Patna: The Comptroller and Auditor General (CAG) of India has painted a grim picture of state’s healthcare system in its latest report, tabled in the state legislature on Thursday. The findings highlighted glaring deficiencies in infrastructure, equipment and human resources in state-run healthcare facilities, reflecting systemic failures that leave citizens vulnerable.
The report revealed that emergency operation theatres (OTs) were unavailable in all four sub-divisional hospitals (SDHs) inspected during the audit. This is a major violation of Indian Public Health Standards (IPHS), which mandate emergency OTs in every SDH.
Senior audit officer Satish Chandra Jha said the test checks were conducted in five districts — Patna, Jehanabad, Vaishali, Madhepura and Nalanda.
Emergency OTs, an important component of healthcare, were absent in all test-checked SDHs, reflecting the severity of the infrastructure crisis.
Another alarming revelation was that only 54% of the ventilators in the inspected districts were functional. Out of 132 ventilators available, just 71 were operational. The rest remained unused due to a lack of technicians and non-functional intensive care units (ICUs). This shortage is dangerous, especially in emergencies where ventilators often determine life or death.
“Fifty-seven ventilators were idle due to the unavailability of skilled staff and non-operational ICUs,” the report said.
The shortage of diagnostic facilities was another area of concern. The report found that 19% to 100% of required diagnostic services were missing in the 68 healthcare facilities inspected. This lack of basic diagnostic tools has crippled effective medical treatment, forcing patients to rely on private labs or travel long distances.
The scarcity of lab technicians compounded the problem. The audit reported a 100% shortage of lab technicians in some facilities during 2016-22. “The absence of lab personnel has been severely hampering the quality and efficiency of healthcare services,” it said.
Shockingly, none of the 10 SDHs, referral hospitals (RHs) and community health centres (CHCs) surveyed had functional blood storage units (BSUs). In many cases, BSUs were non-operational due to the lack of manpower or missing authorisation from the State Licensing Authority. The unavailability of BSUs poses a serious risk to patients requiring blood transfusions in emergencies.
The shortage of medical professionals remains one of the major challenges in Bihar. According to the report, the state needs 1,24,919 allopathic doctors to meet the WHO recommendation of one doctor per 1,000 people. However, only 58,144 doctors are available, a ratio of one doctor for every 2,148 people.
The shortage extends to other healthcare professionals as well. The report highlighted that the shortage of staff nurses ranged from 18% in Patna to 72% in Purnia while the shortage of paramedics ranged from 45% in Jamui to a staggering 90% in East Champaran. Overall, 49% of posts in various health departments and medical colleges remain vacant.
The non-availability of essential drugs has further exacerbated the crisis. The report revealed that 21% to 65% of medicines were unavailable for OPD patients while for IPD patients, the shortage ranged from 34% to 83%.
Also, none of the 25 ambulances inspected had the required equipment, medicines or consumables. The shortages ranged from 14% to 100%, rendering ambulances ill-equipped to handle emergencies effectively.
The lack of infrastructure in major hospitals also painted a grim picture. In top facilities like DMCH, PMCH and GMCH, shortages in required machines and equipment ranged from 25% to 100%, leaving patients without access to critical care.
The report also criticized the state govt for not aligning its healthcare plans with the National Health Policy of 2017. SDHs, which are essential for sub-divisional healthcare, were missing in 47 subdivisions of the state. While the government sanctioned the upgradation of 399 PHCs into CHCs between 2007 and 2010, only 191 had been completed by March 2022.
