The Comptroller and Auditor General of India (CAG) is in the process of conducting a comprehemsive audit of the country’s health sector, and is adopting an approach that is different from earlier exercises done by the CAG, that had a more piecemeal-like approach.
“Earlier, we were auditing on the basis of some research, some state specific issues and so on. This time we are doing it comprehensively. This means that this time we will audit it (the health sector) on common parameters, common objectives, and common risk analyses so that the entire country’s picture is accounted for,” a senior official told Business Standard.
Earlier, state level auditors general (AGs) would choose a subject such as health management, procurement or vacancies, and so on, and audit particular aspects of that theme.
For instance, a CAG report had shown earlier this year that the condition of the health sector in Bihar was far from optimum, as there was a significant shortfall of facilities and staff. CAG had conducted performance audits in five districts–Patna, Biharsharif, Hajipur, Jehanabad and Madhepura–for the period 2014-15 to 2019-20, and found a 52-92 per cent shortage of beds under the Indian Public Health Standards in the district hospitals.
However, this time the reports will be comprehensive. “But this time, you will get a complete picture,” one of the key sources said.
The sources added that the audit would not be published at one go.
“It would be state-wise. But subsequently, we can compile a set of common parameters and establish which state is at what level on these parameters. We will audit on the basis of government policies, objectives and their performance,” the source cited above said.
One whether or not Covid period will be covered, the source cited said it would.
“It will cover the last five years. We may not give a specific title like ‘Covid Management’, but the Covid period will be covered,” the source added.
He said that CAG will not comment on state policies but will look at their performances.
“Let’s suppose a particular state’s policy says it should have a certain number of public health centres–that figure is decided by that state alone. Against this, the audit will assess how many public health centres have opened up, and how they have performed. Any deviation in expenditure will also be explored. Then we will see them (the health centres) from a prudential point of view,” another source said.
The CAG will look at the chief vigilance commission’s guidelines as well as project management guidelines to achieve this, he said.
On which programmes would come under the health audit, he said programmes such as NRHM, Ayushman Bharat would come, but they will all be a part of the comprehensive audit.
“We will see how much the Centre has allocated to each of these programmes, and how states have utilised those funds,” he said.
Urban local bodies
Sources said CAG is also looking at auditing urban local bodies, which were given powers under the 74th Constitutional amendment brought in 1993.
“What was the objective of that amendment? Whether those were fulfilled or not are some of the aspects the CAG would determine,” one of the sources cited above said. .
The 74th Amendment Act established a mandate for decentralising powers and authorities to Urban Local Bodies (ULB) at various levels. This amendment also aimed to create an institutional framework for grassroots democracy through self-governing local bodies in urban areas of the country.
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