Teaching, patient care hit in Govt MCHs, says CAG

Quality teaching, research and patient care in three Government medical colleges and hospitals in the State had been severely hit during the last five years due to non-availability of required teaching staff, infrastructure, essential equipment, books and non-adoption of modern teaching-learning methodology, revealed a report of the Comptroller and Auditor General of India (CAG) presented in the State Assembly on Friday.

The CAG conducted a performance audit on the functioning of three Government medical colleges and their attached hospitals covering the period 2009-14.  It said although a perspective plan was prepared by the Health Department, action taken for its implementation was insufficient.

It also remarked that non-functioning of central research laboratory, clinical pharmacology unit, sub-optimal functioning of Medical Education Units, inadequate exposure of students to patient care, non-adoption of modern teaching-learning methodology and non-updation of MBBS curriculum occurred during the period.

It found that there was severe shortage of required teaching, non-teaching and paramedical staff below the posts sanctioned by the Government.

Infrastructural deficiencies in indoor wards and operation theatres of attached hospitals also affected patient care. Availability of beds in Intensive Care Units (ICUs) remained as low as 69 (two per cent of total bed strengths) with no ICU in Casualty Departments which deprived serious patients of getting specialised emergency care. Besides, Trauma Care Centres costing Rs 3.54 crore in two medical college hospitals (MCHs) (MKCG and VSS) remained non-functional resulting in deficient emergency care to accident victims.

Diagnostic facilities like investigation in immune-pathology and Digital X-ray were not available in any of the three MCHs compelling patients to go to private clinics and laboratories for such tests. Equipment like High Performance Thin layer Chromatography machine and Mammography machine required for measurement of drug concentration and detection of breast cancer purchased at a cost of Rs 3.84 crore from January 2006 to March 2014 remained unutilised.

Death Review/ Prescription Audit required to be conducted as per Government instructions to enhance the quality and efficiency of medical care was not conduced despite increasing trend of death in the three medical colleges.

Supply of medicines to the inpatients was inadequate while 11 types of ‘Not of Standard Quality’ medicines were administered to patients in three attached hospitals.

The MKCG MCH could not utilise fund released by the Government for purchase of equipment and parked Rs 3.66 crore in savings bank account violating codal provision. Central/ State assistance of Rs 7.45 crore meant for up-gradation of the School of Nursing into College of Nursing and strengthening and up- gradation of the three MCHs could not be utilised by May 2014.

Absence of academic audit, annual reports and biometric attendance system contributed to ineffective monitoring of performance of the medical colleges, it said.

It remarked that evaluation of performance of the three Government medical colleges and their attached hospitals was not conducted during 2009-14 though required under the Orissa State Integrated Health Policy. Grievance redress mechanism was poor and inspection mechanism involving the Department, Director of Medical Education and Training and the Principals of the three MCHs remained much below par, it said.