Lok Sabha Question No. 1035 (UNSTARRED), answered on 2016-07-22
Subject: Irregularities in NHM
Ministry: HEALTH AND FAMILY WELFARE
Asked by: RAMACHANDRAN MULLAPPALLY, KIRTI (JHA) AZAD, PRATHAP SIMHA, LADU KISHORE SWAIN, MANOJ KUMAR TIWARI

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1035 TO BE ANSWERED ON 2 2 ND JULY, 2016

## IRREGULARITIES IN NH M

## 1035. SHRI MULLAPPALLY RAMACHANDRAN:

SHRI KIRTI AZAD:

SHRI PRATHAP SIMHA:

SHRI LADU KISHORE SWAIN:

SHRI MANOJ TIWARI:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) the details of funds allocated and released under National Health Mission (NHM) during the last three years, mission/ State/UT - wise;
- (b) whether the Government proposes to increase the funding to States/UTs in order to increase the number of specialist, if so, the details thereof;
- (c)  whether  the  Government  has  taken note  of  received  complaints  regarding financial irreg ularities under NHM if so, the details thereof and the action taken thereon, State/UT - wise;
- (d) whether the Government has put in place a monitoring mechanism to ensure that the money is spent for the intended purpose under NHM, if so, the details thereof and if not, the reasons therefor; and
- (e) the corrective steps taken by the Governm nt in this regard?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI FAGGAN SINGH KULASTE)

- (a): A  statement  indicating  release  under  National  Health  Mission  (NHM)  during  the  l three years, States/UT - wise is annexed.
- (b): Under the NHM, technical and financial support is provided to States/UTs to streng their healthcare systems, including support for engagement of specialists on contractua based on the requirements posed by the States/UTs in their Programme Impl ementation Plans (PIPs), within the resource envelope available for a particular State/UT. To facilitate e of specialists, attractive remuneration including hard to reach area allowance and perf based incentives are approved so that special ists f nds it attractive to join public health facilit

(c): Certain instances of financial irregularities of NHM funds like mis - appropriation, misuse of  funds,  diversion  of  funds  from  one  pool  to  another  without  authorization,  excessi infruct uose purchase, defalcation and improper maintenance of control registers, etc. have to light through Audit reports in States like Uttar Pradesh, Assam, Bihar, Haryana, Ja Kashmir, Odisha and Rajasthan. The State Governments are asked to take acti on to address the deficiencies.

(d) & (e): Public health being a state subject, primary responsibility of implementatio monitoring  of  schemes  under  NHM  rests  with  the  State  Governments.  However,  the  Centra Government has been doing financial monitor ing f the schemes under NHM through following mechanisms:

The Ministry requested the Controller & Auditor General (CAG) for conducting annua transaction audits of the National Health Mission (NHM) in all the States in order to ide existing gaps , facilitate independent monitoring and timely corrective measures so that a q and timely audit assessment becomes available to assist the State Governments in undert remedial measures and achieving the targets of NHM. The CAG has agreed to unde rtake annual audit and performance audit under NRHM for the period from 2011 - 12  to  2015 - 16  has  been initiated at Ministry and in 28 States/UTs.

Besides provision of annual CAG audit, following corrective steps have been put in by  Ministry  of  Health &  Family  Welfare  to  ensure  that  the  money  is  spent  for  the  intende purpose under NHM:

- Examination of quarterly Financial Monitoring Reports by the States;
- Annual Statutory Audits by CAG empanelled major CA audit firms;
- Concurrent Audits;
- Visits b y the teams of Financial Management Group of the Department to States for periodical review;
- Annual  visits  to  States  by  Common  Review  Mission,  which  inter - alia,  looks  at financial systems and mechanisms.
- Financial review by Institute of Public Auditor s of India (IPAI) of NHM in several States.
- Implementation  of  Public  Financial  Management  System  (PFMS)  developed  by  the office of CGA of Ministry of Finance for monitoring and management of funds on ju in time basis.
- Integrated monitoring visits by senior officials of Ministry and National Health System Resource Centre.

## Statement Showing State/UTs wise Allocation and Release under NHM for the F.Ys 2013-14 to 2015-16

## Annexure

Rs. in crore

| Sl. No.   | States                    | 2013-14    | 2013-14   | 2014-15    | 2014-15   | 2015-16    | 2015-16   |
|-----------|---------------------------|------------|-----------|------------|-----------|------------|-----------|
|           |                           | Allocation | Release   | Allocation | Release   | Allocation | Release   |
| 1         | Andaman & Nicobar Islands | 23.83      | 29.06     | 28.22      | 23.36     | 28.21      | 37.26     |
| 2         | Andhra Pradesh            | 1184.24    | 878.73    | 707.15     | 519.73    | 616.23     | 642.89    |
| 3         | Arunachal Pradesh         | 86.31      | 78.60     | 185.65     | 139.41    | 160.01     | 161.65    |
| 4         | Assam                     | 1214.83    | 1077.81   | 1095.38    | 877.13    | 941.29     | 970.84    |
| 5         | Bihar                     | 1487.65    | 1110.32   | 1292.13    | 1148.32   | 1108.61    | 1139.28   |
| 6         | Chandigarh                | 18.53      | 11.46     | 19.40      | 12.15     | 14.24      | 23.88     |
| 7         | Chattisgarh               | 500.72     | 355.98    | 555.66     | 500.41    | 479.38     | 410.80    |
| 8         | Dadra & Nagar Haveli      | 8.73       | 9.23      | 13.99      | 8.40      | 11.37      | 14.37     |
| 9         | Daman & Diu               | 6.48       | 6.50      | 9.69       | 6.91      | 9.11       | 10.53     |
| 10        | Delhi                     | 211.46     | 129.78    | 192.59     | 154.04    | 142.81     | 163.80    |
| 11        | Goa                       | 27.12      | 19.35     | 27.63      | 26.03     | 19.41      | 16.77     |
| 12        | Gujarat                   | 833.94     | 833.72    | 858.47     | 832.86    | 677.65     | 693.78    |
| 13        | Haryana                   | 313.57     | 315.94    | 317.42     | 273.60    | 249.33     | 291.96    |
| 14        | Himachal Pradesh          | 225.95     | 205.29    | 232.00     | 185.84    | 197.92     | 246.49    |
| 15        | Jammu & Kashmir           | 433.87     | 395.10    | 435.17     | 335.51    | 368.00     | 367.89    |
| 16        | Jharkhand                 | 582.97     | 396.38    | 563.92     | 359.62    | 493.37     | 395.15    |
| 17        | Karnataka                 | 814.17     | 611.11    | 834.09     | 697.24    | 706.09     | 740.35    |
| 18        | Kerala                    | 424.15     | 360.98    | 373.58     | 521.99    | 305.87     | 304.14    |
| 19        | Lakshadweep               | 3.61       | 3.20      | 5.89       | 5.08      | 4.28       | 5.69      |
| 20        | Madhya Pradesh            | 1141.03    | 865.94    | 1250.17    | 1162.50   | 1085.37    | 1131.10   |
| 21        | Maharashtra               | 1520.71    | 1218.51   | 1536.58    | 1431.76   | 1282.31    | 1085.92   |
| 22        | Manipur                   | 127.75     | 88.93     | 144.97     | 128.81    | 118.53     | 112.14    |
| 23        | Meghalaya                 | 139.24     | 125.51    | 160.21     | 104.13    | 131.00     | 100.60    |
| 24        | Mizoram                   | 86.20      | 77.43     | 116.53     | 103.28    | 97.87      | 93.51     |
| 25        | Nagaland                  | 114.42     | 99.73     | 131.26     | 114.92    | 108.75     | 104.21    |
| 26        | Orissa                    | 678.99     | 604.20    | 730.09     | 667.16    | 624.71     | 644.52    |
| 27        | Puducherry                | 21.29      | 18.10     | 25.46      | 22.56     | 17.77      | 18.61     |
| 28        | Punjab                    | 362.38     | 333.47    | 351.89     | 379.35    | 284.75     | 295.19    |
| 29        | Rajasthan                 | 1091.20    | 922.93    | 1238.11    | 1115.96   | 1069.38    | 1284.66   |
| 30        | Sikkim                    | 42.32      | 45.91     | 51.42      | 51.60     | 45.86      | 41.00     |
| 31        | Tamil Nadu                | 1020.75    | 906.24    | 968.18     | 952.75    | 794.38     | 1093.22   |
| 32        | Tripura                   | 165.43     | 140.15    | 161.75     | 123.11    | 139.08     | 135.24    |
| 33        | Uttar Pradesh             | 3584.98    | 3024.60   | 2650.25    | 2431.06   | 2299.49    | 2862.23   |
| 34        | Uttarakhand               | 310.55     | 245.25    | 308.10     | 270.55    | 256.60     | 276.38    |
| 35        | West Bengal               | 1179.64    | 948.51    | 1053.27    | 1058.62   | 883.49     | 957.92    |
| 36        | Telangana                 | 0.00       | 0.00      | 506.45     | 378.72    | 440.58     | 436.38    |
|           | Total                     | 19989.01   | 16493.93  | 19132.72   | 17124.48  | 16213.09   | 17310.34  |

## Note:

1. Allocation is per Original outlay/B.E.
2. The above  Releases relate to Central Govt. Grants & do not include state share contribution.