CAG Flags 64 per cent shortage of Hospital Beds in Odisha Government Hospitals
The report indicates that Odisha currently has only 32,767 hospital beds, whereas the National Health Policy mandates a requirement of 91,392 beds.
In percentage terms, the vacancy position of specialists in the DHHs of the State, was maximum in the Dermatology category (55 per cent), followed by Pathology (51 per cent) and Paediatric (51 per cent). Similarly, 1,501 specialist posts had been sanctioned, to provide four key essential specialised services in CHCs, against which only 309 (21 per cent) specialists were in position, as of March 2022. Thus, there was a shortage of 79 per cent of specialists in CHCs.
"Shortage of doctors in healthcare facilities hinders the delivery of quality healthcare services to the public," reads the report.
Similarly, there were significant shortages of staff nurses and paramedics in hospitals at all levels of healthcare facilities. Significant shortage of staff nurses was noticed in PHCs, compared to the sanctioned strength, influencing the medical care of patients in rural areas. Even the sanctioned strength of staff nurses for PHCs in the State was less than the IPHS norm. Against the requirement of 4,02013 staff nurses, the State had sanctioned 2,156 staff nurses for the PHCs.
Healthcare services
The audit report highlighted the considerable gaps in the availability of Outdoor Patient Department and In-Patient Department services in the test-checked hospitals. CHCs were most deficient in providing specialised medical services, due to the absence of specialists. There was a serious dearth of emergency and trauma care services, due to deficient infrastructure, manpower and equipment.
ICU services were available, in only 17 out of the 32 DHHs of the State. Various deficiencies were observed concerning the early identification and management of complications during pregnancy, childbirth and the postpartum period.
The capability to provide adequate maternity services was especially lacking in the CHCs, which had substantial shortages of human resources and investigation facilities. The full range of diagnostic services was not available in the test-checked hospitals, impacting the efficiency of healthcare offered. Support and auxiliary services, including diet, laundry, mortuary, etc., were also deficient in terms of the availability of infrastructure and equipment.
Availability of Drugs, Medicines, Equipment and Other Consumables
"The government was not entirely successful in providing an unbroken supply of essential drugs to patients in public health facilities, in terms of its own prescribed essential/critical drug list. Monitoring/supervision of the supply chain of drugs and medical consumables was inadequate, leading to the exhaustion of stocks of essential medicines, as well as the expiry of drugs. Norms and parameters, prescribed for storage of medicines, were not followed, for ensuring the efficacy of the medicines procured," mentioned the report.
According to the report, hospitals were not fully equipped with essential equipment, in terms of IPHS/NMC norms. Equipment and medical devices were lying idle/ non-functional, in hospitals, due to non-provisioning of the required infrastructure and manpower. Following this, non-availability and idling of equipment impacted the delivery of health services in hospitals, as well as medical education in the MCHs, added the report.
It also pointed out that A large amount of the emergency equipment, such as ventilators and oxygen concentrators, obtained for handling urgent situations, went unused because of insufficient infrastructure and manpower.
Healthcare Infrastructure
Health facilities, at the primary and secondary levels of the healthcare system, did not adequately conform to the Indian Public Health Standards and National Health Policy norms. Hospital beds in health facilities were scarce, as only 0.35 beds were available per 1,000 population in the State.
The report revealed the state faces a 64% shortage in hospital beds against requirements under the National Health Policy, 2017. Only 32,767 beds are available against the required 91,392.
There was a delay in the completion of works and failure of the department to utilise the completed buildings, aggravated the problem of access to quality healthcare. Moreover, there was an acute shortage of staff quarters for the accommodation of staff, including doctors, nurses, paramedics, etc. in healthcare facilities.
