Community Health Centres (CHCs) in Jharkhand are in a bad health and too short of the objective for they was conceived. The audit report prepared by the Comptroller and Auditor General of India highlighted the pathetic condition of one of the important component of the three-tier health delivery system in the State.
The report was today tabled in the monsoon session of Assembly to highlight the state of schemes and performances of departments in General, Social and Economic (Non-PSU) sectors.
The audit report exposed the underachievement at the tertiary level of the three-tier structure envisaged under the health policy of the State Government. The report compiled till July 2013 found that 111 CHC buildings were incomplete beyond their due date of completion after incurring an expenditure of Rs 221.98-crore as a result of delay in site selection and extremely slow pace of work by executing agencies. The CHCs were expected to provide support to Primary Health Centres by acting as referral point for patients coming to Primary Health Centres failed in the objective. As envisaged, one CHC was planned to be set up for every 20,000 tribal area and one for every 30,000 general area in Jharkhand.
“The goal of the CHCs functioning as a referral point could not be achieved,” said Principal Accountant General of Jharkhand, Mridula Sapru.
The report based on a sample size of 36, spanning nine districts, exposed the harsh reality of missing infrastructure and specialist doctors needed to run the centres. The report comes down heavily on the absence of doctors for CHCs and also on the sanctioned posts which is yet to be filled by the State government. As many as seven specialist doctors are required for one CHC. Also, 30 CHCs were found short of required number of beds. The 30 CHCs of the sample size were operating with just six beds against the requisite number of 30 for each such centres.
“The number of specialist doctor is zero against the required strength of 1354. When we brought this to their notice they sanctioned the posts of specialist doctor but that too only 574,” maintained the PAG. However, the audit report pointed towards a dangerous trend of potentially life threatening consequences for patients coming for treatment at these centres. The report found that the CHCs under observation were short of medicines and also non-competent people were distributing medicines to patients. The report also talks about purchase of machines by State run hospital Rajendra Institute of Medical Sciences by overlooking the need for it.
The report also sheds light on the pathetic state of water pipeline projects in Jharkhand due to lack of vision and inability to widen use of projects to make the schemes sustainable and achieve the aim of providing safe drinking water to the people of State. The audit report conducted a review of two projects in nine divisions and discovered that none of the projects termed complete covered households.
“They term a project complete if water reaches a public place however this is not the objective of the scheme. Since we insisted to consider households as well they (Drinking Water and Sanitation Department) have decided to take this into account as well,” maintained Sapru.
The PAG also indicated at misappropriation of interest money earned on the sanctioned fund for Indira Awaas Yojna (IAY). The audit says that the implementing agency has not accounted for interest of Rs 1.05-crore earned on IAY funds despite credit by banks. The IAY was also hit fake a number of fake beneficiaries.
The report has reservations about the method chosen by the Road Construction department, implementation of schemes by Agriculture, Information Technology and under utilization of Twelfth Finance Commission grants by Human Resource Development for education sector in Jharkhand.