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Item Performance Audit of Four Major Public Hospitals in Delhi (2001-2006)(CAG of India, 2007) CAG of IndiaA performance audit of the functioning of four major public hospitals in Delhi was conducted to assess their performance in terms of providing proper medical care by efficient use of available resources and infrastructure. The hospitals reviewed were Lok Nayak Hospital (LNH) and Deen Dayal Upadhyay Hospital (DDUH) under the Government of Delhi, Hindu Rao Hospital (HRH) under the Municipal Corporation of Delhi and Charak Palika Hospital (CPH) under the New Delhi Municipal Council.Item Performance Audit on Mid Day Meal Scheme in Arunachal Pradesh (2009-2014)(CAG of India, 21-07-2015) CAG of IndiaThe ‘National Programme of Nutritional Support to Primary Education’, a Centrally Sponsored Scheme, commonly known as ‘Mid-Day Meal’ (MDM) Scheme, was launched with the primary objective of boosting the universalisation of primary education by increasing enrolment, retention & attendance and simultaneously improving nutritional status of primary school children. Performance Audit of the scheme revealed that the Department covered all Government Primary/Upper Primary Schools (3116), Government-aided Primary/Upper Primary Schools (68) and EGS/AIE Centres (155) in the State under the scheme. However, there were deficiencies like inadequate financial management, short-lifting of food grains, delay in release of funds to schools for meeting cooking costs, inadequate infrastructural facilities in schools and lack of monitoring by the Department. Some major audit findings are highlighted below: 1. No household surveys were conducted to identify the total number of children not enrolled at the Primary stage. No attempt was also made to encourage high level of enrolment through publicity, etc. 2. In 2010-11, against GoI total allocation of 6,687.66 MT of food grains for Primary/Upper Primary level, the Department lifted only 5,928.37 MT and during 2013-14, against the allocation of 6,625.01 MT of food grains for Primary/Upper Primary levels, only 6,598.95 MT were lifted, leading to shortlifting of 785.35 MT of food grains. 3. There was a shortfall in provision of 47,360 meals due to short receipt of food grains in 137 schools. 4. In six schools of West Kameng and Lohit District, 46.61 quintals (23 per cent) of the allotted rice was issued as dry rations instead of cooked meals, violating directives of the Hon’ble Supreme Court of India. 5. In 150 test-checked schools, pucca kitchen sheds were not available in 130 (87 per cent) schools; drinking water facilities in 35 (23 per cent) schools; gasbased chullahs in 148 (99 per cent) schools; and cooking utensils in 9 (6 per cent) schools. 6. During the period 2009-14, there were persistent savings ranging from 1 per cent to 32 per cent. 7. From 2009 to 2014, there were delays ranging up to 21 months in release of Central assistance by the State Government to the Nodal Department. 8. The State Government did not contribute its share, aggregating to ₹ 12.93 crore (63.69 per cent), towards Conversion Costs, Honorarium to cooks-cum-helpers and MME costs. 9. There were deficiencies in meetings of the State, District and Block Level Monitoring Cells to monitor implementation of the scheme. 10. Findings of evaluation studies conducted by an Independent Agency to assess the impact of the scheme were not discussed by the State SMC to address the deficiencies pointed out in the Evaluation Reports.Item Idle Expenditure on Laboratory Equipment and Software for Polytechnics and Govt Engineering Colleges in Chhattisgarh(CAG of India, 25-07-2015) CAG of IndiaProcurement of laboratory equipment and software without assessing the requirement and without ensuring the availability of necessary infrastructure to utilise the equipment resulted in idle expenditure of ₹ 8.62 crore.Item Performance Audit of National Rural Health Mission (NRHM) in Jammu and Kashmir(CAG of India, 2009) CAG of IndiaGovernment of India launched (April 2005) the National Rural Health Mission (NRHM) to carry out necessary architectural correction in the basic health-care delivery system. The Plan of Action includes increasing public expenditure on health, reducing regional imbalance in health infrastructure, decentralization and district management of health programmes, community participation and operationalising community health centres into functional hospitals. The performance audit review of implementation of NRHM in Jammu and Kashmir showed that the status of health profile of the State has been quite encouraging vis-à-vis the performance indicators available for the country. These can be further improved if there is proper fund management/utilisation and various sectors involved are covered in conformity with the guidelines issued for implementation of the Programme. There are large gaps in planning as well as implementation of the Mission activities in the State even after four years of launching the programme. This is evidenced by the findings that no new health centre was put in place, essential services and amenities were not available in many centres and there was critical shortage of technical manpower. Maternal and child health programmes have not made much headway. Planning, implementation and monitoring of the programme through participation of NGOs and community-based organisations was nonexistent.Item Undue Favour to a Firm for Setting up of Language Laboratories in Universities in Odisha(CAG of India, 20-09-2018) CAG of IndiaThe decision to award the work of setting up of LLs in 108 colleges of the State to a private firm on nomination basis was not in order. Further, there was no enrolment in 42 colleges where LLs were set up at the total cost of ₹ 8.64 crore.Item Performance Audit of National AIDS Control Programme in Bihar (1998-2003)(CAG of India, 2004) CAG of IndiaNational AIDS Control Programme aimed at reducing the spread of HIV infection and strengthening the country's capacity to respond to HIV/AIDS on a long term basis. Implementation of the programme in the State suffered mainly due to absence of proper monitoring mechanism. Physical progress in the components of targeted intervention for high risk groups and prevention of HIV/AIDS among low risk groups was either nil or marginal except in the case of condom promotion. Blood banks lacked basic infrastructure facilities. No community centre was set-up for low cost AIDS care. Institutional strengthening was weak. Inter-sectoral collaboration was absent. Thus, the intended objective of reducing spread of HIV infection and strengthening country’s capacity to respond to HIV / AIDS on a long term basis was not achieved to a large extent. Main audit findings are summarised below: 1. During 1998-2002 due to poor spending only 46 per cent (Rs 11.14 crore) of funds allocated (Rs 24.27 crore) by GOI were released. Excess expenditure of Rs 0.49 crore during 1999-2003 on awareness campaign was incurred by diverting funds from different components. Against an allocation of Rs 15.00 lakh relating to civil works, AIDS Control Society advanced Rs 1.17 crore to District Magistrates in March 2003 for construction of rooms for blood banks without approval of NACO. 2. Physical progress in the components of targeted intervention for high risk groups and prevention of HIV/AIDS among low risk groups was dismal during 1998-2003. Lack of mandatory equipments like air conditioners and elisa readers in blood banks rendered the blood banks ineffective. 107 equipments supplied by NACO to 15 blood banks for their modernisation were non functional as the blood banks had no operational license from appropriate authority. Even in seven licensed blood banks 168 equipment supplied by NACO were lying idle. 3. Low cost AIDS care was not initiated in the State as no community care centre was set-up. 4. Intersectoral collaboration was non-existent. Level of awareness development was low and no society was formed at district level for effective implementation of the programme. 5. The number of AIDS cases which was 10 in 1998-99 increased to 63 in 2001-02. 6. There was absence of effective monitoring mechanism of the programme. The reports on the impact analysis of the programme done by ORG Centre (May 2000) and World Bank Mission (May 2002) were not available with the state Government.Item Performance Audit on Drugs and Cosmetics Act in Gujarat (1997-2003)(CAG of India, 2004) CAG of IndiaThe Drugs and Cosmetics Act 1940 (Act) is a Central Act to be implemented by all the States. The Act along with the other associated Acts and the rules made thereunder regulate the import, manufacture, distribution, sale and clinical research of drugs and cosmetics. In Gujarat, huge shortage of Drug Inspectors adversely affected the functioning of the Drugs and Cosmetics Act and the menace of spurious drugs continued to prevail. No follow-up action was taken to withdraw the drugs declared as not of standard quality from the market. The licensing system was ineffective and the DCA did not maintain proper record. Monitoring at State level was poor. Thus the objective of prevention of the menace of spurious drugs to eliminate the danger to human life had not been achieved. Following are the main audit findings: 1. Inadequate strength of technical staff weakened the enforcement of the Administration and diluted regulatory functions. 2. There was sharp increase in pendency in the cases of prosecution. 3. Sales of drugs without complying with the conditions of licences were noticed. 105 sales licences were issued to pharmacies without registered pharmacists to supervise sales in contravention of the provisions of the Act. Shortfall in inspections ranging from 54 to 69 per cent (manufacturing units) and from 63 to 77 per cent (selling units) was noticed. Two Blood banks with serious deficiencies collected 5948 units of blood. Real magnitude of spurious/Not of Standard Quality drugs sold in the market could not be assessed due to inadequate sampling. Under-utilisation of capacity of the laboratory resulted in delay in testing and follow up action. Inordinate delay in despatch of the drug samples to the testing laboratory resulted in delayed declaration of NSQ drugs. Delayed declaration of NSQ drugs resulted in selling of NSQ drugs before they could be withdrawn. 4. Sub-standard drugs worth Rs.68 lakh purchased by CMSO and ESIS were not replaced.Item Integrated Audit of Health and Family Welfare Department in Mizoram(CAG of India, 2009) CAG of IndiaIntegrated audit of the Health and Family Welfare Department in Mizoram revealed poor budget, accounting and procurement procedures and non-implementation of various Centrally Sponsored Schemes. Some of these are highlighted below: 1. The Directorate of Hospital and Medical Education parked funds amounting to Rs. 2 crore in Civil Deposit for periods ranging from 4 to 30 months. 2. An amount of Rs. 30 lakh was drawn for electrification of buildings and fencing works, out of which, only 2.17 lakh was utilised for water connection, while the balance amount remained unaccounted for. 3. Unauthorised disbursement of Rs. 42.44 lakh led to probable misappropriation of funds by the Deputy Director (Nursing). 4. The Directorate of Hospital and Medical Education disbursed Rs. 16.59 lakh to a New Delhi based firm before issue of formal supply order and without ensuring delivery of stores.Item Performance Audit of Post Matric Scholarships for Scheduled Caste Students (All India Report 2012-2017)(CAG of India, 07-08-2018) CAG of IndiaAt the request of the Ministry of Social Justice and Empowerment, a performance audit of the implementation of the scheme covering a period of five years from 2012-13 to 2016-17 in five States of Karnataka, Maharashtra, Punjab, Tamil Nadu and Uttar Pradesh was undertaken by audit. The total expenditure incurred in the scheme in the five States was INR 18,647 crore during the period 2012-17 benefitting 1.36 crore students from the SC community. The performance audit of the implementation of the scheme brought out systemic gaps in scheme guidelines themselves as well as lack of planning, poor financial management and irregularities in disbursement of scholarship funds with a financial implication of ` 581.68 crore as well as discrepancies and inconsistencies in data generated through the web portals with an additional financial involvement of ` 455.98 crore that pointed to the need for a thorough review of the scheme guidelines as well as its implementation so as to ensure that the scheme funds were not misused or diverted for other purposes. Scheme guidelines, critical for laying down mechanism for various processes, were found deficient in many aspects. No mechanism was prescribed for any of the planning exercises of preparation of action plan/perspective plan for identification of eligible beneficiaries before submission of proposals for central assistance to the Ministry nor did the guidelines prescribe any timelines for submission of application by students and their scrutiny and approval. Consequently, there were delays in payment of scholarship to 18.58 lakh students ranging between one to six years in four States of Maharashtra, Punjab, Tamil Nadu and Uttar Pradesh. The guidelines also do not contain any provision for monitoring and evaluation that are essential for decision-makers to realistically evaluate the progress of the scheme and identify impediments to its efficient implementation. The implementation of the scheme was constrained by inadequate allocation of funds by the Central Government as well as poor financial management by the States. Government of India could not meet the growing demand for funds from the States which resulted in accumulation of arrears amounting to INR 5,368 crore in the five selected States. Even the available funds could not be fully utilised in three States of Maharashtra, Tamil Nadu and Uttar Pradesh with INR 375.30 crore remaining undisbursed due to mismatch of bank details which resulted in depriving eligible students of the scholarships. Further, INR 28.94 crore of scholarship funds was diverted in Karnataka and Maharashtra for maintenance of e-scholarship portal and purchase of stationery, computers, etc., during 2012-17. The States also failed to ensure adherence to the scheme guidelines relating to eligibility of beneficiaries and procedures for processing of applications and disbursal of scholarship funds. Audit noted short reimbursement/denial of scholarship amounting to INR 125.82 crore in three States of Karnataka, Tamil Nadu and Punjab. There was excess payment of scholarship of INR 49.67 crore to 1.88 lakh students in Punjab, Tamil Nadu and Uttar Pradesh during 2012-17 due to incorrect application of rates. In Uttar Pradesh, 374 ineligible students were reimbursed scholarship of INR 1.95 crore during 2012-17. Non-adherence to the scheme guidelines relating to revision of income ceiling by Maharashtra and Uttar Pradesh with effect from academic session 2013-14 resulted in denial of benefit to eligible students in the States. The States of Punjab, Maharashtra, Tamil Nadu and Uttar Pradesh were also not covering certain components of the scholarship viz. thesis allowance, book allowance, disability allowance, study tour charges. The Ministry was unable to implement PMS-SC through National Scholarship Portal due to technical issues and decided to implement the same through State portals. However, the State portals lacked both general and application controls required for ensuring access security and providing assurance that transactions are valid, authorized, complete and accurate. In Punjab, Tamil Nadu and Uttar Pradesh, audit noticed discrepancies in data generated by the State portals with financial implication of INR 455.98 crore that necessitates a comprehensive investigation by Ministry as well as States to obviate the risk of irregular payment and malfeasance. Institutional mechanisms for monitoring and grievance redressal including internal audits, periodic inspections and appointment of grievance redressal officers were either not in place or practically non-operational. The Ministry had also not carried out any comprehensive evaluation of the implementation of the scheme to identify changes needed to enhance its effectiveness and ensure achievement of its objectives.Item Performance Audit of Integrated Child Development Services (ICDS) in Kerala (2006-2011)(CAG of India, 19-03-2013) CAG of IndiaThe Integrated Child Development Services launched in 1975 in India aims at holistic development of children up to six years ofage, adolescent girls, pregnant and lactating mothers by providing a package of services like supplementary nutrition, immunisation, health check up, nutrition and health education, etc. This performance review of the implementation of the scheme in Kerala for the period 2006-07 to 2010-11 revealed deficiencies in the implementation of the scheme such as delay in release offunds for scheme implementation, failure to cover the entire targeted population, etc., thereby defeating the basic objectives of the Scheme. Contrary to Government of India guidelines, Take Home Food delivered to children between six months and three years in the State was not fortified with micro-nutrients. The main audit findings are given below: 1. The department was not preparing any long term perspective plan. In the absence of the plan, there were deficiencies in creation of new AWCs and insufficiencies in the delivery of services to beneficiaries in various components in ICDS. 2. There was a shortage of 8,619 Anganwadi Centres (21 per cent) in the State. Fourteen additional Anganwadi Centres (AWCs), sanctioned in 2005 by GOI, were yet to be operationalized. 3. Many functional AWCs in the test checked ICDS projects were functioning in rented premises and lacked basic infrastructure facilities like safe drinking water, toilets, etc. 4. The percentage of child population who were not immunized against Polio and DPT in Palakkad and Malappuram districts were respectively 36 and 31. 5. The objective of universalization of Supplementary Nutrition Programme was not achieved as 56 to 66 per cent of the identified beneficiaries were not covered under the Scheme. 6. The percentage of malnourished children below the age of six years in the State ranged between 27 and 39. Test check of records in Idukki, Malappuram, Palakkad and Thiruvananthapuram districts indicated that 110 out of 1180 children who died during 2011-12, were severely malnourished. 7. GOI guidelines stipulating periodical weighment of child beneficiaries under Supplementary Nutrition Programme to assess their nutritional status was not adhered to during 2007-12. 8. Take Home Ration (THR) valued at % 257.38 crore was purchased from an agency which did not possess the mandatory BIS certification. It was also noticed that an amount of z 22.44 crore was overcharged by the supplier. In a number of cases, test results of the samples of the product were stated to be not satisfactory.