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Item Performance Audit of Four Major Public Hospitals in Delhi (2001-2006)(CAG of India, 2007) CAG of IndiaA 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.Item Performance Audit of Seven National Institutes of Pharmaceutical Education and Research(CAG of India, 2020) CAG of IndiaThis is a performance audit of seven National Institutes of Pharmaceutical Education and Research (NIPER). The Government of India set up the National Institute of Pharmaceutical Education and Research (NIPER) at Mohali as per the provisions of the NIPER Act, 1998 to nurture and promote quality and excellence in pharmaceutical education and research. Subsequently, in the year 2007, the NIPER Act was amended and accordingly in August 2007, the Union Government granted in-principle approval to set up six new NIPER at Hyderabad, Ahmedabad, Kolkata, Guwahati, Raebareli and Hajipur which started functioning from 2007-08. A test check of records was carried out to assess whether the Governance structure prescribed under the Act is in place and adequate infrastructure facilities, faculty, technical and administrative staff for the NIPERs was available, to achieve the objectives envisaged under the Act. The audit criteria were derived from the NIPER Act and related statutes and manuals, minutes of the Board of Governors (BoG) /Steering Committee meetings, agreements signed between NIPER and respective State Governments, Memorandum of Understanding (MoU) signed between mentor Institutes and MoCF and relevant records of the seven NIPERs and DoP/MoCF.Item Performance Audit on Mid Day Meal Scheme in Arunachal Pradesh (2009-2014)(CAG of India, 21-07-2015) CAG of IndiaThe ‘National Programme of Nutritional Support to Primary Education’, a Centrally Sponsored Scheme, commonly known as ‘Mid-Day Meal’ (MDM) Scheme, was launched with the primary objective of boosting the universalisation of primary education by increasing enrolment, retention & attendance and simultaneously improving nutritional status of primary school children. Performance Audit of the scheme revealed that the Department covered all Government Primary/Upper Primary Schools (3116), Government-aided Primary/Upper Primary Schools (68) and EGS/AIE Centres (155) in the State under the scheme. However, there were deficiencies like inadequate financial management, short-lifting of food grains, delay in release of funds to schools for meeting cooking costs, inadequate infrastructural facilities in schools and lack of monitoring by the Department. Some major audit findings are highlighted below: 1. No household surveys were conducted to identify the total number of children not enrolled at the Primary stage. No attempt was also made to encourage high level of enrolment through publicity, etc. 2. In 2010-11, against GoI total allocation of 6,687.66 MT of food grains for Primary/Upper Primary level, the Department lifted only 5,928.37 MT and during 2013-14, against the allocation of 6,625.01 MT of food grains for Primary/Upper Primary levels, only 6,598.95 MT were lifted, leading to shortlifting of 785.35 MT of food grains. 3. There was a shortfall in provision of 47,360 meals due to short receipt of food grains in 137 schools. 4. In six schools of West Kameng and Lohit District, 46.61 quintals (23 per cent) of the allotted rice was issued as dry rations instead of cooked meals, violating directives of the Hon’ble Supreme Court of India. 5. In 150 test-checked schools, pucca kitchen sheds were not available in 130 (87 per cent) schools; drinking water facilities in 35 (23 per cent) schools; gasbased chullahs in 148 (99 per cent) schools; and cooking utensils in 9 (6 per cent) schools. 6. During the period 2009-14, there were persistent savings ranging from 1 per cent to 32 per cent. 7. From 2009 to 2014, there were delays ranging up to 21 months in release of Central assistance by the State Government to the Nodal Department. 8. The State Government did not contribute its share, aggregating to ₹ 12.93 crore (63.69 per cent), towards Conversion Costs, Honorarium to cooks-cum-helpers and MME costs. 9. There were deficiencies in meetings of the State, District and Block Level Monitoring Cells to monitor implementation of the scheme. 10. Findings of evaluation studies conducted by an Independent Agency to assess the impact of the scheme were not discussed by the State SMC to address the deficiencies pointed out in the Evaluation Reports.Item Avoidable Expenditure on Water Supply Contract for District Hospitals in Mizoram(CAG of India, 16-02-2023) CAG of IndiaDirectorate 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.Item Idle Expenditure on Laboratory Equipment and Software for Polytechnics and Govt Engineering Colleges in Chhattisgarh(CAG of India, 25-07-2015) CAG of IndiaProcurement of laboratory equipment and software without assessing the requirement and without ensuring the availability of necessary infrastructure to utilise the equipment resulted in idle expenditure of ₹ 8.62 crore.Item Unfruitful Expenditure Due to Non Functional Trauma Hospital at Khellani Jammu and Kashmir(CAG of India, 23-09-2020) CAG of IndiaFailure of Health and Medical Education Department to make the Trauma Hospital Khellani functional through posting of necessary staff and provision of laboratory/ diagnostic facilities, operation theatre, blood bank and ambulance etc., has rendered the investment of INR 394.59 lakh unfruitful.Item Performance Audit of National Rural Health Mission (NRHM) in Jammu and Kashmir(CAG of India, 2009) CAG of IndiaGovernment of India launched (April 2005) the National Rural Health Mission (NRHM) to carry out necessary architectural correction in the basic health-care delivery system. The Plan of Action includes increasing public expenditure on health, reducing regional imbalance in health infrastructure, decentralization and district management of health programmes, community participation and operationalising community health centres into functional hospitals. The performance audit review of implementation of NRHM in Jammu and Kashmir showed that the status of health profile of the State has been quite encouraging vis-à-vis the performance indicators available for the country. These can be further improved if there is proper fund management/utilisation and various sectors involved are covered in conformity with the guidelines issued for implementation of the Programme. There are large gaps in planning as well as implementation of the Mission activities in the State even after four years of launching the programme. This is evidenced by the findings that no new health centre was put in place, essential services and amenities were not available in many centres and there was critical shortage of technical manpower. Maternal and child health programmes have not made much headway. Planning, implementation and monitoring of the programme through participation of NGOs and community-based organisations was nonexistent.Item Performance Audit of District Hospitals in Manipur(CAG of India, 2021) CAG of IndiaThis 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.Item Undue Favour to a Firm for Setting up of Language Laboratories in Universities in Odisha(CAG of India, 20-09-2018) CAG of IndiaThe decision to award the work of setting up of LLs in 108 colleges of the State to a private firm on nomination basis was not in order. Further, there was no enrolment in 42 colleges where LLs were set up at the total cost of ₹ 8.64 crore.Item Procurement of Disposables at Higher Cost in Karnataka(CAG of India, 09-12-2020) CAG of IndiaFailure of the Karnataka Institute of Medical Sciences, Hubballi to finalise its tender for procurement of disposables within the scheduled time resulted in re-tendering and additional expenditure of INR 1.18 crore.