GOVERNMENT OF JAMMU & KASHMIR Chief Minister’s …jkcmmonitoring.nic.in/iproject/PVR of CHC Ramgarh.pdf · Funding Agency: NABARD (RIDF-VIII) & State Plan Year of Start: ... the

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GOVERNMENT OF JAMMU & KASHMIR

Chief Minister’s Monitoring Cell www.jkcmmonitoring.nic.in

Physical verification report of the project namely

“CONSTRUCTION OF CHC RAMGARH” District Samba

By

Deputy Director, CM’s Monitoring Cell.



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Name of Project: Construction of Community Health Centre,

Ramgarh Implementing Agency: Director, Health Services, Jammu Executing Agency: Chief Engineer, Public Works (R&B), Jammu Funding Agency : NABARD (RIDF-VIII) & State Plan Year of Start: 2003-04 Year of Completion: Incomplete till date and left over works

abandoned Financial Progress (Rs in Lacs)

Particulars NABARD State Share Total Approved Cost 288.06 20.85 308.91 Revised Cost (unapproved)

288.06 51.14 339.20

Funds Released 288.06 40.93* 44.52**

328.99* 332.58**

Expenditure Incurred

288.06 40.93 328.99

* Figures provided by R&B Department ** Figures provided by Health Department Physical Progress SNo Items approved Physical Status 1 Construction of double

storey (G+1) OPD block including sanitary fitting & electrification

Completed, building taken over by Health Deptt. and put to use

2 Construction of double storey (G+1) IPD block (30 bedded) including sanitary fitting & electrification

• Doble storey structure erected • Plastering of walls/roof, laying of floor and

wall tiles partially completed on ground floor and not taken up on 1st floor, septic tank constructed but not covered

• Electric fittings, sanitary fitting work not yet taken up

3 Construction of Medical Officer’s quarters (six numbers G+2) including sanitary fitting & electrification

Four quarters (G+1) completed instead of six (G+2) and therefore building not taken over by Health Deptt.

4 Construction of Mortuary block including electrification

Three room structure constructed, marble laid over floor but wall tiles yet to be laid, ramp not constructed and electric fitting work not



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taken up yet 5 Construction of

Garages block (Garages and Driver’s Residence) including sanitary fitting & electrification

Completed, building taken over by Health Deptt. and put to use partially

6 Construction of approach/ internal roads

Approach road constructed, most of internal roads constructed except the path leading to Medical Officer’s quarter

7 Miscellaneous items i Construction of

compound wall Completed

ii Construction of pre-cast pucca drain

Pucca drain constructed along the boundary wall but no exit available to drain off the waste water, drains not constructed along the internal roads due to which there is problem of water logging within the complex during rains

iiii Provision of Main Gate Gate installed and is in use iv Filling of Pond Completed v Development of lawns,

passages & construction of Rotary

• Rotary constructed but lawns and passages not developed.

• Lawn has been developed by BMO inside the rotary and benches fixed out of funds separately (not out of project cost) provided to him by Health Deptt.

vi External electric supply including transformer and diesel generator set

Electric transformer and DG set installed by Health Deptt. but not out of the funds available under the said project

vii External water supply including sump tank and booster pump

There is no external water supply from PHE to the Hospital complex nor has sump tank been constructed. A one horse power motor has been installed by R&B Deptt. Which draws ground water and supplies it to the PVC water tanks installed over the functional blocks and buildings within the complex

9 Machinery & Equipment X-Ray plant 100 MA X-Ray plant 60 MA Pulse Ox meter Cardiac Monitor Ultra Sound Bole’s Apparatus ECG Machine Dental Chair with Dental Unit Calorimeter 2 Ambulances Oxygen Concentrator Operating Microscope Operation Table Hydraulic Air conditioner one each for OT & Labour Room

Close Circuit for Boyle’s Apparatus

Operation Theatre Light

Almost all the approved/required equipment and machinery (ACs, Ambulances, X-Ray plants, Boyle’s apparatus, Ultrasound, Operation Table/ Light, Microscope, Dental chair with Dental unit, etc.) have been procured/ installed by Health Department out of its own resources and not out of funds available under the project.



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Backdrop of Project

Community Health Centre, Ramgarh situated in CD Block Vijaypur of District Samba is the first referral unit for a number of dispensaries functioning in the villages Koulpur, Abtal, Balotra Chak, Dug, Swankha, Nanga, Nandpur, etc. located along the international border with Pakistan. Need was felt during the last decade to upgrade the CHC by way of constructing a new OPD block, 30 bedded IPD block, residential quarters for the Medical Officers, other necessary infrastructure and machinery to provide round the clock medical treatment to the indoor patients. Accordingly, the Health Department had got a DPR prepared through the State PW(R&B) Department and submitted it to NABARD for funding the project. The project was approved by NABARD in 2003-04 under RIDF-VIII at a cost of Rs 308.91 lacs. Out of Rs 308.91 lacs, NABARD had agreed to provide Rs 288.06 lacs and the remaining amount of Rs 20.85 lacs had to be provided by the State Health Department out of State plan. Since Ramgarh was then a part of erstwhile district Jammu the Construction Division No.1 of PW(R&B)D, Jammu was assigned the task of constructing the hospital within the stipulated time period of three years as per the design approved by NABARD. The construction work was taken up by the Division in 2003-04. An amount of Rs 328.99 lacs has been released to the executing agency against the approved cost of Rs 308.91 lacs, i.e., Rs 20.08 lacs in excess as the project cost is reported to have been revised to Rs 339.20 lacs. Despite of making funds more than the approved cost available to the executing agency some of the works have not been taken and some left incomplete. Only OPD block and Garages block has been completed and handed over to Health Department. After the new district Samba was carved, a separate construction Division of R&B was established at Samba. The jurisdiction of Ramgarh area came under the new Division. The construction Division No. I Jammu did not transfer any unspent balance to Samba Division so that the left over works could be completed.

The inspecting team has to visit Ramgarh twice i.e. on 21st and 24th January 2013. During the first visit the engineers of Samba Division accompanied the inspection team but did not have either the item wise expenditure statement or the drawings of the project. They were asked to collect the requisite documents from the Jammu Division so that inspection is re-conducted on 24th January 2013. However, during the second visit also the engineers turned up with a couple of drawings and year wise expenditure. It is pertinent to mention here that Director Health Services, Jammu and Chief Engineer R&B Jammu have also been asked vide this office communication dated 09-01-2013 and 28-01-2013, respectively, annexed with this report to provide the necessary information. The reply is still awaited.



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Field Observations The important observations made during the field inspection of works executed under the project are:- (a) OPD Block: - An amount of Rs 124.33 lacs has been earmarked

for the new OPD Block of CHC Ramgarh. The OPD Block, a double-storey structure, is complete and has been put to use. The structure is in good condition as it has been properly maintained by the Health Department. Tiles with design of chips have been laid over the floor in the waiting area and most of the rooms on both the floors. Some rooms did have marble flooring. The staircase steps were covered with kota-stone. All the walls have been covered with tiles upto a height of 4-5 feet. Deodar wood has been used in the doors and windows. However, aluminium frames have been got fixed between some sections of the corridor by the BMO after taking over the building from R&B out of additional funds provided under Plan of subsequent years which is in addition to the project cost. Some of these aluminium frames had to be fixed under the approved project but were not fixed by R&B then.

(b) IPD Block: - An amount of Rs 41.58 lacs has been earmarked for

construction of 30 bedded IPD Block. The double-storey structure of the IPD has been raised. The walls of the ground floor have been partially plastered. Some floor area of ground floor has been covered with kota-stone. Some of the walls of the ground floor have been covered with tiles upto a height of 4-5 feet. The remaining civil works are pending. Electric and sanitary work of the building has not been taken up at all. A septic tank has been constructed behind the building but is uncovered making the spot dangerous for the children visiting the Hospital. Moreover, the BMO is of the view that there is need for constructing a ramp in the IPD Block. He also felt that the space in the wards is insufficient to accommodate 30 beds. However, the measurements of the ward were found as per specification although some alteration has been observed in the design of rooms attached to the wards. The reason for non-completion of the structure was enquired from the engineers. It was brought to notice that the work of IPD Block had started even before taking up the construction of the OPD Block but the person to whom the contractor had sub-let the work left the work after constructing the structure of ground floor. Then another person was assigned the remaining task who also left the job incomplete. Thereafter, the building has been abandoned.



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In this context, the Engineers were unable to reply the following queries:- (i) What were the reasons for the contractor to abandon the

work assigned to him? (ii) How much payment has been released to the contractor? (iii) Has any action been taken against the contractor? (iv) Is the contractor still executing works for R&B? Has he been

allotted any other contract thereafter and even as on date? (c) Medical Officers Quarters: - An amount of Rs 40.02 lacs has

been earmarked for construction of 6 quarters for Medical Officers. The building is envisaged to be a triple storey structure having two quarters in each floor. However, only a double storey structure comprising 4 quarters has been constructed and completed. The engineers informed that the soil testing report did not favour the construction of a triple storey load bearing structure. A RCC structure could have been an alternative but this would have escalated the cost by more than double. But there is ample space within the CHC complex and the option of constructing a horizontal double storey structure with 3 quarters each on the ground floor and the first floor could have been an alternative had R&B revised the drawing and obtained approval from the competent authorities. The Health Department has not taken over the building till date on the pretext that there are only 4 quarters and not 6. The Health Department should have taken over this building when it was completed. If at all the Health Department felt that it had been deceived by R&B on this account, it should have recommended the case to the State Vigilance Organisation for an investigation much earlier. Today the building looks a bit shabby as it has been left un-maintained over the years. The floor tiles need to be polished. Some of the taps and sanitary-ware which is reported to have been stolen need to be re-fixed. The building also requires a whitewash and some minor repairs. Another reason as to why the building was not taken over by the Health Department could be that the Medical Officers were smart enough and knew that they will have to stay within the Hospital Complex once the quarters are taken over. The R&B Department did not provide any information about the expenditure incurred on the building. There should have been some saving (may be 1/3rd of the cost) on the structure but the same has not been revealed.



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(d) Mortuary Block: - An amount of Rs 5.66 lacs has been earmarked for the construction of mortuary. A three room single-storey structure has been constructed but door & windows/ shutters have not been fixed nor have the electric works been executed. Marble has been laid over the floor and tiles on walls of two rooms. Construction work of ramp has not been completed. Here again there has to be some saving of funds as the mortuary is incomplete and also not taken over by Health Department.

(e) Garages Block: - An amount of Rs 6.77 lacs has been earmarked

for construction of three garages and 2 drivers quarters. A double storey structure has been constructed with three garages on ground floor and two drivers quarters on the first floor. This structure has been partially taken over by Health Department as two garage rooms were found locked. R&B has stored some junk in these rooms. The engineers were asked to immediately vacate the garage rooms so that the Doctors could use the structure in entirety. BMO Ramgarh informed that some junk had also been dumped by R&B in one of its old quarters which accommodated the chowkidar’s family. The engineers were also asked to remove this junk as well and dispose it off as per norms.

(f) Miscellaneous Items: - An amount of Rs 35.97 lacs have been

earmarked for miscellaneous items. A boundary wall has been constructed. A concrete drain runs along the entire length of the boundary wall but there is no exit for the drained water. A link road of 200 meters has been developed up to black top level but is not in a very good condition. Most of the internal roads have been constructed. The internal road to MO’s quarters has not been constructed. A rotary has been constructed after filling the pond within the complex. However, the lawns were got developed within the rotary and seats installed by the BMO by utilizing funds separately placed at his disposal (not out of project cost). The sump tank of 20,000 ltrs. Capacity has not been constructed nor has any booster pump been procured or installed. Engineers explained that the level of ground water is quite high in the area and therefore a sump tank has not been constructed. The executing agency should have gone for construction of a GSR (Ground Storage Reservoir) instead of a sump tank after seeking necessary approval from competent authority. However, a 1 HP motor has been installed to draw ground water and supply it to the hospital complex. People living in the neighbourhood are also reported to have been utilizing the



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water available in the hospital complex. There is no PHE water supply line to the hospital. An electric transformer was found installed within the complex and a DG set is also available. The BMO disputed that the transformer has been installed under the project. He claims that R&B did not play any role in procurement/ installation of the transformer and DG set which were approved under the project. The expenditure of both these items has been borne by the Health Department (not included in project cost).

(g) Machinery & Equipment: - An amount of Rs 36.50 lacs has been

earmarked for purchase of machinery & equipment. These funds had to be utilized by Health Department which has a central purchase committee in the head office. However, the funds meant for M&E have been diverted and released to the executing agency for unknown reasons. The R&B has reportedly expended this amount for construction purposes. Later on, Health Department by expending separate funds (not out of project cost) has procured and installed almost all the machinery & equipment approved under the project.

Financial Analysis: -

There is need to study the funding of the project by the Health Department and the expenditure incurred by R&B Department. Although an amount of Rs 328.99 lacs which is Rs 20.08 lacs more than the original approved cost of Rs 308.91 lacs has been released by Health Department over a period of 05 years (2003 to 2008) to Chief Engineer, R&B the project remains incomplete till date.

The year-wise detail of funds released and expenditure incurred was provided by R&B and the same is reproduced below: - (Rs in Lacs)

Year Releases Expenditure NABARD State

Share Total NABARD State

Share Total

2003-04 80.88 0.00 80.88 80.88 0.00 80.88 2004-05 0.00 0.00 0.00 0.00 0.00 0.00 2005-06 86.35 3.05 89.40 86.35 3.05 89.40 2006-07 0.00 3.60 3.60 0.00 3.60 3.60 2007-08 120.83 34.28 155.11 120.83 34.28 155.11

Total 288.06 40.93 328.99* 288.06 40.93 328.99 * The releases shown by Health Department is Rs 332.58 lacs and not 328.99 lacs as reported by R&B. This variation needs to be verified & rectified by both the Departments.



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Following inferences can be drawn from the above table:- (a) NABARD funds have been released in three instalments every

alternate year. (b) No funds were released in 2004-05 and only Rs 3.595 lacs in 2006-

07. (c) Almost 50% of the funds were released in 2007-08, fifth year of

execution period. (d) Funds released during each year are reported to have been

expended during the same year.

The reasons for meagre funding of the Project during the initial years and excess releases out of state’s share are inexplicable unless necessary clarification on this account is rendered by the Health Department. The officers in the Health Department informed that releases were made exceeding the approved cost because the original approved cost had been revised by R&B. But while asking about the reasons for escalation in cost, the officials of the Health Department did not have any justification. Even a copy of revised DPR was unavailable in their office records. It is hard to believe that Health Department released funds more than the approved cost without obtaining the copy of revised DPR or seeking approval from competent authorities.

It is worthwhile to mention here that not only has an amount of Rs 20.08 lacs exceeding the approved amount been released to the executing agency but the amount of Rs 36.60 lacs earmarked in the project for purchase & installation of equipment has also been diverted and released for construction purpose. Health Department should not have released the funds available under M&E to the R&B Department.

The item-wise expenditure sought from the executing agency has not been furnished. Therefore, they were asked to provide copies of orders vide which contract was allotted to contractors and payments made to them, but this information was also not revealed to the inspecting team. This information would have helped in assessing the items for which excess payments had been made.

If we take into account the quantum of funds meant for the works which have not been executed or partly executed by R&B, there should have been some unspent balance left with them. Since exact expenditure figures have purposely not been provided by R&B Department, the tentative saving has been roughly calculated on the basis of approved allocation. This figure has been worked out to around Rs 84.50 lacs in the following table:-



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(Rs in lacs) S.No. Approved Items/ Works Approved

amount Tentative

saving A Completed works 1. OPD Block 124.33 ---- 2. Garages Block 6.77 ---- 3. Construction of approach/ internal roads 7.61 ---- 4. Construction of compound wall 12.14 ---- 5. Construction of Pre-cast Pacca drain 4.21 ---- 6. Provision of main gate 0.30 ---- 7. Filling of pond 2.08 ---- 8. 4% for project planning, consultancy and

quality control 10.47 ----

B Partially complete works 1. 30 bedded IPD block (only structure

erected, finishing works incomplete) 41.58 20.00

(about ½) 2. MO Quarters (04 constructed out of 06 ) 40.02 13.00

(about 1/3) 3. Mortuary block (structure erected but not

finished) 5.66 1.00

(about 1/5) 4. Development of lawns, passages and rotary

(Only rotary constructed by R&B, Lawn within the rotary developed out of separate funds provided by Health Department)

6.24 3.00 (about ½)

C Works not executed 1. External water supply including sump tank

and booster pump (work not taken up) 5.00 5.00

2. External electric supply including transformer and DG set (separate funds provided by Health Department)

6.00 6.00

3. Machinery and Equipment (M&E purchased by Health Department out of separate funds)

36.50 36.50

Total 308.91 84.50

Thus, the value of work done is roughly around Rs 224.41 lacs (Rs 308.91 lacs – Rs 84.50 lacs). Even if we take into account the fact that funds were provided to R&B over a period of 05 years and not 03 years and there is an escalation to the extent of 10% (Rs 22.44 lacs) of the value of work done (Rs 224.41 lacs), still an unspent balance of Rs 62.06 lacs (Rs 84.50 lacs – Rs 22.44 lacs) should have been available with R&B in addition to the amount of Rs 20.08 lacs released over and above the approved cost. That is, an unspent balance of Rs 82.14 lacs (Rs 62.06 lacs + Rs 20.08 lacs) should have been available with the executing agency since March 2008. However, R&B Department has reported that the entire amount of Rs 328.99 lacs provided to it under the project has been expended.



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Problem Areas/ Suggestions 1. Siphoning off Public Funds: From the financial analysis performed

in the previous pages it can be construed that tentatively an amount of Rs 82.14 lacs has been siphoned off by the executing agency in connivance with the implementing Department. Health Department has released funds in excess of the approved cost without seeking justification or obtaining revised DPR and has also diverted funds meant for M&E to R&B Department. R&B has indicated the entire amount provided to it as expended and has not even bothered to complete the left over works. Suggestion: A copy of the PVR need to be forwarded to the State Vigilance Organisation for conducting a probe into the financial details of the project and access the actual public money that has been siphoned off and fix responsibility on the officers/ officials involved.

2. Incomplete Works: The project is incomplete even after a span of 9 years and the left over works have been abandoned by the executing agency. Probably no work has been carried out at site under the project by the executing agency during the last 4-5 years. Suggestion: It seems very unlikely that the executing agency can come out clean after the proposed investigation is completed. After the investigation is over the task of accomplishing the left over works need to be expedited so that NABARD is furnished the completion certificate in respect of this project as well as CHC, Samba which is pending since long.

3. Requirement of machinery & equipment in CHC Ramgarh: The BMO Ramgarh informed that there is need of following items in the CHC:-

(a) X-Ray Plan 300 MA: This is required because the already installed 100 MA X-Ray Plant is not much beneficial when X-Ray of spinal cord has to be taken.

(b) Light of OT: The light installed over the OT is an old one and now needs to be replaced.

(c) Electronic Caughtry. (d) Boyl’s Basic Machine with Ventilator: The existing Boyl’s apparatus is

without ventilator. (e) Horizontal Autoclave. (f) C-Arm Machine. (g) Laparoscope for general surgery.



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Suggestion: The Director, Health Services, Jammu needs to examine these demands and provide what so ever is necessary for improving the functioning of the CHC.

4. Repair of old infrastructure in CHC Ramgarh: The CHC was already functioning at Ramgarh which has been upgraded partially. The old buildings in the complex, such as BMO’s quarter, BMO’s Office, old hospital building, Chowkidar’s quarter, old mortuary require some repair and maintenance. The BMO focussed mainly on the old hospital building which comprises of IPD wards, Medical store, Labour room, etc. A major crack (1 cm wide) was observed on one of the walls. Tiles laid on walls of dark room adjoining the X-Ray room had peeled off due to dampness. The toilets attached to the male and female wards are in bad condition and have been sealed in order to protect patients from the foul smell. Since the new IPD is not ready, there is inadequate space in the old hospital building to accommodate the machinery and equipment provided under NRHM. Suggestion: The Director, Health Services, Jammu needs to prioritise the repair/ up-gradation works to be executed in CHC Ramgarh and get these executed in 2013-14, if adequate funds are not available under non-plan/ plan during the current year.

5. Disposal of Solid Waste: The solid waste of the Hospital is presently being disposed-off by burning the waste dumped in a pit dug within the complex close to the mortuary. Chemicals are also being used to dispose off some solid waste. There is need to address this issue. The BMO intimated of already having approached the State Pollution Control Board for registration of the CHC, but failed in the attempt as his request was turned down by the Board when he could not trace and produce the revenue papers of the land from where the CHC complex is functioning. Suggestion: The Deputy Commissioner, Samba needs to ask the Revenue staff to pay a visit to Ramgarh, verify the land records and prepare/provide another copy of land papers of the CHC Complex to the BMO Ramgarh so that he can get the hospital unit registered with the SPCB and also apply for a PHE water supply connection.

6. Employee of Health Department running a Medical Shop during office hours: S. Jasbir Singh, a Junior Pharmacist in the Health Department posted in district Samba was found during office hours working in a Medical Shop located outside the main gate of the CHC. A photograph of the official seated in the shop is attached with the report as evidence. It has been learnt that the official was earlier



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posted in CHC Ramgarh but has managed his transfer to Samba when he was forced to render his official duties and prevented from indulging in private business during working hours. Either patronage from local politicians or higher ups in the administration seem to have infused courage into the official to violate government norms in broad daylight. Suggestion: The Director, Health Services, Jammu needs to immediately initiate disciplinary action against the official as per norms.

7. Wastage of spending Rs 10.47 lacs meant for project planning, consultancy and quality control: - Almost 4% of the project cost has been approved for seeking consultancy, planning the execution and controlling the quality of works put to execution. These funds which are to the tune of Rs 10.47 lacs seem to have gone down the drain due to the following reasons:-

a. The layout of the various structures to be constructed within the complex is widely spread out as a result of which it becomes eminent to construct a larger network of internal roads connecting the various buildings. As a result, the scope for further expansion of the hospital has become bleak. The IPD and OPD blocks should have been constructed in proximity with interconnecting corridors.

b. There is no provision of ramp in the double storey IPD Block which is necessary as post operative patients have to be shifted to wards on ground as well as first floor of the block.

c. There is no provision for fire fighting equipment in the project. d. A triple storey design for MO’s Quarters has been proposed & got

approved without conducting a soil test.

Physical Verification Conducted by :

Madan Gopal Sharma, Deputy Director Planning, Monitoring Cell, Chief Minister’s Secretariat.

Officer of Executing Agency who accompanied the inspecting officer:

Sh. L.K.Mattoo, Xen, (R&B) Samba Division Sh. Devi Dayal, AEE, (R&B) Samba Division Sh. Sukhdev Sharma, JE (R&B) Samba Division

Date of conduct of physical inspection: 21-01-2013 & 24-01-2013



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Sign board at the take off point of approach road

Drain water flowing across approach road to the CHC



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Main Gate of the CHC

OPD Block & Rotary



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Incomplete 30 bedded IPD block

Medical Officers Quarters



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Driver Quarters and Garage

Incomplete Mortuary Block



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S.Jasbir Singh a Junior Pharmacist running a private business

during office hours opposite to the main gate of the CHC

1 Horse Power electric motor & hand pump installed for providing

water supply to the CHC

Documents

GOVERNMENT OF JAMMU & KASHMIR Chief Minister’s …jkcmmonitoring.nic.in/iproject/PVR of CHC Ramgarh.pdf · Funding Agency: NABARD (RIDF-VIII) & State Plan Year of Start: ... the