One visit to emergency of GMC can make anyone conclude what kind of medical services are there in Jammu. With already overburdened GMC being the only backbone of the existing health infrastructure in entire Jammu region, people are left on their own to run from pillar to post for Super Specialty Treatment. Missing critical care ambulances further add to the woes of suffering, those who can afford private ones survive while the poor suffer like cattle in the war field. Government it seems is clueless on health sector. The so called hollow claims of best health care State has been exposed by the performance audit of NHM conducted by CAG between March 2016 and August 2016 for the time period 2011-16 with glaring lapses right from ground to top level.
As per audit , no planning at all for Block Health Action Plan (BHAP) and whatever DHAPs were submitted for approval to the GoI were delayed from one to three months which consequently resulted in delayed approvals by GoI. Our State year after year, has achieved only 6-7 percent expenditure on health against targeted 10 percent and only 60 to 80 percent of funds had been utilised. Unauthorised diversion of funds in crores for clearing the liability of diet charges of five hospitals created against all norms. Similarly cost of land to the tune of Rs.2.18 crore had been paid irregularly for compensation of land out of the mission’s resources. Under rules, Annual Maintenance Grants (AMG) cannot be provided to rental health institutions housed in private buildings but excess AMG of Rs.5.26 crore was projected for private accommodations (326 PHCs and 3626 SCs) and shown as rent-free for approval and release of funds thereof in 2014-15 and 2015-16. As per norms for hilly/ tribal/ difficult areas, there should be one CHC(Community Health Centre) for population of 80,000, one PHC (Primary Health Centre) for population of 20,000 and one SC (Sub Centre) for population of 3,000 but as of March 2016, there were 3,193 health institutions (DHs: 22; CHCs: 84; PHCs: 398; NTPHCs: 239 and SCs: 2450) in the State with shortages of 13 CHCs, 46 PHCs and 468 SCs as per the population criteria. The State Government in October 2014 upgraded 371 SCs to the level of New Type Primary Health Centres (NTPHCs). Out of 40 SCs upgraded as NTPHCs in three audited districts of Rajouri (18), Doda (11) and Udhampur (11), two SCs (Marmat and Jijhote in Doda District) did not exist on the ground while as none of the remaining 38 NTPHCs had been provided with the required facilities by way of additional manpower and other infrastructure indicating that only nomenclature of the SCs was changed to NTPHCs thereby defeating the purpose of up gradation of SCs to NTPHCs. During 2011-16, none of the SCs/ PHCs/ CHCs had been upgraded to the level of IPHS in the State. No categorisation of SCs as Type ‘A’ and Type ‘B’ existed in the State. In audited districts, none of the CHCs and PHCs had been upgraded to FRU and 24×7 PHCs during the years.
Even the works related to construction and up gradation of DHs/ CHCs/ PHCs/ SCs were allotted by the department without considering the requirements; neither the cost estimates were technically vetted nor there was monitoring of the construction works at any level. The Mission Director released in January 2011 Rs 2.40 crore to DHS Jammu for procurement of 12 critical care ambulances but despite supply order being placed in February 2013 and after expenditure of Rs 0.61 lakh on account of petrol, lubricant charges, toll tax, etc., no ambulance could be procured and ultimately the balance of Rs 2.39 crore was transferred in November 2015 to the J&K Medical Supplies Corporation Jammu after about five years and public is still waiting for them. Similarly procurement of ambulances to be operated on Helpline number 108 had not been approved by the State Government till July 2016 though an amount of Rs15 lakh was released in January 2013 by the Mission Director NRHM in favour of the DHS Jammu for establishment of Health Helpline which was subsequently refunded in the next month (February 2013) without utilisation. The shortage of staff quarters is to the extent of 91 per cent, 93 per cent and 94 per cent in three DHs, six CHCs and 12 PHCs respectively and no staff quarters were available in two CHCs and eight PHCs. The position of staff in 22 District Hospitals as per IPHS norms was to the extent of 86 per cent for medical specialists and 78 per cent for nurses and para-medical staff. The position of staff in Blood Banks in DHs is worse as the sanctioned and effective strength was only 10 against required 132 posts as per IPHS norms.
(To be continued)
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