A parliamentary panel has told the Health Ministry to decide the location of new AIIMS keeping in mind the existing healthcare infrastructure in the vicinity of earmarked area, so that duplication of facilities is avoided.
The committee in its 111th report on the Functioning of New AIIMS (Phase-I) under the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) expressed concern at the duplication and concentration of tertiary care services at a particular place.
"In the places that have been selected for setting up of AIIMS-like institutions, the critical gap in the tertiary healthcare is already being filled by private sector," the department-related parliamentary standing committee on health and family welfare said.
"The committee strongly believes that AIIMS should be located in an area with low human development index that lags behind in tertiary healthcare," it said.
According to the panel, site selection for any AIIMS-like institution requires a detailed assessment of the geographical location and the demographic distribution. Easy accessibility and transportation availability is one major concern, it said.
At several places like Guwahati, Patna and now in Madurai, where a new AIIMS was recently announced, the government had already selected government medical colleges for upgradation programme under the PMSSY, it noted.
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"The committee strongly recommends that the ministry, while deciding the location of the new AIIMS, must take note of the already existing healthcare infrastructure in the vicinity of the earmarked area so that duplication of healthcare facilities is avoided," it said.
The committee suggested that the healthcare system should be such that delivery of medical facility and care is regionally distributed and even the remotest region is well within its outreach to address regional imbalances in provision of healthcare facilities.
Expressing dissatisfaction at the failure of the ministry to monitor the timely completion of the project, mainly the construction activities in all the new AIIMS-like institutions, the panel recommended that the ministry should ensure proper planning and timely execution for its completion.
According to the committee, careless selection of the project consultants did more harm than good and caused unwarranted delays in the construction activity.
The committee also feels that AIIMS-like institutes and hospitals should be excluded from the National Building Code guidelines or some amendments in the guidelines can be made so that AIIMS-like institutions are allowed to carry out vertical expansion.
"This will not only ensure the optimum utilisation of land but also resolve the delays caused due to unavailability of land," it said.
The committee in its report stated that it also came across several discrepancies in the procurement exercise and expressed concern over AIIMS-like institutions having purchased the same medical equipment at a higher cost than their counterparts in the health industry.
"Despite similar CMC/training/warranty conditions, a substantial price differential has been observed in the procurement of the same medical equipment by the private corporate hospitals and the new AIIMS," it said.
It has recommended that the ministry should carry out a detailed assessment in all such cases where price differential is more than 10 per cent in the procurement of equipment by private/corporate hospitals and AIIMS-like institutions.
The panel also expressed disappointment over the performance of Procurement Support Agency and recommended strong monitoring of its functioning along with quarterly submission of a status report on the procurement of medical devices to the committee under the PMSSY scheme.
It also underlined the need to follow a competitive tendering mechanism for procurement of any equipment rather than a single bid tender procurement.
The panel further recommended that the other AIIMS- like institutions should emulate AIIMS Bhubaneshwar that has procured 130 medical equipment with ISO.BIS certification.
This would not only minimise the cost but also promote the domestic manufacturers, boosting government's flagship Make in India campaign, it said.
Aggrieved at the shortage of faculty and non-faculty staff in all the AIIMS-like institutions, the panel asked the ministry to address this acute shortage as it has a direct impact on the quality of health service and medical education in the institutes.
It has also sought to be apprised of the number of faculty that have been employed from other premier medical institutes and asked new AIIMS-like institutions to submit a status note on the number of applicants and number candidates employed and rejected.
The panel also sought to know the reasons for the rejection of such candidates.
The panel mentioned a CAG report which highlighted that in six new AIIMS -- Bhopal, Bhubaneshwar, Jodhpur, Patna, Raipur and Rishikesh -- shortage of faculty posts ranged from 55 per cent to 83 per cent. Similarly, the shortage of non-faculty posts ranged from 77 to 97 per cent.
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