A recent audit by the Comptroller and Auditor General (CAG) has revealed severe shortcomings in Maharashtra’s public healthcare system, exposing systemic neglect, chronic resource shortages and financial inefficiencies. Covering the years 2016 to 2022, the report presents a grim picture of the health sector struggling to meet demands of its population, particularly in rural areas.
The audit uncovered widespread staff shortage, with a 27 per cent deficit in doctors and a staggering 42 per cent vacancy rate in district hospitals. Nurses and paramedics are also in short supply, with gaps of 35 per cent and 31 per cent, respectively. Tertiary care hospitals are faring even worse, with 57 per cent nursing positions and 44 per cent paramedical roles vacant. The report highlights how acute personnel shortage leaves healthcare workers overburdened, and exacerbate inequities in access to care, particularly in rural regions.
The state’s infrastructure also falls short of Indian Public Health Standards (IPHS). Only 7 per cent of district hospitals meet these benchmarks for maternal and child health services. Emergency and diagnostic facilities remain grossly inadequate, with hospitals lacking essential imaging equipment. Moreover, 70 percent of health infrastructure projects planned under 2013-2014 development scheme remain incomplete. A Rs 31.91-crore hospital in Amravati, completed in 2015, has not been operational due to administrative delays, exemplifying inefficiencies of the system.
The report also highlights severe procurement inefficiencies. Between 2016 and 2022, the state’s primary supplier, Haffkine Bio-Pharmaceutical Corporation, failed to deliver 71 per cent of requested medicines and equipment. Existing medical supplies were often improperly stored or maintained, rendering them ineffective. Biomedical waste management, a critical aspect of public health, remains neglected, with many healthcare facilities failing to comply with disposal norms, thus posing significant environmental and public health risks.
Funds meant for key health programmes are also underutilised. Between 2016 and 2022, 76 percent of the budget allocated to urban health missions and 50 percent of funds for rural health programmes remained unspent. Disease eradication initiatives, such as the National Tuberculosis Elimination Programme and the National Leprosy Eradication Programme, failed to meet their targets due to inadequate funding and ineffective implementation.
Emergency preparedness is another weak area. Hospitals lack basic fire safety equipment, and no systems are in place to monitor or improve the efficiency of facilities during crises. The report criticized the failure to follow fire safety norms across healthcare institutions, leaving patients and healthcare staff vulnerable during emergencies. Even basic patient needs, such as tailored diets, are often ignored, with irregular inspections of food quality in public hospitals.
Dr Rajesh Sharma, a public health expert, described the findings as “a wake-up call for Maharashtra’s healthcare system.” He said, “The persistent gaps in staffing, infrastructure, and fund utilisation have left the system ill-equipped to handle the growing health demands of the population. Addressing these issues requires an urgent, multi-pronged approach from both policymakers and administrators.”
To address these challenges, the CAG recommended filling staff vacancies through expedited recruitment processes and increasing the health budget to meet national benchmarks. Infrastructure projects need to be completed without further delays, while regulatory bodies must enforce strict compliance with licencing requirements and biomedical waste management rules. The report also urged the adoption of Clinical Establishments Act, 2010, to ensure uniform standards for private healthcare facilities.
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