
Shimla: A report by the Comptroller and Auditor General (CAG) has exposed serious lapses in the healthcare system of Himachal Pradesh, highlighting issues such as doctors practicing without valid registration, unregulated private clinics, shortage of essential drugs, and poor monitoring of ultrasound clinics.
Key Findings of the CAG Report
1. Doctors Practicing with Expired Licenses
- As of September 2022, 2,779 doctors had failed to renew their medical registration with the Himachal Pradesh Medical Council.
- Despite the Himachal Pradesh Medical Council Act, 2003 mandating registration, no action was taken against these doctors.
- The State Medical Council (SMC) lacks a mechanism to track inactive or relocated doctors, allowing unregistered practitioners to operate unchecked.
- The SMC also failed to publish an annual list of registered doctors for public reference.
2. Unregulated Private Clinics & Lack of Inspections
- The CAG found 3,610 clinics were provisionally registered across Kinnaur, Solan, and Kangra between 2016-2022.
- 11 out of 23 inspected clinics were operating without renewal, and one clinic was unregistered altogether.
- The State Health Department failed to track clinics operating without registration or employing unqualified staff.
3. Unchecked Overpricing in Private Healthcare
- No government-mandated pricing exists for private medical procedures in Himachal Pradesh.
- Many private clinics set their own rates, leading to potential overcharging of patients.
- 18 out of 23 clinics inspected did not display their treatment charges, violating guidelines.
4. Shortage of Essential Drugs in Government Hospitals
- As per Indian Public Health Standards (IPHS), 493 essential drugs should be stocked in government hospitals.
- The drug shortage ranged from 20% to 58% in district hospitals across Kinnaur, Solan, and Kangra.
- Civil hospitals and community health centers also lacked essential medicines, forcing patients to purchase them, increasing out-of-pocket expenses.
5. Failure to Inspect Ultrasound Clinics
- Regulations require ultrasound clinics to be inspected every three months to prevent illegal sex determination.
- Between 2016-2022, inspections fell short by 30% to 66%, which may have contributed to a declining child sex ratio in Himachal Pradesh (from 919 in 2015-16 to 929 in 2019-21, as per NFHS data).
6. Poor Drug Regulation & Biomedical Waste Management
- Drug testing is delayed, leading to patients unknowingly consuming substandard medicines.
- Some drug manufacturers were found charging higher prices than government-notified rates.
- Blood banks and X-ray facilities were operating without valid licenses.
- Hospitals lacked approval from the State Pollution Control Board (SPCB) for handling biomedical waste, posing health hazards.
CAG’s Recommendations
The report urges the Himachal Pradesh government to implement the following:
✅ Maintain digital records of all registered medical practitioners.
✅ Develop a mechanism to track unregistered or inactive doctors.
✅ Begin permanent registration of private clinics and conduct regular inspections.
✅ Increase drug sample testing and ensure results are delivered on time.
✅ Regulate treatment costs in private healthcare to prevent overcharging.
✅ Enforce licensing requirements for blood banks, X-ray machines, and biomedical waste disposal.
Conclusion
The CAG’s findings expose major gaps in the Himachal Pradesh healthcare system, from unregistered doctors to drug shortages and unregulated private clinics. The report calls for immediate reforms to ensure patient safety, medical accountability, and regulatory compliance.