New Delhi: The Comptroller and Auditor General of India said in its report that while carrying out an audit of ‘Management of Health Services in Indian Railways‘ it observed the shortage of medical and para medical staff in test checked hospitals of the Zonal Railways. “There was also shortage in availability of machines/medical equipment with reference to IPHS (Indian Public Health Standards) norms. Even the minimum requirement of machines/medical equipment as per clinical Establishment (Registration and Regulation) Act 2010 was not being met,” the CAG said in its recent report.
According to the CAG, the Indian Railways (IR) provide medical and health services to about one crore railway beneficiaries through 129 hospitals and 586 Health Units and the review on “Management of Health Services in Indian Railways” covered the issues for assessing the adequacy and quality of health services provided by it during the period 2017-18 to 2021-22.
“Audit examined the implementation of various policies and guidelines framed by the IR in relation to resources and their utilisation, availability of required infrastructure, management of resources during COVID pandemic, procurement of medicines/equipment etc.,” the CAG said.
It added, “Audit observed that the share of expenditure on healthcare services to total expenditure of IR had shown an increasing trend but there was a sharp drop in 2021-22. There were several instances of patients leaving hospitals against medical advice.”
The CAG found that the Indian Railways incurred substantial expenditure towards referral of patients to non-railway recognised hospitals and medical audit of referral cases was not conducted in 7,38,297 (98.72 per cent) cases.
It said that the expenditure is showing an increasing trend.
“Medical treatment to the eligible beneficiaries of Ayushman Bharat Yojana were not implemented in many Railway Hospitals. Bed Occupancy Ratio (BOR), which is an indicator of the productivity of the hospital services, was found less than the standard norms in many hospitals,” the CAG said.
It added, “There is a scope for strengthening the monitoring and internal control mechanism to ensure conduct of medical audit, procurement of quality drugs, timely receipt of test reports and implementation of Hospital Management Information System (HMIS).”
Recommending to ensure availability of funds and other resources namely medical and para medical staff, machines/equipment, etc. as per the IPHS norms and Clinical Establishment (Registration and Regulation) Act, 2010 to provide required medical treatment, it asked the Railways to review periodically to assess the resources and infrastructure needs of the hospitals.
“Gaps between the prescribed standards and existing service delivery should be reviewed and efforts may be made to address the gaps. This should be commensurate with railway employees and families dependent on railway medical facilities,” the CAG said.
