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Item Performance Audit of Upgradation of Govt Medical Colleges in Maharashtra (Marathi Version)(CAG of India, 2020) CAG of IndiaA centrally sponsored scheme of “Strengthening/Up-grading of State Government Medical Colleges (SUSGMC)” through financial assistance for starting Post Graduate (PG) courses by creating PG seats for new PG courses and increasing PG seats of existing courses was launched by the Ministry of Health and Family Welfare (MoHFW), Government of India (GoI) at the end of the 11th Plan and the scheme had a validity period of entire 12th Plan period (2012-13 to 2016-17), further extended up to March 2019. The scheme funds were directly released to the GMCs by the MoHFW (GoI) on the basis of recommendations of the Technical Evaluation Committee (TEC) under Directorate of Health Services and after the approval of the Empowered Committee (EC). Based on the TEC visit to the GMCs between 13.09.2010 and 16.09.2010 and its recommendations MoHFW selected 11 GMCs (11.10.2011 and 26.12.2011), in Maharashtra for implementation of the scheme and approved a total fund of INR 345.79 crore with central share (75 per cent) of INR 259.34 crore and State share (25 per cent) of INR 86.45 crore. This amount was approved for starting PG courses by creating 116 PG seats in two GMCs and increasing 409 PG seats for 112 existing courses and creating 167 PG seats for 60 new PG courses in remaining nine GMCs by creating new capital assets, upgrading medical equipment and appointment of faculty. This performance audit was conducted to assess whether appropriate planning was done for effective and efficient implementation of the scheme, adequate funds were provided, monitoring was effective and envisaged outcomes of the scheme were achieved. Audit examined records in all 11 Government Medical Colleges and in the Directorate of Medical Education and Research, Government of Maharashtra for the period from 2011-12 to 2018-19.Item Idle Expenditure on Establishment of Trauma Care Centres in Maharashtra (Marathi Version)(CAG of India, 20-09-2020) CAG of IndiaTrauma Care Centre at Vaijapur, District Aurangabad was not operational since last six years for want of electric supply resulting in idle expenditure of INR 1.66 crore.Item Performance Audit on Public Health Infrastructure and Management of Health Services in Maharashtra (Marathi)(CAG of India, 21-12-2024) CAG of IndiaMaharashtra is the second most populous and the third largest State in terms of area in the country. Providing adequate and quality healthcare services to a large population requires a robust healthcare infrastructure and services. Primary and secondary healthcare in Maharashtra is provided by the Public Health Department, Government of Maharashtra while tertiary healthcare is provided mostly by the Medical Education and Drugs Department, Government of Maharashtra. The Urban Development Department, Government of Maharashtra also provides primary, secondary and tertiary healthcare in urban areas through Municipal Corporations/Councils. Drugs, medicines and medical equipment were centrally procured and supplied to Public Health Department and Medical Education and Drugs Department through Haffkine Bio-Pharmaceutical Corporation Limited, a Government of Maharashtra Company. The Performance Audit was conducted to assess the availability of human resources, drugs, medicines, equipment and the adequacy and quality of healthcare infrastructure in the State. The funding and expenditure under central and centrally sponsored health sector schemes, adequacy and effectiveness of regulatory mechanisms and the improvement in the health and well-being of people as per Sustainable Development Goal-3 were also assessed. Public health is a State subject and the States are expected to frame their own policies on the line of the National Health Policy to guide the development of the health sector. Government of Maharashtra is yet to frame a State-specific Health Policy. Audit noticed shortage of manpower at every level of the Health Care Institutions functioning under Public Health Department, and Medical Education and Drugs Department. The shortage of doctors, nurses and paramedical staff was 22 per cent, 35 per cent and 29 per cent respectively in primary and secondary healthcare under Public Health Department. Whereas in respect of Women Hospitals under Public Health Department the shortage of doctors, nurses and paramedical staff was 23 per cent, 19 per cent and 16 per cent respectively. There was also shortage of 42 per cent in the cadre of the specialist doctors under Public Health Department. The shortage of doctors, nurses and paramedics under Medical Education and Drugs Department was 37 per cent, 35 per cent and 44 per cent respectively. The overall shortage in the cadre of doctors, nurses and paramedics in the State under Public Health Department and Medical Education and Drugs Department was 27 per cent, 35 per cent and 31 per cent respectively. Audit also noticed regional disparity in the shortage of manpower. Similarly, the vacancies in the Trauma Care Centres under Public Health Department and Medical Education and Drugs Department were 23 per cent and 44 per cent respectively. The vacancies in the cadre of doctors, nurses and paramedical staff in AYUSH colleges and hospitals under Medical Education and Drugs Department was 21 per cent, 57 per cent and 55 per cent respectively. The sanctioned strength of doctors was less than the requirement as per Indian Public Health Standards, 2012 by 17 per cent under Public Health Department. Government may fill up the vacancies in the health sector in a time-bound manner to ensure optimal and qualitative delivery of healthcare services to public. Government may also increase the sanctioned strength of doctors under Public Health Department as recommended in Indian Public Health Standards.