A cost overrun of Rs 29.28 billion took place in setting up of six new All India Institutes of Medical Science (AIIMS) after the release of allocated Rs 149.7 billion till 2016-17, according to a report released on Tuesday.
A performance audit report on the Pradhan Mantri Swasthya Suraksha Yojana was tabled in the parliament on August 8 by the Comptroller Auditor General of India. The CAG performance audit report stated that out of 42 departments in new AIIMS, 6-14 speciality, super-speciality and other departments have not become functional. Shortage of faculty posts in different AIIMS ranges from 55 per cent to 83 per cent, while for non-faculty posts it is 77 per cent to 97 per cent.
According to the report, only 152 to 546 beds were available against the requirement of 960 beds in each of the six new AIIMS. “1,318 equipment having estimated cost of Rs 4.54 billion remained undelivered as on March 31 2017 for periods up to 25 months from the due date of delivery,” it said, adding that time overrun for the new AIIMS is about four to five years. Four of the AIIMS – at Bhopal, Jodhpur, Patna and Raipur, made excess payments of Rs 19 crore to contractors due to adoption of higher rates in the Bill of Quantities, price escalation in violation of contract and change in mode of contracting.
The report found that during the second phase of the scheme, land for AIIMS-Raebareli was provided by the Uttar Pradesh government after four years of its approval and AIIMS-Raiganj was deferred to fifth phase after the West Bengal government did not provide land initially.
“The six new AIIMS were holding an unutilised balance of funds of Rs 12.67 billion, while Rs 3.93 billion for civil works and Rs 4.37 billion for procurement of equipment is unspent with the executing agencies,” it said.
The PMSSY was announced in August 2003, under which setting up of AIIMS and upgradation of existing State Government Medical Colleges and Institutions (GMCIs) was to be undertaken to ensure adequate availability of tertiary level health care and quality medical education across the country, under this scheme a total of 20 new AIIMS and 71 Government Medical Colleges/Institutions (GMCIs) were to be established in a phase wise manner with a total budget of Rs 14,970 crore for AIIMS and Rs 9,207 crore for GMICs.
In its first phase, the scheme envisaged setting up six AIIMS-like institutions and upgradation of 13 medical colleges and institutions. Over a period of time, the scheme has been expanded to cover 20 new AIIMS and 71 GMCIs in six phases.
In six new AIIMS (Bhopal, Bhubaneshwar, Jodhpur, Patna, Raipur and Rishikesh) shortage of faculty posts ranged from 55 per cent to 83 per cent. Similarly, the shortage of non-faculty posts ranged from 77 per cent to 97 per cent.
The CAG report also shows that the scheme suffered from poor planning. For instance, instead of standard operational guidelines, the Project Management Committee often issued ad doc decisions. Even simple things like the land required for the project was underestimated by approximately 37 per cent and requirement for equipment had also been under assessed. As a result, the revised approval had to be obtained in March 2010 which held up commencement of work on many packages. This led to delays in setting up the institutes. The first 6 AIIMS were to be completed between August 2011 and July 2013 but missed their deadlines.
On an average there was a delay of about four to five years. The scheme also did not put in adequate measure to evaluate and monitor the projects. State Project Monitoring Committees were not constituted for two new AIIMS at Raipur and Rishikesh. For the remaining four new AIIMS, though the State PMCs were constituted, the stipulated number of meetings was not held.
The GMCIs did not fare any better. The upgradation work in eight GMCIs in Phase-I and Phase-II was delayed by as much as 84 months in many cases. A total of 408 equipment costing Rs 71 crore were either not installed or installed and 977 equipment costing Rs 34 crore were idle/non-functional in nine GMCIs. Funds amounting to Rs 63 crore were unutilised and around Rs 26 crore were diverted.