FWD) could appoint AYUSH doctors on contractual basis in only 911 PHCs out of 1,474 PHCs, and no appointment of AYUSH doctors were made in 363 CHCs and 24 DHs in the State. The Doctors appointed in these PHCs could not provide the AYUSH services due to lack of coordination between the Commissionerate of Health and Directorate of AYUSH in establishing a mechanism for supply of AYUSH medicines through the Pharmacies and adequate facility of equipment/instruments. AYUSH hospitals were not available in eight out of 33 districts in the State. 2. Projects already planned were either not taken up or projects completed were not put to use which included projects planned for establishment of GAHs in two districts without facility of AYUSH services. Out of 15 wellness centres established in test-checked hospitals, seven centres were non-functional. Only average 3.97 per cent of budget provision of H&FWD was allocated for AYUSH during 2014-19. Government of Gujarat (GoG) could utilise only 56 per cent of Government of India (GoI) grant received under NAM. Facilities of Operation Theatres (OTs) were either not available or non-functional in 10 out of 15 test-checked GAHs. Instruments prescribed as per CCIM and CCH Regulations for OTs, laboratories and diagnostic units were either not available or found lying idle in the test-checked hospitals. Reducing trend in number of patients taking thalassemia treatment were found in test-checked thalassemia specialty clinics of test-checked hospitals due to absence of expert Vaidhya. Stock of 148 to 251 EDs were not available in 15 test-checked GAHs as of March 2019. Instruments/ equipment in some test-checked hospitals were found lying idle or in non-usable condition. Shortage of key posts such as Resident Medical Officers, Nurses, Vaidya Panchkarma and Pharmacist were noticed in test-checked GAHs and GHH. Out of 32 testchecked Ayurved and Homoeopathy dispensaries, five dispensaries were functioning without Medical Officer. 3. Full coverage of syllabus in AYUSH medical colleges was found doubtful, as actual teaching hours imparted for both theory and practical sessions were much less than the teaching hours prescribed under CCIM Regulations, 2016. Only 43 per cent students and 54 per cent students had prescribed 75 per cent attendance in theory and practical subjects respectively in test-checked Government Ayurved Colleges (GACs). Shortage of teaching staff (Professors, Readers and Lecturers) were observed in four out of six testchecked GACs. The above facts of not completing the prescribed hours of teaching, lack of required attendance of classes for students and shortage of teaching staff had adverse bearing on pass percentage of students in Bachelor of Ayurvedic Medicine and Surgery (BAMS) in the State as 45 per cent students had failed the examination. None of the test-checked colleges had the facility of teaching pharmacy and quality testing laboratory for providing practical training on preparation of medicines/drugs. Facility of in-house Central Research Laboratory (CRL) for Post Graduate (PG) course was not available in the two test-checked colleges which provided PG course. 4. Drugs manufactured in the two test-checked Government Ayurved Pharmacies were supplied without conducting quality tests. Co-operative Pharmacy at Odhav, Ahmedabad were manufacturing and supplying drugs without valid licence. None of the test-checked pharmacies were mentioning the expiry dates of medicines. Drug inspectors of test-checked districts had failed to conduct the prescribed inspection of all manufacturing units of Ayurved and Homoeopathy medicines. Out of 1,520 AYUSH drug samples tested during 2014-19, 87 samples were found of ‘Not of Standard Quality’ (NSQ). NSQ drugs were not recalled in 27 out of 30 cases test-checked and the drugs were found as consumed. Instances of delay in testing of drug samples and non-conduct of prescribed tests by Food and Drugs Laboratory (FDL) were noticed in audit. Existing allopathic drug inspectors and analysts of the State were notified for AYUSH by GoG in contravention of the provision of Drugs and Cosmetics (D&C) Rules which envisage for minimum Ayurveda, Siddha or Unani (ASU) qualification. 5. Even after lapse of more than six years, the Centre of Excellence (CoE) could not complete the five activities of research assigned to it. Research projects under NAM were not completed. Shortfall in inspection of AYUSH dispensaries by the District Ayurved Officers (DAOs) were noticed during 2014-19.
Performance Audit on Provision of Healthcare Services and Medical Education Through Indian Sustem of Medicine in Tamil Nadu (2013-2018)
(CAG of India, 24-06-2021) CAG of India
The policy of the Government is to provide holistic health care by bringing Indian Systems of Medicine (ISM) into the mainstream. Government seeks to achieve its objectives by expanding the existing network of ISM institutions, improving the quality of medical education, etc. The present Performance Audit revealed near absence of a system for management of project funds provided by the Central and the State Governments, chronic shortage of physical and human infrastructure in medical institutions and lack of efforts to further research and development in ISM. 1. Delays in procurement of equipment resulted in huge sums lying in the bank accounts of Tamil Nadu Medicinal Plant Farms and Herbal Medicine Corporation Ltd., (TAMPCOL) and State AYUSH Society. The Department parked unutilised funds with TAMPCOL. 2. The shortage of manpower across various posts ranged from 10 to 38 per cent in regular ISM wings, 48 per cent in ISM wings created under National Rural Health Mission and up to 100 per cent in ISM wings created under AYUSH. 3. Out of 297 ISM wings in the sampled districts, 31 stopped functioning and 25 functioned for four days or less per week due to shortage of medical personnel. 4. TAMPCOL, the PSU which manufactures and supplies medicines to ISM wings supplied only 47 and 50 per cent of the total quantity of medicines indented by the hospitals/wings during 2016-17 and 2017-18 respectively due to inadequate provision of funds and short production. No medicines were supplied to Unani wings during 2016-17. 5. During 2013-18, 82 drugs found to be ‘Not of Standard Quality’ could not be frozen or recalled immediately from distribution due to delay in drug testing on account of shortage of staff in drug testing laboratory. 6. Ayurveda, Unani and Homoeopathy colleges of the Government did not offer Post Graduate courses, hampering expansion of the reach of ISM. 7. The Research and Development wing sanctioned by the Government in 2013 at a cost of INR 12 crore did not start functioning even as of August 2018 and the assets created were lying idle due to lack of coordinated action in procuring equipment and recruiting staff
Unfruitful Expenditure on Construction of AYUSH Hospital at Harwan, J&K
(CAG of India, 23-09-2021) CAG of India
Departmental failure to seek prior permission from the Lakes and Waterways Development Authority, before taking up the construction works of integrated Ayush Hospital and Wellness Centre at Harwan, resulted in unfruitful expenditure of INR three crore, blocking of INR 3.38 crore and creation of liability of INR 2.75 crore.
Unfruitful Expenditure on ISM Centre and Dispendary Due to Non Availability of Land in J&K
(CAG of India, 23-09-2020) CAG of India
Departmental failure to ensure the availability of land before taking up the construction of hospital buildings and execute works as per cost estimates and ensure their completion over a period of eight years, resulted in unfruitful expenditure of INR 1.16 crore and interest liability of INR 44.21 lakh on the borrowed funds.

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