CAG set to conduct comprehensive audit of country's health sector

Current approach to be based in common parameters, goals and analysis, as opposed to earlier exercises done on the basis of some research or state-specific issues

The Comptroller and Auditor General of India (CAG) is in the process of doing a comprehensive audit of the country’s health sector, and is adopting an approach different from its earlier exercises, whose remit was relatively narrow.

“Earlier we were auditing on the basis of some research and state-specific issues. This time we are doing it comprehensively and 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 audit particular aspects of that.

For instance, a CAG report had shown earlier this year the health sector in Bihar was far from optimum because there was a significant shortfall of facilities and staff.

Ths 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.

The audit, however, will not be published at one go.

“It will 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,” another officer said, adding, the Covid period would be covered.

“It will cover the past five years. We may not give a specific title like ‘Covid Management’,” the officer added.

He said the CAG would not comment on state policies but 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 be explored. Then we will see them (the health centres) from a prudential point of view,” another official said. 

The CAG will look at the Central Vigilance Commission’s guidelines as well as those relating to project management for this, he said. 

Programmes such as the National Rural Health Mission and Ayushman Bharat will come under the 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

Officials said the CAG was looking at auditing urban local bodies, which were given powers under the 74th Constitutional amendment, introduced 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 officers 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 at creating an institutional framework for grassroots democracy through self-governing local bodies in urban areas.