The national rural health mission is an ambitious scheme launched by the UPA I government to take health care to villages. The government’s publicity department has made it out as a flagship scheme that has done wonders. It has been claimed that it has delivered on all fronts and across social segments and has set new standards. But the claims appear to be gross misrepresentation and exaggeration in the light of the actual state of implementation. There have been many reports of corruption, mismanagement and other problems. Now the Public Accounts Committee of parliament has given details of how wasteful and inefficient the scheme has been. The PAC has called the scheme a joke and a fiasco and told the health ministry to restructure it.
Some facts about the scheme discovered by the PAC are shocking. Health centres in villages are used as cowsheds and godowns. Doctors are not available, not to speak of specialists. Even nurses, midwives or paramedical staff are in short supply. Testing facilities and services are non-existent or inadequate. In places where machines and equipment are available they are not used and long periods of lack of use make them unusable. Medicines past their expiry dates are given to patients and in many states there is no check on the quality of medicines which are purchased. The state of infrastructure and hygiene is very bad and there is virtually no monitoring. The government has not made any assessment of the performance of the scheme after it was launched. The PAC audit has found that the scheme can be said to be not a failure only in two of the 18 states where it is implemented.
Considering that the government has spent Rs 30,000 crore on the scheme till now, the scale of misuse and wastage of funds is clear. Bringing health care to villages is full of difficulties and challenges and only the government can effectively do that. It spends only one per cent of the GDP on health care though a target of 3 per cent has been set. If even the one per cent is spent the way the PAC has found it is, any increase in fund allocation will hardly help, except to increase corruption. The government needs to take a hard look at the scheme again, make it useful to ordinary people in the villages and stop the misuse of the funds.