The Disease Management Association of India (DMAI) has recently submitted a report to the Public Accounts Committee (PAC), pointing out that almost 25 per cent of the money allotted by the government for the healthcare sector goes unused. The report that was filed after detailed study on the PAC report on NRHM, highlighted several grey areas that demand immediate corrective measures to ensure efficient delivery of healthcare services to the patients through time bound and planned use of allotted funds.
Taking cognisance of the alarming figures given in the report, the committee headed by Dr Murali Manohar Joshi as the chairman, has agreed to take up this matter in the next meeting with serious consideration for auditing unused funds. As per the report, currently, the Ministry of Health and Family Welfare (MoHFW) is unable to utilise even one per cent of the GDP on health which is a huge setback to the Indian healthcare programme.
Rajendra Pratap Gupta, president, DMAI pointed out that considering the huge lacunae in the present system, it is imperative that the PAC or any competent independent regulator starts the audit of unspent funds allocated for each social sector so that the benefit of the plan reaches the targeted population. “As DMAI, we would be interested in pursuing this issue further with the concerned authorities. Also, a clear and enabling policy framework is required, so that the bureaucrats can take decisions without fear on fund allocation utilisation, and the absorptive capacity of the system increases to 100 per cent.”
To address this matter, the association suggested the government to take up a public private partnership (PPP) model in the12th five year plan that will enable the use of three per cent of the total healthcare budget. The DMAI president stressed that adopting an effective PPP model will be the best available solution to this problem as it will ensure accountability and transparency in the whole process.
Further the detailed analysis of the report highlighted several drawbacks as well. Audit scrutiny revealed that mission steering group (MSG) which was required to periodically monitor progress of the mission met only four times in four years instead of 8 times as per the laid guidelines. Also the delegation of powers to the MSG and EPC (Empowered Programme Committee) was subject to the condition that a progress report regarding National Rural Health Mission (NRHM), also indicating deviation from the financial norms and modifications in ongoing schemes, would be placed before the cabinet on an annual basis. However, during the past four years, the Mission had submitted a progress report to the Cabinet only once in August 2008 (as per the PAC report).