Mumbai: The state Comptroller and Auditor General of India (CAG) found crippling shortages in Maharashtra’s public health system in terms of both trained medical professionals and infrastructure.
The CAG audit of the working of the public health department and medical education and drugs department between 2016 and 2022, stated an overburdened staff in some of the state’s public healthcare units attended to almost double the population they were mandated to handle. Around 41% of the sanctioned posts for gynaecologists in various state-run hospitals were vacant, along with 50% for anaesthetists, 48% for radiologists, and 74% for chest medicine specialists, even though the state has among the highest burden of tuberculosis in the country.
The CAG report also highlighted that the deadlines for some health infrastructure projects were missed, and a few districts failed to utilise the health budget allocations.
Pointing to poor financial management, the CAG report asked the govt to ensure budgetary funds are utilised throughout the year instead of a rush of expenditure in March.
Importantly, the CAG stated that even though the National Health Policy mandated that the health budget should be 8% of the total budget, Maharashtra’s health budget last year was only 4.91% of the overall budget.
The report, tabled in the legislative assembly on Saturday, found a third of the posts, on average, were vacant in both public health and medical education departments. The overall shortage was 27% among doctors, 35% among nurses, and 31% in the paramedical staff.
The shortage was acute at higher levels—for instance, the shortage of doctors in the primary and secondary levels of public healthcare was 22% as against 42% among superspecialists needed to run tertiary hospitals and medical colleges. In trauma care centres, the vacancy for doctors was 23% in public health department institutions and 44% in medical education’s institutions. AYUSH colleges and hospitals were in a similar situation, with 21% vacancy for doctors, 57% for nurses, and 55% for paramedical staff.
The audit noticed 70% of the work of constructing healthcare institutions and 90% on upgrading healthcare institutions as per the master plan (Jan 2013 and June 2014) was not completed as of Sept 2022. Besides, 433 works included in the master plan could not be started due to the non-availability of land, the report noted.
The common man, especially in rural areas, endured long waits to meet doctors: out-patient department services in hospitals were inadequate, with 93% of rural hospitals having only one registration counter against two required as per Indian Public Health Standards, in the seven selected districts. The audit noticed long waiting times for registration, and 26% of doctors attended to more than double the minimum number of patients as per Indian Public Health Standards. Speciality OPDs for general medicine and general surgery were not available in district and women’s hospitals, as well as medical colleges.
