•  The Comptroller and Auditor General of India hauled up the Odisha government over reported mismanagement of Niramaya - a much-vaunted free medicines distribution scheme

Systemic flaws in the implementation of Niramaya Scheme 

  • The Odisha State Medical Corporation Limited (OSMCL), a nodal agency for implementation of Niramaya Scheme in the State, failed in timely procurement and supply of drugs, equipment and instrument to health institutions as per indent, says the General and Social Sector report of CAG. The report was tabled in the State Assembly. 
  • The CAG finds that the procurement process was riddled with systemic flaws and numerous instances of non-adherence to the procurement policy, consequently impacting availability of drugs and equipment. 
  • There was stock out of essential drugs in hospitals leading to out-of-pocket expenditure by the patients. 
  • Monitoring of inventory management through e-Niramaya software application was ineffective leading to shortage of drugs in health institutions and expiry of drugs as well. 

Problems in supply 

  • The government was unsuccessful in providing an unbroken supply of essential drugs to the patients in public health institutions as per its own prescribed Essential Drug List. 
  • The government’s mandate to provide all prescribed drugs to patients free of cost in public health institutions remained largely unfulfilled. 
  • The Odisha Government has been boasting of its Niramaya scheme which is implemented since May 1, 2015. 
  • According to the report, the audit noticed that 349 kinds of drugs valued 4.18 crore had expired during April 2017 to May 2019. These expired drugs were lying in 39 warehouses.


Comptroller and Auditor General of India (CAG) 

  • The Constitution of India provides for an independent office of the Comptroller and Auditor General of India (CAG) in chapter V under Part V. 
  • The CAG is mentioned in the Constitution of India under Article 148 - 151. 
  • He is the head of the Indian Audit and Accounts Department. 
  • He is the guardian of the public purse and controls the entire financial system of the country at both the levels - the centre and state. 
  • His duty is to uphold the Constitution of India and the laws of Parliament in the field of financial administration. 
  • CAG audits the accounts related to all expenditure from the Consolidated Fund of India, Consolidated Fund of each state and UT having a legislative assembly. 
  • CAG audits all expenditure from the Contingency Fund of India and the Public Account of India as well as the Contingency Fund and Public Account of each state. 
  • CAG audits all trading, manufacturing, profit and loss accounts, balance sheets and other subsidiary accounts kept by any department of the Central Government and the state governments. 
  • CAG audits the receipts and expenditure of all bodies and authorities substantially financed from the Central or State revenues; government companies; other corporations and bodies, when so required by related laws. 
  • He ascertains and certifies the net proceeds of any tax or duty and his certificate is final on the matter. 

Reports Submitted

  • He submits his audit reports relating to the accounts of the Centre and State to the President and Governor, who shall, in turn, place them before both the houses of Parliament and the state legislature respectively. 
  • He submits 3 audit reports to the President: audit report on appropriation accounts, audit report on finance accounts and audit report on public undertakings. 

Free medicine schemes 

  • "NIRAMAYA" - is the Free Medicines Distribution Scheme of the Govt. of Odisha, Health & Family Welfare Dept. 
  • It is a flagship programme of Govt. of Odisha being implemented since 1st May 2015. 
  • Rajasthan has also launched free medicine scheme - Mukhyamantri Nishulk Dava Yojana - on 2nd October 2011. 
  • National Health Mission under its Free Drug Service Initiative, started giving rankings to the states, in order to encourage them to provide free drugs to their patients coming to public health facilities. 

Similar initiatives in India

  • TN Model -Tamil Nadu introduced a free medicines model in 1995 consisting of highly effective system of drug procurement, quality checks and supply and distribution centered on government hospitals. 
  • National Health Mission -In 2018 Union cabinet has announced National Health Mission (NHM) which would have a “special focus” with “intensification of initiatives such as National Health Mission Free Drugs and Diagnostics Services. 
  • National Health Policy - Even the National Health Policy 2017 specifically emphasizes provisions for free medicines and diagnostics at public hospitals. ● But there is still no national scheme guaranteeing free essential medicines to patients in the country. 
  • Jan Aushadhi Kendras - Union government has set up medical dispensaries under Jan Aushadhi Yojana to provide medicines at 50-90 per cent cheaper than branded drugs available in the market. 
  • This scheme aims to make healthcare affordable and encouraging Ease of Living. 
  • Ayushman Bharat Yojana or National Health Protection Scheme - is a centrally sponsored scheme launched in 2018, under the Ayushman Bharat Mission of MoHFW in India. ● The scheme aims at making interventions in primary, secondary and tertiary care systems, covering both preventive and promotive health, to address healthcare holistically. 
  • It is an umbrella of two major health initiatives namely, Health and Wellness centers and National Health Protection Scheme (NHPS). 

Source: The Hindu


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