CAG report highlights lapses in AAP's health model: Shortage of staff, no toilets in Mohalla Clinics, funds misuse

Rekha Gupta tabling the CAG report in Assembly.

The Comptroller and Auditor General (CAG) report on the Public Health Infrastructure and Management of Health Services has raised concerns about the operational effectiveness of Delhi's Mohalla Clinics, a key component of the Aam Aadmi Party's (AAP) healthcare initiative.

The audit identifies significant issues, including staff shortages and the absence of essential facilities such as toilets in these clinics.

The CAG's report accessed by CNN-News18 says that 21 Aam Aadmi Mohalla Clinics did not have toilets, 15 did not have a power backup six did not have any table for check-ups and 12 did not have accessibility for the physically disabled. In AYUSH dispensaries, 17 of the 49 inspected dispensaries had no power backup, seven had no toilets and 14 had no facility for drinking water.

Further, the CAG report also flagged underutilization of funds received under the 'Emergency Covid-19 Response Plan'. The report reveals that only Rs 582.84 crore of the Rs 787.91 crore provided by the Centre for tackling COVID-19 was used by the Delhi government, with a substantial Rs 83.14 crore out of Rs 119.85 crore earmarked for drugs and supplies, including PPE and masks, remaining unspent.

Negligible bed enhancements and staffing issues

The CAG report also highlights the minimal increase in hospital beds across Delhi. Despite budgetary commitments from 2016-17 to 2020-21 to add 32,000 beds, only 1,357 beds were added. It also shows alarmingly high bed occupancy rates in major hospitals, ranging from 101% to 189%. This suggests that hospitals were forced to accommodate more than one patient per bed or even made patients lie on the floor due to overcrowding.

Another critical issue is staffing shortage, with the report citing a deficit of 8,194 healthcare staff, including a 21% shortage of nurses and a 38% shortage of paramedics. Furthermore, long wait times for surgeries were reported, such as 2-3 months for general surgeries at Lok Nayak Hospital and 6-8 months for burns/plastic surgeries. The report also highlighted underutilised infrastructure at multiple hospitals, including idle operation theatres (OTs), unused ICU beds, and non-functional equipment at facilities like Rajiv Gandhi Super Speciality Hospital (RGSSH) and Janakpuri Super Speciality Hospital (JSSH).

Deficiencies in basic services and unused infrastructure

The CAG also flagged a severe lack of essential services across hospitals, with ICU facilities absent in 14 of the 27 hospitals, blood banks missing in 16, oxygen supply unavailable in 8, mortuary services lacking in 15, and ambulance services absent in 12 hospitals. The audit also noted that many CATS ambulances lacked critical life-saving equipment. Hospitals were forced to directly procure 33-47% of essential drugs due to failures in the procurement process.

The report further said 15 plots of land, worth Rs 648.05 lakh, which had been acquired between 2007 and 2015 for hospital development, remained unused for up to 15 years.

The report also flagged the delay in the completion of new hospital projects, with only three of the hospitals initiated during Sheila Dikshit’s tenure as Chief Minister being completed. The delays ranged up to six years, and the final project costs far exceeded the initial tendered amounts, raising concerns about inefficiency and corruption in these projects.

The report, covering the financial year ending March 31, 2023, was submitted to the Delhi government on September 24, 2024 - and is part of the 14 CAG reports tabled by the Rekha Gupta-led BJP government in the Delhi Assembly.

It also flagged that the Delhi government suffered cumulative losses of over Rs 2,000 crore due to the 2021-2022 excise policy for reasons ranging from weak policy framework to deficient implementation.

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