Audit lands health authority in hot waters

AGP discovers lack of proper financial management, poor health facilities and lapse of millions of rupees of funds

FAISALABAD: The Auditor General of Pakistan (AGP) has detected irregularities of over Rs456 million during the audit of annual budget and accounts of District Health Authority (DHA) Faisalabad for the financial year 2018-19 and audit year 2019-20.

It was observed that the District Health Authority faces acute shortage of doctors and paramedics.

Against the 635 sanctioned posts of doctors and specialists only 408 positions have been filled while 237 posts are vacant, which is approximately 37% of total sanctioned posts. Moreover, out of the 758 technical and 784 other staff seats, only 568 and 708 positions are held respectively leaving a lot of room for hiring.

AGP office was concerned about the unsatisfactory service delivery by health officials particularly with respect to outdoor patients. Reportedly, doctors’ availability is another issue which requires immediate government attention.

During 2018-19, the Out Patient Department (OPD) had 635 doctors/specialists and as many as 7.6 million patients visited it whereas 145,651 patients visited the indoor department.

Data reveals that only one doctor was available for 12,333 patients over the year.

The bed capacity also stood at 563 in 2018-19 instead of the targeted 1,331. Authorities noted a huge gap in health services delivery by the health authorities in Faisalabad.

The audit has put to light poor financial management of DHA which call upon a complete overhaul of the authorities’ internal controls and financial discipline.

The audit department also noticed that the authority failed to provide record of Rs15.42 million in one case.

In addition to it, irregular expenditure of Rs232.77 million was reported in 25 cases along with discrepancy in records involving an amount of Rs4.57 million in two other cases.

Financial attest audit findings also highlighted non-transfer of receipt - Rs22.85 million, non-reporting of fixed assets - Rs26.18 million, payment of inadmissible risk allowance - Rs1.12 million, payment of inadmissible conveyance allowance to lady health workers - Rs66.82 million.

Audit report further maintained that DHA Chief Executive Officer failed to completely utilize the budget for the year 2018-19 and various funds related to medicine and development remained unutilized due to inefficiency of the management.

The focus of the authority remained on provision of trauma and outpatient services; no planning was carried out by the relevant officials to overcome shortage of human resource in various departments as well as reduce burden on employed health professionals to ensure government determined patient to doctor ratio.

Medicine procurement too, was ignored leading to hospitals buying medicines through local purchase (LP) at higher rates which caused loss unnecessary financial losses to the health authority.

DHA was established on January 1, 2017 under the Punjab Local Government Ordinance 2013. Over time neither a chairman was appointed by the government nor the board of directors constituted.

Notably, out of total annual budget of Rs4.23 billion comprising of Rs4.11 billion non-development and Rs127.73 million development funds, an amount of Rs705.52 million lapsed due to non-utilization.

It was concluded that DHA failed to achieve the targeted indicators set for the purpose of good service delivery.

Published in The Express Tribune, May 23^rd, 2020.