CAG raps J-K govt for issuing substandard medicines

The Comptroller and Auditor General (CAG) has rapped Jammu and Kashmir Health and Medical Education Department for issuing substandard medicines worth Rs 82.74 lakh to patients and procurement of machinery for Rs 1.17 crore on the basis of fake or forged supply orders.
Food controller organisations in Srinagar and Jammu had lifted 1,833 samples from health institutions during 2010-15, out of which 43 samples were declared as 'not of standard quality', the CAG said in its report which was tabled in the state Assembly this week.
However, cross check of the data in the sampled health institutions showed that 50.95 lakh tablets, capsules and injections worth Rs 82.74 lakh declared 'not of standard quality' had been issued for supply to patients.

"This was due to absence of a proper mechanism for monitoring of reports once the samples were lifted by the Drug and Food Controller organisation as by the time test reports had been received by the hospitals entire quantity of drugs and medicines of the sampled drug or medicines had been administered either fully or partly to the patients," it said.
Against total allocation of Rs 167.29 crore from 2010-11 to 2014-15 for procurement of medicines, machinery and equipment under NRHM (CSS), Rs 99.05 crore (59 per cent) remained unspent resulting in non-extension of intended benefits to the patients, the report said.

Of the unutilised amount, Rs 20.82 crore remained blocked for a period ranging from two to five years, it said.

With regard to purchase of machinery and equipment, the report said audit analysis showed that out of 1,014 supply orders worth Rs 81.57 crore issued by the test check health institutions during 2010-15, 93 supply orders worth Rs 11.41 crore had been placed against rate contracts, validity of which had expired.
As many as 581 supply orders with a value of Rs 19.17 crore had been placed on the basis of rate contracts finalised by the health institutions located outside the state and on the DGSD rate contracts, the report said.

Out of 236 supply orders worth Rs 5.81 crore placed by the district hospitals, supplies worth Rs 4.22 crore involving 193 supply orders had been procured from the open market, it said.
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"The cross verification showed that six supply orders (25 per cent) claimed to have been issued by AIIMS New Delhi, had either not been issued by AIIMS or had been tampered with resulting in procurement of machinery or equipment to the extent of Rs 1.17 crore on the basis of fake or forged supply orders by the institutions," it said.
"Since the exercise has been conducted by the audit in a test check manner, possibility of such procurement on large scale and by the other health institutions cannot be ruled out," the report said, adding the matter was referred to Commissioner Secretary of the Department on April 2015.

In its recommendation, the CAG called for a robust mechanism for regular testing of drugs before they are administered to the patients.
It also asked the government to consider ensuring rationalisation of expenditure to be incurred on procurement of medicines and equipment and also consider operationalisation of procurement corporation.
In its report, the CAG also took a dig on Health Department for its failure to prepare the drug formulary by last year despite lapse of several years after adopting the drug policy.
The state government adopted a drug policy in February 2012 which, inter-alia, provided for completion of certain formalities for preparation of a drug formulary.

However, the Department only early this year notified the Jammu and Kashmir Drug Formulary, which is an exhaustive list of drugs or medicines out of which alone the procurement of drugs/medicines can be made by the J&K Medical Supplies Corporation.
The State did not have a Drug Formulary till date and had to rely on the formularies of other states for its procurement needs.
This Formulary was notified based on the recommendations of a Committee constituted by the government in 2013 under the Chairmanship of Dr Ajit K Nagpal, the first Director of Sher-e-Kashmir Institute of Medical Sciences, Soura and Convener, Task Force on Health Sector Reforms in J&K.

The CAG also criticised the department for frequent restructuring or reconstituting of purchase committees and said it had the working of the committees adversely.