Days after releasing the Comptroller and Auditor General's (CAG) report on loss due to faulty excise policy, an audit report of the CAG  on "Public Health Infrastructure and Management of Health Services', on Delhi's hospitals and Mohalla clinics, on Friday tabled in the Delhi Assembly, has  painted a grim picture, crumbling the city's healthcare system.

The CAG report highlights mismanagement, shortage of equipment and healthcare staff in the hospitals of the national capital. The reports also points out poor condition of Mohalla Clinic, one of the most touted healthcare scheme by the previous Aam Aadmi Party (AAP) government in Delhi.

This is the second CAG report which has been tabled in the House, details six years of findings on the Delhi health infrastructure and pointed out that there was a critical shortage of medicines, equipment and staff affecting the affordability and efficiency of the health services. A report on the Delhi liquor policy was tabled in the assembly last Tuesday. At least reports on the previous AAP government's performance are to be tabled by the Rekha Gupta-led BJP dispensation.

Patients at the Lok Nayak Hospital have had to wait two-three months for general surgeries and six-eight months for burn and plastic surgeries. Chacha Nehru Bal Chikitsalaya Hospital also has a 12-month-long waiting period for pediatric surgeries.

"There was high workload in registration counters in test checked hospitals namely Lok Nayak Hospital, Rajiv Gandhi Super Specialty Hospital, Janakpuri Super Specialty Hospital and Chacha Nehru Bal Chikitsalaya. The average consultation time per patient was less than five minutes in Medicine Department and Gynaecology Department of Lok Nayak Hospital (LNH).

Due to shortage of pharmacists, patient load per pharmacist or counter in LNH was high and medicines were not distributed on the same day. Shortage of essential medicines and equipment was also observed in ICU/ emergency departments of two test checked hospitals (LNH and RGSSH).  Waiting time for major surgeries in the Surgery Department and Burn and Plastic Surgery Departments of LNH was two-three months and six-eight months respectively and at the same time, six out of 12 modular OTs in RGSSH and all the seven modular OTs in JSSH were found lying idle due to shortage of manpower.   Many Ambulances of Centralised Accident and Trauma Services (CATS) were running without essential equipment and devices," the CAG report said.

The report claimed that out of 27 hospitals in Delhi, 14 lacked ICU facilities, 16 did not have blood banks,  eight did not have oxygen supply, 12 did not have ambulance services and a staggering 15 hospitals were operating without a mortuary.

On the other hand, at the Rajiv Gandhi and Janakpuri Super Speciality Hospitals infrastructure such as operation theatres, ICU beds and trauma centres have gone unused due to lack of a specialised staff, the report added. The report further stated that Essential Drugs List (EDL), the list of drugs that should be available at all times in Hospitals and other health facilities, was not prepared annually and was prepared only thrice during the last 10 years.

According to report, Central Procurement Agency (CPA) which was entrusted with the duties of procurement of drugs and equipment for GNCTD hospitals was not functioning optimally as hospitals had to procure 33 to 47 per cent of essential drugs from local chemists for meeting their day-to-day requirements during 2016-17 to 2021-22.

Out of 86 tenders floated for procurement of equipment by CPA, only 24 (28 per cent) were finally awarded.

Audit also noticed procurement of medicines from blacklisted and debarred firms by CPA. There was also short supply or shortage of injections for rare and fatal diseases like Haemophilia and Rabies.

"Against the proposed addition of 10,000 beds (Budget speech 2016-17) only 1,357 beds were added during 2016-17 to 2020-21.

The Department was unable to utilise any of the 15 plots acquired (June 2007 and December 2015) at a cost of Rs 648.05 Lakh for establishing hospitals and dispensaries, despite having possession for periods ranging between six to 15 years. Out of the eight new hospitals under construction during the audit period, only three were completed. There were delays up to six years in completion of hospital projects," the report said.

The report said Delhi government had spent 12.51 per cent of its total expenditure and 0.79 per cent of GSDP on health services during 2021-22 which was more than eight per cent of budget and way below 2.5 per cent of GSDP targeted under National Health Policy 2017.

The report stated that a review of 74 Mohalla Clinics found none had the full stock of all 165 essential medicines.

The CAG report also highlighted the lack of essential equipment such as pulse oximeters, glucometers, X-ray viewers, thermometers and blood pressure monitors at these facilities.