District Hospitals

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https://resourcerepository.azimpremjiuniversity.edu.in/handle/apurr/57

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Unfruitful Expenditure on 300 Bed Hospital in Faizabad, Uttar Pradesh
(CAG of India, 26-03-2015) CAG of India
Not only the construction of the hospital building was incomplete (₹ 51.34 crore), even after three years of scheduled date of completion, the decision for procurement of equipment (₹ 4.40 crore) without ensuring completion of the hospital building in Faizabad district, was injudicious.
Unfruitful Expenditure on 100 Bed Hospital at Sirauli Gausspur, Barabanki, Uttar Pradesh
(CAG of India, 26-03-2015) CAG of India
Due to lackadaisical approach of the Government, 100 bed hospital at Sirauli Gausspur, Barabanki did not come up (November 2014) even after seven years of sanction, rendering ₹ 13.77 crore spent on its construction unfruitful.
Unfruitful Expenditure Arising from Non-Functional Upgraded Building of Hospital at Badal Punjab
(CAG of India, 27-02-2020) CAG of India
Due to laxity on the part of the Department and Baba Farid University of Health Sciences in providing requisite grant-in-aid and additional staff, the upgraded building constructed at a cost of INR 4.88 crore could not be put to use even after more than four years of its taking over by Senior Medical Officer, Civil Hospital, Badal, thereby rendering the expenditure of INR 4.88 crore unfruitful.
Idle Expenditure on MCH Building at Konark in Odisha
(CAG of India, 03-04-2021) CAG of India
Construction of Maternal and Child Health building without making plan for its operationalisation led to idling of the building, thereby rendering the expenditure of ₹ 5.96 crore incurred on construction of the building idle.
Improper Planning Leading to Idling of Three Multi-Storeyed Buildings at RGGGH Chennai in Tamil Nadu
(CAG of India, 24-06-2021) CAG of India
Improper planning and failure to assess the actual requirements by RGGGH and DME led to idling of three structurally completed multi-storeyed buildings constructed at a cost of INR 55.33 crore thereby depriving critical care to the needy patients.
Unfruitful Expenditure on Hospital Ship on River Brahmaputra
(CAG of India, 12-07-2021) CAG of India
“Establishment of Hospital Ship on the river Brahmaputra” a GoI funded novel project for providing health care services, remained incomplete and unfruitful after incurring an expenditure of INR 2.20 crore on the project.
Wasteful Expenditure on Four Buildings at Dhubri Civil Hospital, Assam
(CAG of India, 12-07-2021) CAG of India
Lack of co-ordination between National Health Mission (NHM) and H& FW Department, Government of Assam led to dismantling of four buildings constructed by NHM at a cost of `2.36 crore on the land proposed for construction of Medical College and Hospital, Dhubri. Further, the dismantling cost of INR13 lakh was also borne by the State Government.
Delays by Contractors in Construction of Health Infrastructure and Short Levy of Liquidated Damages in Karnataka
(CAG of India, 21-09-2021) CAG of India
The Chief Engineer, Health Engineering Wing levied nominal penalty for delays on part of the contractors in completing the works based on the recommendations of the Executive Engineers of the divisions. This resulted in short levy of liquidated damages of ₹ 14.63 crore besides extending undue benefit to the contractors.
Construction of Hospital and Medical College Buildings by PWD in Madhya Pradesh
(CAG of India, 25-12-2021) CAG of India
Audit observed deficiencies during execution of work not only led to excess payment and extra cost to work but affected quality of work as well. There were instances of adoption of incorrect rates, payment of transportation charges and excess payment on consumption of cement to the contractor. As a result, some parts of the works created extra financial burden on the Department, even though the quality of the work was not assured.
Avoidable Expenditure on Water Supply Contract for District Hospitals in Mizoram
(CAG of India, 16-02-2023) CAG of India
Directorate of Hospital and Medical Education (DHME), Health and Family Welfare Department, Government of Mizoram (GoM), Aizawl entered (May and December 2012) into Memorandum of Understandings (MoU) with a firm M/s Intergen Energy Limited (IGEL), New Delhi for installation of renewable energy and water treatment plant to supply water at nine Hospitals which include Referral Hospital, Falkawn and all eight District Hospitals of Mizoram. This was based on the suo-moto proposal submitted (February 2012) by the firm to GoM, for installation of Water Treatment Plant with solar power water pumping system to supply water on the basis of BOOT at the nine Hospitals. Audit observed that all Hospitals were getting water supplies on priority from Public Health Engineering (PHE) Department and there were no insufficiency in supply of water to the Hospitals reported, before or during the period of MoU with IGEL. Hence, engagement of IGEL was arbitrary and proposal of the firm was agreed to by the Department without ascertaining the actual need for water supply in the Hospital. Thus, expenditure of ₹ 0.50 crore for installation of Water Treatment Plants in five Hospitals and ₹ 4.80 crore on buy-back MoU in June 2019 totalling ₹ 5.30 crore was avoidable as there was no scarcity of water in the Hospitals prior to signing of agreement with the firm. Hospitals also did not report any issue in water supply during the stoppage of operation of the firm. Hence, there was a total avoidable expenditure of ₹ 5.30 crore in addition to committed liability of ₹ 4.20 crore against the balance payable on MoU on buy-back of equipment and water supplied. Further, Department, was supposed to terminate the MoUs on failure of IGEL to supply the required volume of water but entered into an unnecessary buy-back agreement.
Delay in Establishing Govt Homeopathy College and Hospital in Ambala District
(CAG of India, 22-03-2023) CAG of India
Time over-run with three years delay in establishing Government Homoeopathic College and Hospital in Ambala District resulted in creating extra burden of INR 3.88 crore on the State exchequer apart from depriving the intended benefit to the General Public and students of the State. There was cost over-run of INR 3.39 crore and infructuous expenditure of INR 48.89 lakh due to failure of internal controls in finalisation of site.
Non Completion of Maternal and Child Health Block in Kakinada District Hospital
(CAG of India, 25-09-2023) CAG of India
The construction of Maternity and Child Health block at Government General Hospital, Kakinada was stalled after incurring an expenditure of ০12.99 crore due to non-release of timely funds by Government of Andhra Pradesh received under National Health Mission from Government of India (GoI). Also, the intended purpose of providing maternity and child health care with requisite facility could not be achieved even after a lapse of seven years from the date of provisioning of funds by GoI and the expenditure made became wasteful.
Performance Audit on Healthcare Service Delivery in Govt Hospitals at District Level in Gujarat (2010-2015)
(CAG of India, 31-03-2016) CAG of India
Health is one of the most important parameters for ascertaining the quality of human life. Availability, accessibility and usability of sound healthcare system are essential requirements to meet the challenges in the field of Health. In Gujarat, 21 District Hospitals (DHs), a secondary level hospital and 13 hospitals attached with medical colleges, and one tertiary care hospital on Public Private Partnership (PPP) mode, are functioning at district level to provide preventive, promotive and curative healthcare services to the population. The performance audit on “Delivery of Healthcare Services in Government Hospitals at District Level” was conducted for the period 2010-15 during April and August 2015 and the following deficiencies were noticed - 1. Department had prepared a Five Year Plan for betterment of healthcare services in district level hospitals, however, the plan was not comprehensive as the current status of healthcare services of the hospitals vis-a-vis the requirement as per Indian Public Health (IPH) Standards was not identified. Further, the plan had no specific targets and enshrined timeframe to achieve the targets. 2. The sanctioned strength of all cadres of staff including doctors and nurses remained much below the IPH Standards in some test-checked DHs. The shortfall in the cadres of Specialist Doctors ranged between 29 and 77 per cent, and that of Medical Officers ranged between seven and 69 per cent vis-a-vis IPH Standards. The situation was alarming in DH Surendranagar, DH Godhra, DH Petlad and DH Vadodara where shortage in the cadre of Specialist Doctors was more than 60 per cent as compared with IPH Standards. 3. Availability of beds in DHs was neither as per IPH Standards nor in consonance with the requirements. Out of 13,833 beds available in district level hospitals, 10,645 beds were available in 11 districts to cater to a population of 3.55 crore and only 3,188 beds were available in remaining 22 districts to cater to a population of 2.49 crore. Shortage of beds in test-checked DHs ranged between 52 and 73 per cent. Audit observed instances of highly congested wards and patients lying on the floor; two patients were accommodated on one bed for transfusion of iron sucrose, and patients accommodated in the passageway due to non-availability of vacant beds. 4. Number of essential drugs viz. Amoxycilin, Diclofenac Sodium, Hepatitis B Vaccine, Injection Ceftazimide, Insulin, etc. were not available in the stock for more than four months in all test-checked hospitals. Resultantly, patients were forced to purchase medicines from the open market. 5. Instances of supply of Not of Standard Quality (NSQ) medicines by Gujarat Medical Services Corporation Limited (GMSCL) were noticed in test-checked hospitals. Most of the NSQ medicines were issued to the patients due to delay in receipt of sample testing reports. 6. Essential specialist services of General Medicines, Obstetrics and Gynaecology, Paediatrics, Orthopaedics, Radiology, etc. were either not available or partially available in all test-checked DHs except in DH Palanpur, due to vacant posts of Specialist Doctors. 7. Accident, Emergency and Trauma care services were either not available or were not equipped with essential equipment in test-checked DHs. 8. Intensive Care Units (ICU) meant to attend critically ill patients, were not available in DH Petlad, DH Surendranagar and DH Vadodara. In other test-checked DHs, only one or two ICU beds were fully equipped with life saving equipment to handle critical cases. The situation in test-checked Civil Hospitals (CHs) was also deplorable, as only five and nine ICU beds were fully equipped with life saving equipment as against 11 and 36 available beds in CH Bhavnagar and CH Vadodara respectively. 9. Availability of Gynaecologists, Paediatricians and life saving equipment are essential for delivery of maternal and child healthcare services. Audit observed instances of higher neo-natal and maternal deaths, vacant posts of Gynaecologists and Paediatricians, and lack of life saving equipment and beds in the maternity ward of test-checked DHs. Instances of patients accommodated on the floor were noticed in test-checked DHs. 10. The departments of diagnosis, imaging and blood banks are integral components of a hospital to provide healthcare services. Audit observed that equipment for conducting various tests were not available in the diagnosis and imaging departments in test-checked DHs. Blood bank/blood storage centres were either not established or remained non functional in test-checked DHs except in DH Godhra, DH Surendranagar and DH Himatnagar. 11. Referral management and infection control were not upto the mark in any of the test-checked DHs. 12. IPH Standards prescribed for quality assurance was either not followed or partially followed by the test-checked DHs.
Performance Audit of Four Major Public Hospitals in Delhi (2001-2006)
(CAG of India, 2007) CAG of India
A performance audit of the functioning of four major public hospitals in Delhi was conducted to assess their performance in terms of providing proper medical care by efficient use of available resources and infrastructure. The hospitals reviewed were Lok Nayak Hospital (LNH) and Deen Dayal Upadhyay Hospital (DDUH) under the Government of Delhi, Hindu Rao Hospital (HRH) under the Municipal Corporation of Delhi and Charak Palika Hospital (CPH) under the New Delhi Municipal Council.
Performance Audit of District Hospitals in Jharkhand
(CAG of India, 2021) CAG of India
This is a Performance Audit of District Hospital Outcomes in Jharkhand, covering the period 2014-19. This performance audit was carried out during 2019-20 with the objective of assessing the quality of medical services and patient care being provided by District Hospitals (DHs) in the State. In this outcome based audit, we have focused on patient care received at the DHs in the State. Various services like Out-Patient and In-Patient Services, Maternity Services, Diagnostic Services, Infection Control and Drug Management have been assessed on the basis of pre-determined criteria in the sampled DHs. We have also used pre-determined outcome indicators for assessing In-Patient Services. District hospitals being the pivotal point of the public health system in Jharkhand, influence the performance of the entire healthcare system. Despite a considerable increase in public health expenditure in the State during 2014-19, this performance audit revealed that the test-checked district hospitals (DHs) did not fare well on the outcome indicators relating to efficiency, service quality and clinical care capabilities.
Performance Audit of District Hospitals in Manipur
(CAG of India, 2021) CAG of India
This Stand Alone Report of the Comptroller and Auditor General of India contains the results of Performance Audit of Select Public Health facilities of tertiary care (Medical College & Hospitals), secondary care (District-level Hospitals), and primary care (one CHC and one PHC in selected districts) in the State of Manipur covering the period 2014-15 to 2018-19. In this Performance Audit we have focused on patient care given by secondary and tertiary care levels in the State. We assessed the availability of basic infrastructure facilities in the State, adequacy of manpower in the selected DHs and various Services provided therein like Out-Patient and In-patient Services, Emergency Services, Drug Management, Infection Control, Bio Medical Waste Management, Diagnostic Services, Fire control measures etc. and select services of maternity and child care, Cancer and HIV/ AIDS, based on pre-determined performance indicators/criteria in the sampled hospitals. We have adopted the Indian Public Health Standards (IPHS) guidelines as prescribed by Government of India, which are a set of uniform standards envisaged to improve the quality of health care delivery in the country as well as State norms as applicable for benchmarking various audit findings.
Performance Audit of District Hospitals in Meghalaya
(CAG of India, 2020) CAG of India
This Stand Alone Report of the Comptroller and Auditor General of India contains the results of Performance Audit of Select Public Health facilities of secondary care (District-level Hospitals) and primary care (one CHC and one PHC in selected districts), in the State of Meghalaya covering the period 2014-15 to 2018-19. In this Performance Audit we have focused on patient care given by the primary and secondary care levels in the State. We assessed the availability of basic infrastructure facilities in the State, adequacy of manpower in the selected DHs and various Services provided therein like Out-Patient and In-patient Services, Maternity Services, Emergency Services, Drug Management, Infection Control, Bio Medical Waste Management, Diagnostic Services, Fire control measures etc. based on pre-determined performance indicators/ criteria in the sampled district level and block level hospitals (CHC and PHC). We have adopted the Indian Public Health Standards (IPHS) guidelines as prescribed by Government of India which are a set of uniform standards envisaged to improve the quality of health care delivery in the country as well as State norms as applicable for benchmarking various audit findings. Audit Objectives: The objectives of carrying out this Performance Audit of selected district hospitals in Meghalaya were to assess whether: i. adequate and essential resources - manpower, drugs, infrastructure, equipment, and consumables were available for effective functioning of the district hospitals; ii. timely and quality healthcare was delivered through line services like OPD, IPD, ICU, OT, trauma & emergency, etc. and diagnostic services; iii. support services like drug storage, sterilisation, hygiene, waste management, infection control, ambulance, power back-up/ UPS, etc. were aiding the line departments in providing a safe and sterile environment in the hospitals; and iv. adequate and timely healthcare services were available in selected services relating to maternal and infant care and specialities like cancer care.
Performance Audit of District Hospitals in Sikkim
(CAG of India, 2021) CAG of India
This Standalone Report of the Comptroller and Auditor General of India contains the results of Performance Audit of Select Public Health facilities of secondary care (District-level Hospitals) and primary care (one CHC and one PHC of State Capital District) in the State of Sikkim covering the period 2014-15 to 2018-19. The Comptroller and Auditor General of India (CAG) has reviewed the provision of healthcare services by Government of Sikkim, at periodic intervals. The C&AG had earlier (Report No. 3 of 2011) reviewed the Functioning of Primary Health Centres (PHCs) and Community Health Centres (CHCs) of the State In this Performance Audit, we have focused on patient care given by the secondary care levels in the State. We assessed the availability of basic infrastructure facilities in the State, adequacy of manpower in the selected DHs and various Services provided therein like Out-Patient and In-patient Services, Maternity Services, Emergency Services, Drug Management, Infection Control, Bio Medical Waste Management, Diagnostic Services, Fire control measures etc. based on pre-determined performance indicators/ criteria in the sampled district level and block level hospitals (CHC and PHC). We have adopted the Indian Public Health Standards (IPHS) guidelines as prescribed by Government of India which are a set of uniform standards envisaged to improve the quality of health care delivery in the country as well as State norms as applicable for benchmarking various audit findings. Audit Objectives: The objectives of carrying out this Performance Audit of select district hospitals were to assess whether: i. adequate and essential resources - manpower, drugs, infrastructure, equipment, and consumables were available for effective functioning of the district hospitals; ii. timely and quality healthcare was delivered through line services like OPD, IPD, ICU, OT, trauma & emergency, etc. and diagnostic services; iii. support services like drug storage, sterilisation, hygiene, waste management, infection control, ambulance, power back-up/ UPS, etc. were aiding the line departments in providing a safe and sterile environment in the hospitals; and iv. adequate and timely healthcare services were available in selected services relating to maternal and infant care.
Performance Audit of District Hospitals in Nagaland
(CAG of India, 2020) CAG of India
This Stand Alone Report of the Comptroller and Auditor General of India contains the results of Performance Audit of Select Public Health facilities of secondary care (District-level Hospitals) and primary care (one CHC and one PHC in selected districts) in the State of Nagaland, covering the period 2014-15 to 2018-19. In this Performance Audit, we have focused on the patient care given by the primary and secondary care levels in the State. We assessed the availability of basic infrastructure facilities in the State, adequacy of manpower in the selected District Hospitals and various services provided therein like Out-Patient and In-Patient Services, Maternity Services, Emergency Services, Drug Management, Infection Control, Bio-medical Waste Management, Diagnostic Services, Fire Control measures etc., based on pre-determined performance indicators/ criteria in the sampled district level and block level hospitals (CHC & PHC). We have adopted Indian Public Health Standard (IPHS) prescribed by the Government of India and adopted by the Government of Nagaland which are a set of uniform standards envisaged to improve the quality of health care delivery in the country as well as State norms as applicable for benchmarking various audit findings. Audit Objectives: The objectives of carrying out this ‘Performance Audit of Select District Hospitals in Nagaland’ were to assess whether: i. Adequate and essential resources - manpower, drugs, infrastructure, equipment, and consumables are available for effective functioning of the DHs; ii. Timely and quality healthcare is delivered through line services like OPD, IPD, ICU, OT, trauma & emergency etc., and diagnostic services; iii. Support services like drug storage, sterilization, hygiene, waste management, infection control, ambulance, equipment etc., were aiding the line departments in providing a safe and sterile environment in the hospitals; and iv. the adequacy and timeliness of select healthcare services relating to maternal and infant care, cancer and HIV/AIDS.
Performance Audit of District Hospitals in Mizoram
(CAG of India, 2021) CAG of India
This Stand Alone Report of the Comptroller and Auditor General of India contains the results of Performance Audit of Select Public Health facilities of secondary care (District Hospitals) and primary care (one Community Health Centre and One Primary Health Centre in each selected districts) in Mizoram for the period 2014-19. In this Performance Audit we have focused on patient care given by the primary and secondary care levels in the State. We assessed the availability of basic infrastructure facilities in the State, adequacy of manpower in the selected DHs and various Services provided therein like Out-Patient and In-Patient Services, Maternity Services, Emergency Services, Drug Management, Infection Control, Bio Medical Waste Management, Diagnostic Services, Fire control measures, etc. based on pre-determined performance indicators/ criteria in the sampled district level and block level hospitals (CHC and PHC). We have adopted the Indian Public Health Standards (IPHS) guidelines as prescribed by Government of India which are a set of uniform standards envisaged to improve the quality of health care delivery in the country for benchmarking various audit findings. Audit Objectives: The objectives of carrying out this Performance Audit of select DHs are to assess whether: i. adequate and essential resources - manpower, drugs, infrastructure, equipment and consumables are available for effective functioning of the district hospitals; ii. timely and quality healthcare is delivered through line services like OPD, IPD, ICU, OT, trauma & emergency, etc. and diagnostic services; iii. support services like drug storage, sterilisation, hygiene, waste management, infection control, ambulance, power back-up/ UPS, etc. are aiding the line departments in providing a safe and sterile environment; and iv. the adequacy and timeliness of healthcare services relating to maternal and infant care, cancer, and HIV/ AIDS.

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