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MONEY NOT SPENT IN HEALTHY PURSUITS
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Organizational set-up: The additional director of health services (tuberculosis), West Bengal, is in overall charge of implementation of the programme in the state. The assistant chief medical officer of health public health and family welfare plans, organizes, implements and supervises the programme in the districts.

For implementation, monitoring, supervision and evaluation of the programme, the state tuberculosis control society, under the chairmanship of the secretary, health and family welfare department, and the district tuberculosis control society with the district magistrate as its chairman, are functioning at the state/district level respectively. The programme is implemented in the districts through the district tuberculosis centre, tuberculosis units, treatment centre, microscopy centre, department of tuberculosis centres and DOT workers.

Audit coverage:

The accounts and records for 1996-2001 of 5 districts, namely Bardhaman, Birbhum, Darjeeling, Howrah and Malda as well as those of the department and directorate of health and family welfare, including central medical stores, were test-checked during December 2000-June 2001. The findings of the audit are given in the succeeding paragraphs.

Finance:

(a) The National Tuberculosis Control Programme was a Centrally sponsored scheme shared by the Central and state governments on a 50:50 basis. The government of India provided its share in kind. From 1997-98 onwards, the GOI released its share in cash for purchase of drugs. During 1996-2001, Rs 36.54 crore was spent against budget provision of Rs 40.88 crore.

The reasons for excess/ savings were not stated by the department though called for.

Against Central release of Rs 4.21 crore (1997-01), state release was only Rs 2.71 crore, resulting in a shortfall of Rs 1.50 crore in the state share.

Reasons for shortfall in state release were not stated by the department though called for.

Of Rs 4.21 crore of GOI assistance received (1997-2001), Rs 3.38 crore was utilized, though only Rs 1.41 crore was booked in accounts. The entire fund of Rs 0.67 crore, received in January 2001, remained unspent due to its allotment to the drawing and disbursing officer on March 29, 2001. The department did not reconcile department expenditure with those booked in the accounts of the principal accountant general (accounts and entitlement).

In the three test-checked districts (Bardhaman, Birbhum and Darjeeling), the GOI grant of Rs 18.40 lakh, received during 1999-2001, remained unspent for want of advance planning as of June 2001 though funds (Rs 30 lakh) were received in August, 1999.

(b) The Revised National Tuberculosis Control Programme is a cent per cent Centrally sponsored scheme and the assistance, both in cash and kind, is being released to the societies directly by the GOI.

The state tuberculosis cell did not compile year-wise/ district-wise receipt and expenditure figures though copies of sanctions from the GOI and quarterly statement of expenditure from districts were received by them. Thus the government was not aware of the position of funding for the state as a whole, and control and monitoring by the ADHS (TB),West Bengal, over the districts in this regard was very inadequate.

Out of Rs 3.77 crore available during 1997-2001 in 5 test-checked districts including the state tuberculosis control society, only Rs 2.22 crore (59 per cent) could be spent.

Rs 3.01 crore of assistance given in kind by the GOI through the Medical Store Depot, Calcutta, during 1996-2000 was not adjusted in the accounts of the state government, reasons of which were not stated by the ADHS (TB).

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