The Comptroller and Auditor General (CAG) flagged severe shortcomings in Delhi’s government hospitals in a performance review of the city’s health care system between 2016 and 2022, tabled in the Delhi Assembly on Friday. The report highlighted severe staff shortages, an acute lack of life-saving infrastructure, long wait times in hospitals for surgeries, and the underutilisation of pandemic relief funds.
The report – Public Health and infrastructure and Management of Health Services – was presented in the assembly on Friday by Delhi chief minister Rekha Gupta.
Among other issues, the CAG highlighted a string of deep-rooted human-resource deficiencies in Delhi’s government health department. It revealed an overall shortage of around 21% staff in the Delhi government’s health department.
Among Delhi’s 28 hospitals/colleges, teaching specialists had the highest shortfall at 30%, followed by a 28% shortage of non-teaching specialists, and a 9% gap in medical officers.
The report adds, that the deficit in the cadres of nurses and paramedic staff was about 21% and 38% respectively.
Another concern raised in the audit report was the unavailability of critical life-saving infrastructure at government hospitals in the city. The CAG found that 14 of 27 government hospitals lacked ICU services, 16 had no blood banks, eight had no oxygen supply, and 15 did not have mortuaries.
Surgery delays, the report said, were another concern. The CAG found that patients at Lok Nayak Hospital (LNH) waited two to three months for general surgeries and six to eight months for burn and plastic surgeries. At Rajiv Gandhi Super Specialty Hospital (RGSSH), six of 12 modular operation theatres remained unused, while Janakpuri Super Specialty Hospital left all seven of its modular OTs idle due to staff shortages.
Poor utilisation of funds
The report also criticised the government’s financial management, noting that only 0.79% of Delhi’s Gross State Domestic Product (GSDP) was spent on healthcare in 2021-22, well below the 2.5% target set by the National Health Policy.
The CAG also found that roughly a third – 31.1% – of all funds received by the Delhi government by the Centre during Covid-19 pandemic remained unutilised.
“Under Emergency Covid Response Plan, GNCTD received total funds of ₹787.91 crore (lump sum amount of ₹ 24.67 crore, ₹ 292.22 crore in first phase, and ₹ 471.02 crore in the second phase from the Government of India (GoI). Out of this, GNCTD utilised only ₹ 542.84 crore (November 2021),” the report stated.
However, the report added that the “reasons for under-utilisation of funds for the implementation” of the Covid-19 programme were “awaited.”
Several hospitals, the CAG’s audit found, significantly underutilised their funds between 2016-22: Rajiv Gandhi Super Specialty Hospital (13-71%), Janakpuri Super Specialty Hospital (13-49%), Chacha Nehru Bal Chikitsalaya (7-26%), and Lok Nayak Hospital (2-7%).
Talking about the poor utilisation of funds, the Delhi health minister Pankaj Singh had on Thursday alleged a “ ₹700 crore scam” under the previous Aam Aadmi Party (AAP) government. “All scams will be probed into. After the CAG report, no person will be spared,” he had said.
The audit further criticised the government on its apparent failure to expand health care infrastructure in the Capital.
It noted that against the proposed addition of 10,000 hospital beds announced in the 2016-17 budget, only 1,357 beds were added by 2021. Medicine shortages and procurement mismanagement were also flagged. Some drugs supplied by the Central Procurement Agency were of inferior quality, and due to delayed testing, some substandard medicines were used in hospitals. The report also found that certain medicines were procured from blacklisted firms.
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