CAG flags deep gaps in public healthcare; PAC wants visible change by June end

New Delhi: A CAG audit of Delhi’s public healthcare system has flagged deep structural gaps — from staff shortages and overcrowded hospitals to drug supply failures and underutilised funds — raising serious questions about the capital’s ability to deliver timely and quality care.The findings of the performance audit between 2016-17 and 2020-21 (extended to 2021-22) were examined by Public Accounts Committee (PAC) of Delhi assembly and presented in the House on March 23, 2026. The committee set a June 30 deadline for visible improvements.At the core of the crisis is a significant manpower shortage. The audit reported an overall staff deficit of 21% in health department, with sharper gaps among teaching specialists (30%) and paramedical staff (38%).Hospitals have struggled to recruit and retain super-specialists due to limited career growth and stagnant pay structures, directly affecting patient care. As a result, doctors in major hospitals are seeing an average of 87 patients per day, leaving less than five minutes per consultation and placing immense strain on Delhi’s healthcare workers.This pressure is reflected in hospital infrastructure and patient services. Outpatient departments remain overcrowded, with long queues often seen for registration and pharmacy services.Basic amenities such as clean toilets, seating and waiting areas are inadequate in many of the facilities. Patients also face long delays for surgeries — two to three months on average for general procedures and up to six to eight months for specialised surgeries like burns and plastic operations. Paradoxically, some operation theatres remain underutilised due to staff shortages, even as patient backlogs continue to grow.The audit also raised serious concerns about drug availability and procurement. The Central Procurement Agency (CPA), responsible for supplying medicines to govt hospitals, failed to provide them between 33% and 47% of essential drugs. This forced the hospitals to rely on local purchases, often at higher costs.Quality control lapses were flagged, with medicines prescribed before test reports, often delayed by two to three months, were received. In some cases, drugs later found to be substandard had already been administered to patients, raising significant safety concerns.Infrastructure expansion also lagged far behind targets. Despite plans to add over 10,000 hospital beds, only about 1,235 were added during the audit period. The bed-to-population ratio in Delhi govt hospitals stands at just 0.7 per 1,000 people, well below the recommended benchmark of two beds per 1,000.Several hospital projects faced delays of up to six years, while land acquired for healthcare facilities remained unused for six to fifteen years, pointing to serious gaps in planning and execution.Financial inefficiencies have compounded these challenges. The audit highlighted underutilisation of funds, with savings ranging from 9% to as high as 78% in different years. Notably, Rs 510 crore allocated under National Health Mission remained unspent, indicating weak implementation. Overall, Delhi’s public health expenditure stood at just 0.8% of its Gross State Domestic Product, far below the 2.5% target set under National Health Policy.Public health programmes have also fallen short of expectations. Only 48% of pregnant women received the full set of antenatal check-ups, while HIV screening reached just 36% of the target population. Additionally, only half of all maternal deaths were reviewed, limiting opportunities for systemic learning and improvement. The audit also pointed to gaps in the implementation of centrally sponsored schemes, citing weak monitoring and poor utilisation of resources.The report concludes that despite increased budget allocations and policy intent, execution failures continue to undermine Delhi’s public healthcare system, ultimately affecting patients.Following the audit, PAC held multiple review meetings in 2025 and early 2026, seeking responses from the health department. Govt has since assured corrective measures, including recruitment drives, digitisation of hospital systems, improved drug procurement and infrastructure expansion.“The committee expresses its serious concern over the lack of basic civic amenities and facilities in hospitals in a capital city like Delhi. While appreciating the efforts now being taken, it feels much more needs to be done. The department has assured of action and given timelines for taking corrective actions with regard to the audit report. The department should take all necessary steps to adhere to the timelines and assurances... and take remedial measures by June 30, 2026,” stated the PAC.