A compliance audit (Civil) report of the Comptroller and Auditor General of India (CAG) for the year ended in March 2023 released recently has flagged failure of Director of Medical Education (DME) and Dean, Government Medical College and ESI Hospital, Coimbatore, in including the hospital’s outsourcing charges of ₹12.34 crore as expenditure, while claiming reimbursement from the Employees’ State Insurance Corporation (ESIC).
The audit found that the Directorate had not included the amount in the statement of expenditure submitted for Audit Certification and it did not form part of the reimbursement claim made to the ESI Corporation for the financial years 2016-17 to 2020-21.
The report said that as per a Memorandum of Understanding (MoU) signed between ESIC and Health and Family Welfare Department, the upgraded medical college hospital was transferred to the government of Tamil Nadu under the administrative control of DME in November 2016. The expenditure incurred by the State government for running the institution is reimbursed, when a claim with ESI Corporation is preferred through the DME and the Director of Medical and Rural Health Services ESI (DMRHS-ESI).
The Dean of the institution requested the Accountant General of the State in December 2021 to certify the expenditure incurred by the hospital towards pay and allowances of the staff, office expenses, maintenance of equipment, bio-medical waste, stores, medicines and dietary charges for the financial years 2016-17 to 2020-21, said the report.
Based on the Audit Certificate issued in May 2022, the reimbursement claim of ₹170.91 crore for the period was preferred with ESI Corporation in June 2022. ESI Corporation reimbursed ₹113.91 crore as full and final payment in December 2022 for the financial years 2016-17 to 2019-20 and the same was remitted by DMRHS-ESI into the State Government’s account. The reimbursement for 2020-21 was pending settlement as in July 2023.
Scrutiny of records during the audit in February to June 2023 at the medical college hospital and Directorate of Medical Education revealed that DME has an outsourcing arrangement with Tamil Nadu Medical Services Corporation, which appoints an agency for housekeeping and security services through tender process. The directorate makes the payment to the outsourcing agency.
During 2017-21, the directorate incurred consolidated expenditure of ₹656.92 crore for outsourced services in all its medical institutions, including ₹12.34 crore in Government Medical College and ESI Hospital, Coimbatore.
The audit observed that though the institution came under the control of DME in November 2016 itself, steps for reimbursement of the hospital’s expenditure on an annual basis was taken only in December 2021.
It said that the Dean failed to include the outsourcing charges in the statement of expenditure for 2016-21 submitted to DME for Audit certification and the DME, in turn, merely forwarded the certified expenditure to DMRHS-ESI for claim from ESI Corporation without exercising due diligence. Due to this, the State government lost out on reimbursement of outsourcing charges from ESI Corporation and had to bear the consequent additional financial burden.
Besides, a belated reimbursement claim of hospital expenditure for the financial years 2016-21 from ESIC in June 2022 was not in order. The matter was referred to the Government in August 2023 and reminded in September 2023 and in February 2024. However, a reply had not been received till March 2024, the report stated.
Published – April 29, 2025 11:16 pm IST