New Delhi, Dec 17: Absence of facilities for treating bio-medical waste and non-functioning medical equipment were among some of the serious lapses noted by the CAG at hospitals and health units run by the railways, which cater to 64 lakh beneficiaries.
Railways provides medical and health services to 64 lakh beneficiaries through 129 hospitals and 588 health units spread over 17 zonal railways and five production units. A sample group of 69 hospitals and 89 primary health units /dispensaries were selected for a performance assessment vis-a -vis budgetary control, utilisation of available manpower and efficiency in hospital administration.
"The authorisation for management and handling of bio- medical waste was not obtained by 27 selected hospitals and health units over five zonal railways. Bio-medical waste was improperly disposed of either by deep burial or burning in open air," the CAG said.
As to financial management, the government auditor found that there was a lack of effective budgetary control.
Also, besides variation between the final grant and the actual expenditure, there was idle investment of Rs 17.64 crore due to improper planning in the setting up of the Nursing College and Hostel at Majerhat near Kolkata.
While capital expenditure was 4 per cent of the total spending on health during 2008-13, the revenue expenditure for providing medical services to railway beneficiaries constituted only 2.68 per cent of the ordinary working expenses of railways.
The CAG also reported that there were 1,970 medical officers as on April 1, 2013, as against the sanctioned strength of 2,473, which is a shortage of 503 doctors or 20.34 per cent. It also found a shortfall of 2,102 paramedical staff.
Shortage of doctors and paramedical staff partially affected the health services provided by railways, the CAG said while noting that medical equipment remained idle due to non-availability of skilled professionals.
"Despite having incurred an expenditure of Rs 80.23 crore towards engagement of contractual medical practitioners/ specialists, expenditure of Rs 1,146 crore was incurred during 2008-13 towards treatment of railway patients at non-railway hospitals," CAG noted.
According to the CAG, there was a lack of proper storage facilities at many hospitals across zonal railways. In Central Railway, medicines worth Rs 75 lakh were destroyed in a fire in the AC drugs storeroom due to defective air conditioner and improper storage of combustible X-ray films.
Incorrect assessment of requirement led to surpluses and loss of shelf life of medicines worth Rs 24.18 lakh, it added. At 20 hospitals and health units across eight zonal railways, substandard drugs worth Rs 21.45 lakh were supplied.
At six of the hospitals and health units, the drugs were given to the patients before receipt of the test results, the CAG has found. The CAG also observed that despite an expenditure of Rs 57 crore for repair and maintenance, there were several instances of failure of medical equipment.
The national auditor found that 56 pieces of medical equipment procured at a cost of Rs 20.73 crore in nine zonal railways and two production unit hospitals were either not in working condition or commissioned belatedly. An equipment procured by Central Hospital of Western Railway at a cost of Rs 62 lakh remained unutilised for 28 of the 60 months of its codal life.
The railways also provides diet to patients on a 'No profit, No loss' basis but CAG observed that the expenditure incurred for providing diet to patients was more than the amount recovered from them, resulting in a loss of Rs 7.80 crore. In addition, short recovery of diet charges from the patients touched Rs 1.78 crore.