The compliance audit report of the Comptroller and Auditor General (CAG) for the year ending March 2017, which was tabled in the Gujarat Assembly on Wednesday, has revealed that only 54 per cent of the BPL families in the state have been enrolled under the Mukhyamantri Amrutam (MA) and Mukhyamantri Amrutam Vatsalya (MAV) yojana till March 2017.
According to the report, the data maintained by the health and family welfare department stated that as of March 2017, there are 41,49,913 BPL families in the state. Out of these, only 22,63,156 families had been enrolled in the MA scheme till March 2017.
Thus, despite village-to-village enrollment rounds, only 54 per cent of these families could be enrolled.
The CAG also pointed out that the health and family welfare department has not followed the enrollment procedure. Instead, the report revealed, the department had opted for bulk printing of MA cards for the BPL families already registered under the Rashtriya Swasthaya Bima Yojana (RSBY) scheme. These bulk printed cards have been found to lack vital information like photographs, fingerprints, age and relationship, posing difficulties for beneficiaries in getting immediate medical treatment.
The detailed audit analysis further revealed that the high percentage of BPL enrollment in the years 2012-13 (15,39,052) and 2013-14 (6,09,956) was due to this bulk printing of cards (20,10,850 cards) which also led to duplication. In the absence of a system to identify duplication, it was found that beneficiaries had more than one active card.
Meanwhile, enrollment in 11 districts — Ahmedabad, Anand, Banaskantha, Bhavnagar, Dahod, Jamnagar, Kutch, Rajkot, Surat, Surendranagar and Vadodara — was even below the state average of 54 per cent, with Jamnagar reporting the lowest at 32 per cent.
Additionally, despite bringing in Accredited Social Health Activists (ASHA) for mobilising and bringing the remaining BPL families for enrollment in the subsequent three years, on incentive basis (Rs 100 per BPL family), the enrollment was quite low (2,52,306 during 2014-15 to 2016-17).
The report has also highlighted the unequal distribution of hospitals across the state. According to the report, 10 out of 33 districts in the state lack empanelled hospitals. Only four districts —Ahmedabad, Rajkot, Surat and Vadodara — in the state had empanelled hospitals for all clusters. This has forced the beneficiaries to move to other districts for availing treatment, specifically for cancer and cardiac and paediatric ailments.
The percentage of movement of beneficiaries to Ahmedabad, Rajkot, Surat and Vadodara was 74, 59, 44 and 62 per cent, in the period, respectively.
The audit also observed that 78 per cent of the beneficiaries preferred treatment at private hospitals due to lack of infrastructure and non-availability of specialists at government hospitals. This was reflective of the fact that out of a total claim of Rs 557.70 crore for treatment provided to beneficiaries under the scheme during 2012-17, the claim made by private hospitals was Rs 433.39 crore against the claim of Rs 124.31 crore by government hospitals.
The report states that the objective to provide cashless medical treatment for ‘catastrophic diseases’ as per the state government resolutions to the BPL families in the state remained unachieved even after a lapse of more than five years.
The non-revision of financial limit available under the scheme despite increase in package rates twice led to lesser benefits. Many instanced of empanelled hospitals charging fees were also noticed, thus, defeating the very purpose of providing cashless treatment to the beneficiaries.