VIJAY DEO JHA
Ranchi, March 15: The performance audit of the District Hospitals of Jharkhand conducted by the Comptroller and Auditor General of India (ACGI) has said that there is a critical requirement for sustained and determined action to close the gap between patient care received and the target outcomes in District Hospitals (DHs). The test checks were carried out at six selected DHs across Jharkhand.
The report tabled in the assembly during the budget session on Tuesday covers the period 2014-19. The survey was carried out during 2019-20 with the objective of assessing the quality of medical services and patient care being provided by DHs in Jharkhand.
The performance audit indicates that Jharkhand requires focussed plans to meet the standard and expectations of the National Health Policy. The audit assessed various services like Out-Patient and In-Patient Services, Maternity Services, Diagnostic Services, Infection Control and Drug Management.
The report observed that the Health Department did not formulate its own standards and norms to ensure the availability of all types of resources and services adequately in DHs in respect of out-patient and in-patient services, pathology investigations, and human resources. The department even did not carry out any methodical gap analysis to plug loopholes.
The report said that the state government should ensure that the existing standards and norms for the provisioning of services and resources for the district hospitals are strictly followed. It also recommended punitive actions against officials for intentional violation of norms or negligence in services.
It was found that the patient load in the Out-Patient Departments (OPDs) increased by 57 percent in 2018-19 compared to 2014-15. But despite the increase in the number of patients in OPDs, the number of doctors was not increased. A single doctor was burdened to check and treat patients. The report says that doctors are so burdened with a load of patients that it adversely affected consultation time which was less than the suggested minimum consultation time of five minutes. Less consultation time, increasing waiting times and an overall weak grievance redressal system adversely affected the quality of service. The report pointed out that some of the DHs lack suitable seating facilities and toilets. and. Recommendations.
The report expresses concern over poor diagnostic services, both radiological and pathological, in terms of availability of functional equipment, consumables and human resources in the test-checked DHs. A majority of the test-checked DHs did not have the requisite range of X-ray machines. Ultrasonography (USG) facility was not available in two DHs and Computed Tomography (CT) scan was not available in any of the test-checked DHs.
The audit report found that Intensive Care Units (ICU) were established only in nine DHs between July 2016 and May 2017 out of the 23 DHs in Jharkhand. But ICUs always faced a shortage of equipment and medicines were noticed in ICUs as far as an audit conducted at six test-check DHs. Thus, critical care to patients was not adequate and they were likely to have been referred to higher government health facilities.
It added that the Separate Accident and Trauma wards for providing better care to patients were not available in five test-checked DHs except in Hazaribagh and patients were referred to the nearest higher government health facility.
The health service is lacking in terms of the Disaster Management Plan (DMP). Except one in East Singhbhum. The audit report has exposed DHs lacked proper plan in case of any kind of disaster.
