PARLIAMENT OF INDIA RAJYA SABHA. Demands for Grants (Demand No. 5) of the (Ministry of AYUSH)

Transcription

1 REPORT NO. 95 PARLIAMENT OF INDIA RAJYA SABHA DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEE ON HEALTH AND FAMILY WELFARE NINETY-FIFTH REPORT Demands for Grants (Demand No. 5) of the (Ministry of AYUSH) (Presented to the Rajya Sabha on 29th April, 2016) (Laid on the Table of Lok Sabha on 29th April, 2016) Rajya Sabha Secretariat, New Delhi April, 2016/Vaisakha, 1938 (Saka)

2 Website : rs-chfw@sansad.nic.in

3 Hindi version of this publication is also available PARLIAMENT OF INDIA RAJYA SABHA DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEE ON HEALTH AND FAMILY WELFARE NINETY-FIFTH REPORT Demands for Grants (Demand No. 5) of the Ministry of AYUSH (Presented to the Rajya Sabha on the 29th April, 2016) (Laid on the Table of Lok Sabha on the 29th April, 2016) Rajya Sabha Secretariat, New Delhi April, 2016/Vaisakha, 1938 (Saka)

4 CONTENTS PAGES 1. COMPOSITION OF THE COMMITTEE... (i)-(ii) 2. INTRODUCTION... (iii) 3. ACRONYMS... (iv)-(v) 4. REPORT OBSERVATIONS/RECOMMENDATIONS AT A GLANCE MINUTES ANNEXURES

5 COMPOSITION OF THE COMMITTEE ( ) 1. Prof. Ram Gopal Yadav Chairman RAJYA SABHA 2. Shri Ranjib Biswal 3. Shri Rajkumar Dhoot 4. Dr. Bhushan Lal Jangde + 5. Smt. B. Jayashree 6. Dr. R. Lakshmanan 7. Shrimati Kahkashan Perween 8. Shri Ambeth Rajan 9. Shri Jairam Ramesh ^10. Dr. T.N. Seema LOK SABHA 11. Shri Thangso Baite 12. Dr. Subhash Ramrao Bhamre 13. Shrimati Ranjanaben Bhatt 14. Shri Nandkumar Singh Chauhan 15. Dr. Ratna De (Nag) # 16. Shri Devendra alias Bhole Singh 17. Dr. (Smt.) Heena Vijay Gavit 18. Dr. Sanjay Jaiswal 19. Dr. K. Kamaraj 20. Shri Arjunlal Meena 21. Shri J. Jayasingh Thiyagaraj Natterjee 22. Shri Chirag Paswan 23. Shri C. R. Patil 24. Shri M.K. Raghavan 25. Dr. Manoj Rajoria 26. Dr. Shrikant Eknath Shinde 27. Shri R.K. Singh 28. Shri Kanwar Singh Tanwar + ceased to be member of the Committee w.e.f. 21st March,2016. ^ ceased to be member of the Committee w.e.f. 2nd April, # ceased to be member of the Committee w.e.f. 18th April,2016. (i)

6 (ii) 29. Shrimati Rita Tarai 30. Shri Manohar Untwal 31. Shri Akshay Yadav SECRETARIAT Shri P.P.K. Ramacharyulu, Additional Secretary Shri Anil Kumar Gandhi, Director Shri Dinesh Singh, Joint Director Shri Rajesh Kumar Sharma, Assistant Director Shri Pratap Shenoy, Committee Officer

7 INTRODUCTION I, the Chairman of the Department-related Parliamentary Standing Committee on Health and Family Welfare, having been authorized by the Committee to present the Report on its behalf, hereby present this 95th Report of the Committee on the Demand for Grants (Demand No 05) of the Ministry of AYUSH, for the year The Committee held one sitting, on 21st March, 2016 for examination of Demands for Grants of the Ministry of AYUSH and heard the Secretary (AYUSH) and other Officers thereon. 3. The Committee considered the Draft Report and adopted the same in its meeting held on 28th April, The Committee while making its observations/recommendations has mainly relied upon the following documents: (i) Address by the President of India to both Houses of Parliament assembled together on 23 rd February, 2016; (ii) Speech of Finance Minister on 28 th February, 2016 while presenting the Union Budget ; (iii) Implementation of Budget Announcements ; (iv) Detailed Demands for Grants of the Ministry of AYUSH for the year ; (v) Annual Report of the Ministry for the year ; (vi) Outcome Budget of the Ministry for the year ; (vii) Detailed Explanatory Note on Demands for Grants of the Ministry of AYUSH for the year ; (viii) Physical and financial targets fixed and achievements made so far during the Twelfth Plan period; (ix) Projection of outlays for the schemes to be undertaken by the Ministry during the remaining years of the Twelfth Five Year Plan; (x) Details of under-utilization of the allocations made under different heads during the last three years; (xi) Written replies furnished by the Ministry to the Questionnaires sent to them by the Secretariat; (xii) Presentation made by the Secretary (AYUSH) and other concerned officers; and (xiii) Written clarifications furnished by the Ministry, on the points/issues raised by the Members during the deliberations of the Committee. 5. For facility of reference and convenience, observations and recommendations of the Committee have been printed in bold letters in the body of the Report. PROF. RAM GOPAL YADAV NEW DELHI; Chairman, April 28, 2016 Department-related Parliamentary Standing Vaishakha 8, 1938 (Saka) Committee on Health and Family Welfare Rajya Sabha. (iii)

8 ACRONYMS AYUSH : Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy AIIA : All India Institute of Ayurveda AIIY : All India Institute of Yoga AIIH : All India Institute of Homoeopathy AIUM : All India Institute of Unani Medicine ASUDTAB : Ayurveda, Siddha, Unani Drug Technical Advisory Board AES : Acute Encephalitis Syndrome CCIM : Central Council of Indian Medicine CCH : Central Council of Homoeopathy CCRAS : Central Council for Research in Ayurvedic Sciences CCRUM : Central Council for Research in Unani Medicine CCRH : Central Council for Research in Homoeopathy CCRYN : Central Council for Research in Yoga and Naturopathy CCRS : Central Council for Research in Siddha CDSCO : Central Drug Standard Control Organization D.Y.Sc. : Diploma in Yogic Science DCC : Drug Control Cell EFC : Expenditure Finance Committee EHIP : Effects of Homoeopathic Intervention in Pre-Diabetes FEDMAP : Federation of Medicinal and Aromatic Plants Stakeholders FRLHT : Foundation for Revitalisation of Local Health Traditions FSMHP : Foundation for Spastic and Mentally Handicapped Persons HPL : Homoeopathic Pharmacopoeial Laboratory IPGTRA : Institute of Post Graduate Teaching and Research in Ayurveda IMPCL : Indian Medicines Pharmaceutical Corporation Ltd. ISM&H : Indian Systems of Medicines and Homoeopathy ICFRE : Indian Council for Forest Research and Education (iv)

9 (v) ICPO : Institute of Cytology and Preventive Oncology IEC : Information, Education and Communication MDNIY : Morarji Desai National Institute of Yoga MSP : Minimum Support Price MPs : Medicinal Plants NIA : National Institute of Ayurveda NIS : National Institute of Siddha NIH : National Institute of Homoeopathy NIUM : National Institute of Unani Medicine NIN : National Institute of Naturopathy NEIAH : North Eastern Institute of Ayurveda and Homoeopathy NEIFM : North Eastern Institute of Folk Medicine NMPB : National Medicinal Plant Board NEGERD : Non-Erosive Gastroesophageal Reflux Disease NIRT : National Institute for Research in Tuberculosis PCIM : Pharmacopoeia Commission for Indian Medicine PLIM : Pharmacopoeial Laboratory for Indian Medicine RAV : Rashtriya Ayurveda Vidyapeeth RRIUM : Regional Research Institute of Unani Medicine RCTs : Randomized Controlled Trials SVDYWC : Swami Vivekananda District Yoga Wellness Centre SMPBs : State Medicinal Plants Boards TKDL : Traditional Knowledge of Digital Library UCs : Utilization Certificates

10 1 REPORT Brief Background 1. The Ministry of AYUSH came into existence w.e.f Previously, it was known as a department established in 1995 under the Ministry of Health and Family Welfare and was designated as the Department of Indian Systems of Medicine and Homoeopathy (ISM&H). It was further re-designated as the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) in November, Formation of the Ministry of AYUSH is an offshoot of the policy of the Government s thrust on recognition and significance of the Traditional Systems of Indian Medicine. 1.2 The Ministry is responsible for policy formulation, development and implementation of programmes for the growth, development and propagation of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) systems of Health Care. Sowa Rigpa is the recent addition to the existing family of AYUSH systems. Composition 1.3. The Ministry has a broad Institutional framework to carry out its activities in the field of AYUSH consisting of: Regulatory Bodies: - Central Council of Indian Medicine (CCIM) Central Council of Homoeopathy (CCH) 1.5 Research Councils Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi; Central Council for Research in Unani Medicine (CCRUM), New Delhi; Central Council for Research in Homoeopathy (CCRH), New Delhi; Central Council for Research in Yoga and Naturopathy (CCRYN), New Delhi; and Central Council for Research in Siddha (CCRS), Chennai. 1.6 Educational Institutions National Institute of Ayurveda (NIA), Jaipur; National Institute of Homoeopathy (NIH), Kolkata; National Institute of Naturopathy (NIN), Pune; National Institute of Unani Medicine (NIUM), Bangalore; Institute of Post Graduate Teaching and Research in Ayurveda (IPGTRA), Jamnagar (aided by the Department); 1

11 2 Morarji Desai National Institute of Yoga (MDNIY), New Delhi; National Institute of Siddha (NIS), Chennai; Rashtriya Ayurveda Vidyapeeth (RAV), New Delhi; All India Institute of Ayurveda, New Delhi (being developed) North Estern Institute of Ayurveda and Homoeopathy, Shillong (being developed); and North Eastern Institute of Folk Medicine, Passighat, East Siang District, Arunachal Pradesh (being developed). 1.7 Laboratories & Pharmacopoeia Commission Pharmacopoeial Laboratory for Indian Medicine (PLIM), Ghaziabad; Homoeopathic Pharmacopoeial Laboratory (HPL), Ghaziabad; and Pharmacopoeia Commission for Indian Medicine (PCIM), Ghaziabad. 1.8 Public Sector Undertakings Indian Medicines Pharmaceutical Corporation Ltd. (IMPCL). 1.9 National Medicinal Plant Board (NMPB) Drug Control Cell (AYUSH) The National Policy on Indian Systems of Medicine and Homoeopathy (ISM&H) adopted in 2002, paved way for integration of ISM with health delivery systems in an improved and phased manner, which was taken forward both by the AYUSH Department and as part of the mainstreaming component of AYUSH under the National Rural Health Mission (NRHM) resulting into a considerable expansion of AYUSH services. NATIONAL AYUSH MISSION 1.12 The Union Government of India has approved and notified National AYUSH Mission (NAM) on after merging the following Centrally Sponsored Schemes: - (i) (ii) Centrally Sponsored Scheme Development of AYUSH Hospitals and Dispensaries; Centrally Sponsored Scheme Development of AYUSH Institutions; (iii) Centrally Sponsored Scheme Development of Quality Control of ASU&H Drugs; and (iv) National Mission on Medicinal Plants Prior to the launching of NAM, these four Centrally Sponsored Schemes were implemented individually, which, however, were grouped/merged together under NAM subsequent to Cabinet approval in September, At the Central level, the Mission is steered by a National AYUSH Mission Directorate, chaired by Secretary (AYUSH) with members from other Departments and assisted by an Appraisal Committee supported by Central Programme Management Unit (PMU). At the States/UT level, there is a provision for a separate State/UT AYUSH society whose Governing Body is chaired by the Chief Secretary and Executive Body chaired by the Principal Secretary/Secretary in charge of AYUSH to oversee the implementation of the Scheme.

12 3 Objectives of National AYUSH Mission (NAM) 1.14 National AYUSH Mission inter-alia envisages: - Better access to AYUSH services through increase in number of AYUSH Hospitals and Dispensaries Ensure availability of AYUSH drugs and trained manpower Improvement in quality of AYUSH education through enhancement in the number of upgraded AYUSH educational Institutions Improvement in availability of quality ASU&H drugs through increase in number of Pharmacies Setting up of Drug Laboratories in the States which are responsible for enforcement mechanism of ASU&H drugs Sustain availability of quality raw materials by promoting Medicinal plants Consequent upon rationalisation of the Central Sector Schemes and Centrally Sponsored Schemes, the total ongoing main umbrella schemes were reduced from 12 to 6 only (five Central Sector and one Centrally Sponsored) and total schemes and sub-schemes to 46 as mentioned hereunder: - Central Sector Schemes A. Strengthening of Ministry of AYUSH (i) Secretariat Ministry of AYUSH B. Support to AYUSH Institutions (i) (ii) (iii) (iv) (v) (vi) All India Institute of Ayurveda (AIIA), New Delhi All India Institute of Yoga (AIIY) All India Institute of Homoeopathy (AIIH) All India Institute of Unani Medicine (AIUM) Grant for Institute of Post Graduate Teaching and Research in Ayurveda (IPGTRA), Jamnagar Grant to National Institute of Ayurveda (NIA), Jaipur (vii) Grant to Rashtriya Ayurveda Vidyapeeth (RAV) (viii) Grant to National Institute of Siddha (NIS), Tamil Nadu (ix) (x) (xi) Grant to National Institute of Homoeopathy (NIH), Kolkata Grant to National Institute of Unani Medicine (NIUM), Bangalore Morarji Desai National Institute of Yoga (MDNIY), New Delhi (xii) Grant to National Institute of Naturopathy (NIN), Pune (xiii) North Eastern Institute of Ayurveda and Homoeopathy (NEIAH), Shillong (xiv) North Eastern Institute of Folk Medicine (NEIFM), Passighat, East Siang District, Arunachal Pradesh

13 4 (xv) National Institute of Medicinal Plants (xvi) National Institute of Sowa Rigpa (xvii) Indian Institute of AYUSH Pharmaceutical Sciences (xviii) Public Sector Undertaking Indian Medicines Pharmaceutical Corporation Limited (IMPCL), U.P. C. Support to Statutory Institutions (i) (ii) (iii) Grant to Central Council of Indian Medicine (CCIM), New Delhi Grant to Central Council of Homoeopathy (CCH), New Delhi National Medicinal Plant Board (NMPB) D. Research & Development (i) (ii) (iii) (iv) (v) (vi) (vii) Grant to Central Council for Research in Ayurvedic Sciences Grant to Central Council for Research in Unani Medicine Grant to Central Council for Research in Yoga & Naturopathy Grant to Central Council for Research in Homoeopathy Grant to Central Council for Research in Siddha Central Council for Research in Sowa-Rigpa Extra Mural Research Projects through Research Institutes etc. E. Strengthening of AYUSH Delivery System (i) (ii) (iii) (iv) (v) (vi) (vii) Pharmacopoeia Committees of ASU and strengthening of Pharmacopoeia Commission of Indian Medicine (PCIM) AYUSH expansions in CGHS Yoga training for Police Personnel Pharmacopoeial Laboratory of Indian Medicine, Ghaziabad Homoeopathic Pharmacopoeia Laboratory, Ghaziabad Information, Education and Communication AYUSH and Public Health (viii) Assistance to accredited AYUSH Centres of Excellence in non-governmental/private sector engaged in AYUSH education/drug development & research /clinical research/folk medicine etc. (ix) Traditional Knowledge of Digital Library (TKDL) and Indian Systems of Medicines and Homoeopathy (ISM&H) Intellectual Property Rights

14 5 (x) Re-orientation Training Programme of AYUSH Personnel / Continuing Medical Education (ROTP / CME) (xi) Development of AYUSH IT Tools, Applications and Network (xii) Promotion of International Cooperation (xiii) Development of common facilities for AYUSH industry clusters (xiv) Incentive to Industry Participation in fairs/conducting market survey (xv) Pharmacovigilance initiative for ASU drugs (xvi) Central Drug Controller for AYUSH Centrally Sponsored Schemes F. National Health Mission: AYUSH (i) National AYUSH Mission (NAM) 2. Budgetary Allocation 2.1 As per the information furnished to the Committee, during the Eleventh Five Year Plan, the Ministry of AYUSH (erstwhile Department of AYUSH) was initially allocated crore for the plan schemes. Against this actual year-wise plan allocation (B.E.) received during Eleventh Five Year Plan was crore. The total expenditure during Eleventh Five Year Plan was crore. The plan allocation and expenditure during the last four years of the Twelfth Plan is as under :- Table No. 1 (` in Crore) Year Allocation Utilisation of Funds BE RE * * Expenditure upto Apprising the Committee of the total RE allocations made in the first four years of the 12th Plan vis-à-vis, the total Twelfth Plan approved outlays and the actual expenditure incurred, the Ministry has stated that against the total approved outlay of crore, the total allocation made in RE from to is crore and the actual expenditure is crore (expenditure figures as on 29 th February, 2016). Scheme/ programme-wise expenditure during to is given in Annexure-I. 2.3 The Twelfth Plan total approved outlays, total BE, RE and AE during the last four years and plan allocation for the financial year as informed by the Ministry of AYUSH is as under: -

15 6 Table No th Plan Outlay BE RE Actual Expenditure Plan Allocation For the Financial To To To Year (upto ) (` in Crore) 2.4 For the year , the Ministry of AYUSH has been allocated an amount of crore under the Plan Head. The Ministry has informed that the allocation of crore has been made against the projected demand of crore. 2.5 Apprising the Committee of the expenditure vis-a-vis allocations made on the Plan side under various major schemes/programmes for the Ministry has furnished the following information:- Table No. 3 Plan Allocation and Expenditure for under major schemes/programmes (` in Crore) Sl. Schemes/Programmes BE RE AE Excess(+) / No. (As on Savings (-) ) 1. Central Sector Schemes System Strengthening (a) Strengthening of Department of AYUSH (b) Statutory Institutions (c) Hospitals and Dispensaries (d) Strengthening of Pharmacopeial Laboratories (e) Information, Education and Communication (f) AYUSH and Public Health Educational Institutions Research and Development including Medicinal Plants (1) Research Councils (2) National Medicinal Plants Board HRD (Training Programme/Fellowship/Exposure Visit Development of AYUSH Industry Pharmacovigilance initiative for ASU drugs

16 7 7. National AYUSH Library and Archives Central Drug Controller for AYUSH B. Centrally Sponsored Scheme (i) National Mission on AYUSH including Medicinal Plants TOTAL Apprising the Committee of the financial performance of the Ministry during , the Secretary, Ministry of AYUSH during his evidence before the Committee on 21 st March, 2016 submitted that was the first full year of the National AYUSH Mission and the Ministry has achieved almost hundred percent utilization of the budgetary funds. He also submitted that it was slightly unfortunate that despite the fact that the Ministry had achieved more than its target of utilization of funds by September (2015) end, the Ministry had to suffer a Budget cut of hundred crores in the total BE allocation. 2.7 In reply to a query, the Secretary (AYUSH) informed that the Ministry has been allocated crore on the plan side for as against the projected demand of crore. 2.8 On being asked about the effect of the reduced allocation for on the activities of the Ministry, the Secretary informed the Committee that the goals of the National AYUSH Mission would be adversely affected. 2.9 In reply to another query regarding the share of central expenditure on AYUSH in the total expenditure on AYUSH in the country, he submitted that most of the States are largely implementing the Central-sector schemes. Since the Centre-States funding pattern is 60:40, it means that if we are spending 60 per cent, the States are spending the balance 40 per cent. But there are many States which, on their own, have a very large AYUSH budget, especially in South India The Committee has also been furnished the following information regarding the quantum of expenditure in percentage terms in each quarter of the fiscal year :---- Table No. 4 BE RE Percentage Expenditure w.r.t. BE (upto ) Ist Qtr. IInd Qtr. IIIrd Qtr. IVth Qtr. Plan Non-Plan From the information provided by the Ministry, the Committee finds that there were certain budgetary heads under which the entire budgeted plan funds had to be surrendered in These budgetary heads are as under:----

17 8 Table No. 5 Sl. Name of the Scheme BE Reason for surrender No. 1 All India Institute of Yoga 0.10 Non-approval of the scheme 2 All India Institute of Unani Medicine Non-approval of the scheme 3 Homoeopathic Medicines Pharmaceutical 0.10 Non-approval of the scheme Co. Ltd. (` in crore) 4 Acquisition of Office Building Payment to NBCC discontinued on the direction of the Ministry of Finance 5 National Institute of Medicinal Plants 0.50 Non-approval of the scheme 6 Indian Institute of AYUSH Pharmaceutical 0.10 Non-approval of the scheme Sciences 7 TKDL and ISM&H Intellectual Property 0.10 Non-receipt of any proposals from Rights TKDL 8 Survey on usage and acceptability of AYUSH 0.20 No proposal received to conduct survey/evaluation 9 Central Council for Research in Sowa Rigpa 0.50 Non-approval of the scheme 10 Scheme for Acquisition, Cataloguing, 0.50 Scheme discontinued Digitisation and Publication of Text Books and Manuscripts 11 Development of AYUSH IT Tools, 0.30 As per actual requirement Applications and Networks 12 Pharmacovigilance initiative for ASU drugs 1.00 Non-approval of the scheme 13 National AYUSH Library and Archives 0.10 Non-approval of the scheme 14 Central Drug Controller for AYUSH 1.00 Non-approval of the scheme 2.12 In reply to a question regarding the expenditure incurred during under the Central Sector and Centrally Sponsored Schemes, the Ministry has furnished the following information:---- Table No-6 (` in crore) Scheme BE Expenditure % utilisation RE Expenditure (as on as on ) Centrally Sector Scheme Centrally Sponsored Scheme TOTAL

18 The Ministry has also furnished information regarding expenditure figures vis-à-vis the BE and RE allocations scheme/programme-wise for and which is at Annexure-II The following information has been supplied to the Committee regarding percentage of surrendered funds on account of normal savings, economy measures and non-approval of schemes/programmes during and : Table No. 7 (` in crore) Total Amount Normal savings On account of On account of Non-approval of surrendered economy measures Schemes/ inadequate proposals % 0.00% 99.70% % 0.00% 98.83% 2.15 The Ministry has cited the following reasons for under-utilization of the budgeted funds for various schemes: - (i) (ii) (iii) (iv) (v) (vi) Non-filling of vacant posts; Non-approval of the Schemes; Increase / reduction in allocation at RE stage; Unspent balance; Pending Utilisation Certificates; Delay in execution of work; (vii) Non-receipt of adequate and viable proposals; and (viii) Tardy/delayed pace of construction and procurement, etc The Ministry has also informed the Committee that it has taken the following steps for ensuring optimum utilization of funds during :---- (i) (ii) Regular periodic expenditure review meetings were held at Secretary and Joint Secretary level to scrutinize the status of utilization of budgetary allocations under various heads and also to draw periodic roadmap for course correction and improved uptake of funds. Projections of expenditure on month / quarter-wise was made and vigorously implemented. As a result of constant dynamic assessment of monitoring, the utilization of funds that was put in place, possible slack in certain Schemes were identified in a timely manner so that available funds could be utilized in other areas where it was required. Consequently savings to the tune of ` crore were identified by regular monitoring under various heads and reappropriated where demand existed through seeking approval under supplementary grants.

19 10 The details of the approval sought by identifying available savings through the three batches of supplementary grants as given below : 1 st Batch. ` crore (Plan) 2 nd Batch ` crore (Plan) 3 rd Batch ` crore (Plan + Non-Plan) (iii) (iv) (v) (vi) Special emphasis was laid in ensuring timely flow of funds during the first two quarters of the Financial Year Special focus was given to expenditure in priority areas viz. SCSP, TSP and North Eastern region, to avoid any slack. Consequent to the adoption of these measures, pace of expenditure and utilization was significantly high in than previous years. In fact, the Ministry has made a turnaround in utilization of funds. For Centrally Sponsored Scheme of National AYUSH Mission:- (a) (b) (c) (d) All State / UT Governments were requested to furnish the State Annual Action Plan for requirement of funds as per resource pool under NAM. The State Chief Secretaries were also requested to give their personal attention to draw the entire amount released under the Mission from the state treasury and utilize the Grantin-aid. The Ministry has reviewed the progress of implementation for the past release from the State/UTs during the Mission Directorate meetings. All State / UT Governments were requested to furnish the utilization certificates for erstwhile Centrally Sponsored Scheme For all new integrated AYUSH Hospitals approved by the Ministry, the States were asked by the Ministry to sanction the required permanent posts within one year The Committee observes from Table No. 2 that as against the total Twelfth Plan approved outlays of ` crore, the total allocation made in RE from to is ` crore and the expenditure incurred as on 29th February, 2016 is ` crore only. The Committee notes from Table 1 that the actual expenditure has invariably been considerably lower than the Revised Estimates in and and slightly lower in Despite the fact that a Zero Based Budgeting exercise which requires that budget request be evaluated thoroughly, starting from the zero base, was undertaken at the beginning of the Eleventh Plan, a substantial amount of ` crore of the budgeted funds could not be utilised during the first four years of the Twelfth Plan period, which is a matter of serious concern. The Committee is constrained to observe that such a substantial gap between the RE allocations and the actual expenditure is indicative of fiscal indiscipline and unrealistic projection of estimates. Had the Ministry assessed requirement of funds realistically and monitored their deployment diligently such a shortfall in utilization of the budgeted funds could have been avoided and the unspent amount utilized more gainfully somewhere else. The Committee, therefore, recommends that a comprehensive analysis of the trend of expenditure

20 11 incurred under various heads of the Ministry during the last four years be carried out with a view to rectifying and improving upon the existing system of assessing fund requirement. The Committee would also expect the Ministry to make its estimates only after proper assessment and planning in future The Committee notes that the Ministry has been allocated ` crore in BE on the plan side against the projected demand of ` crore and thus there is a shortfall of ` crore. The Committee takes note of the submission of the Secretary (AYUSH) that we will be able to achieve almost hundred percent utilization of the funds budgeted for and that the goals of the National AYUSH Mission will be affected due to the shortfall in allocation for The Committee observes that health needs of a vast and diverse country like India cannot be met by a single healthcare system and AYUSH healthcare systems, which besides being curative, are also preventive and promotive healthcare systems, have a vital role to play in expanding the outreach of healthcare to the people because of their inherent advantages in terms of diversity, modest cost, low level of technological input, etc. The shortfall in allocation for will have adverse impact on the key priorities of the National AYUSH Mission which aims at mainstreaming of AYUSH, improving quality of ASU&H drugs, setting up of drug laboratories, improvement in AYUSH education etc. The Committee observes that the BE allocation of ` crore is lower than the BE and allocation of ` crore each and is only marginally higher than the allocation of ` crore in BE The Committee observes that in a resource-constrained country like India, it is extremely difficult to meet the demands for funds, however genuine, of the Ministry in full and therefore in order to obtain the best possible health outcomes, it is imperative that allocation of resources is prioritized across competing ends. The Committee would, therefore, like the Ministry to work out the bare minimum additional increase that the Ministry needs in its budget for for carrying out activities/ programmes which are absolutely essential and cannot be postponed till next year and approach the Ministry of Finance for allocating that amount through supplementary grants. The Committee desires to be kept apprised of the response of Ministry of Finance in this regard The Committee notes that as compared to the BE allocation of ` crore for the Department of Health and Family Welfare, the Central expenditure on AYUSH for is ` crore only. State Governments are spending much more on AYUSH than the Union Government. To make an in-depth analysis of total Government expenditure on AYUSH, the Committee would like the Ministry to collect and furnish information to the Committee on the total Government expenditure on AYUSH (i.e. combined spending on AYUSH by the Centre and all States) as also the Centre-States ratio in total Government expenditure on AYUSH. The Committee would also like to know whether any policy pronouncement of raising AYUSH share in total Government expenditure on health had been articulated in the Twelfth Five Year Plan The Committee s scrutiny of Table No. 5 reveals that for 14 heads of account, budgetary provisions had been obtained in BE but not a single rupee was spent. Of the 14 schemes, the budgeted funds of as many as nine schemes could not be utilised due to non-approval of the schemes. For example, ` crore had been allocated at the stage of BE for All India Institute of Unani Medicine but nothing was spent and the entire allocated amount of ` crore was surrendered. The Committee is of the considered view that this trend is indicative of serious shortcomings in formulating the Budget Estimates and ineffective monitoring of utilization of the

21 12 budgeted funds for implementing schemes. The Committee, therefore, recommends to the Ministry to take appropriate corrective measures to arrest this trend of inappropriate projection of fund requirements in formulating budget estimates for schemes, which are left unutilised owing to lack of approvals, non-receipt of proposals etc. The Committee would advise the Ministry to propose budget allocations for schemes only after obtaining all necessary clearances so that the scarce resources do not remain locked up and surrendered later The Committee observes from Table No.4 that the Ministry incurred expenditure of ` crore of the non-plan funds in the second quarter of the Financial Year and has thus breached the ceiling of 33% as stipulated by the Ministry of Finance. The Committee would expect the Ministry to show greater financial discipline and responsibility by evenly laying out expenditure in future. Pending Utilisation Certificates 2.23 The Committee has been monitoring the pendency of Utilization Certificates (UCs) under various schemes of the Ministry for the last few years. On being asked about the total number of UCs, the amount involved therein and the time since when the UCs have been pending, the Ministry has informed that there are 1529 number of Pending UCs and total amount involved is ` crores in Central Sector Schemes from to For Centrally Sponsored Schemes, the number of Pending UCs is 309 and total amount is ` crores The Committee is concerned to note that the number of the pending UCs and the amount involved therein is still very high despite the efforts made by the Ministry. It is also a matter of great concern that the pending UCs date as far back as which points to the fact that the steps taken by the Ministry so far have not yielded the desired results. The Committee observes that the time lag in submission of UCs delays release of funds to the implementing agencies and thus adversely affects quality of spending. It is, therefore, imperative on the part of the Ministry to have a relook at the system of monitoring of the progress of utilization of the funds at the level of implementing agencies and come out with a multi-pronged strategy for liquidation of pending UCs so as to ensure that execution of projects is not delayed due to pending UCs. 3. Updation of Central Registers of Indian Medicine and Homoeopathy 3.1 The updation of Central Registers of Indian Medicine and Homoeopathy has been engaging the attention of the Committee for quite some time. On being asked about the issue of the status of updation of Central Registers of Indian Medicines and Homoeopathy, reduction of time lag between the receipt of information from the State Governments and its updation in the Central Registers of Indian Medicine and Homoeopathy, and the forward movement, if any, made towards digitization of Central Registers of Indian Medicine and Homoeopathy, the Ministry in its written reply has informed the Committee that CCIM has already started the digitization of Central Register since 10 th July, 2015 due to which the time period to obtain Central Registration Certificate was reduced to days (subject to the availability of the name of the practitioner in the Central Register). 3.2 The Ministry has further informed that the updated status of Central register of Indian Medicine as on was that Central Registration of 13 States (Bihar, Chhattisgarh, Goa, Gujarat, Haryana, Himachal Pradesh, Jharkhand, Madhya Pradesh, Orissa, Punjab, Rajasthan, Uttar Pradesh and Uttarakhand) had been completed upto The updation of Register for the remaining States was under active process which would further take 3-4 months.

22 The Ministry has also mentioned that in compliance to advice given by the Committee, CCH had awarded the contract to a company to undertake the work of digitization of Central Register of Homoeopathy which would complete the work within next few months. The updation of Central Register of Homoeopathy for Bihar had been completed upto October, 2015 and also for the States of Andhra Pradesh, Arunachal Pradesh, Chhattisgarh, Delhi, Goa, Haryana, Himachal Pradesh, Punjab & Uttarakhand had been completed and was under publication. 3.4 The Central Register in respect of names of practitioners borne on State Registers of Karnataka and Andhra Pradesh would be completed by the end of March, The time period for updation of the Central Register was 3 to 9 month in CCH. The time period was expected to be reduced substantially after digitization. 3.5 The Committee has been impressing upon the Ministry the need for timely updation of Central Registers of Indian Medicine and Homoeopathy. The Committee notes that the Ministry has undertaken the work of digitization of the Central Registers. The Committee observes that the updation of both Central Registers of the Indian Medicine and Homoeopathy is of vital importance for HR planning and forecasting. The Committee, therefore, recommends to expedite the work relating to updation and digitization of both the Central Registers. The Committee also desires to be apprised of the progress made in this regard. 4. National Institutes National Institute of Ayurveda (NIA), Jaipur 4.1. In reply to a query regarding the physical and financial performance of NIA during , the Ministry has furnished the following information:- (i) (ii) (iii) 90 Admissions were made in BAMS Under Graduate Course. 83 Admissions were made in M.D./M.S.(Ayurveda) Post-Graduate course. 30 Admissions were made in AYUSH Nursing & Pharmacy Diploma Course. (iv) 47 Mobile Camps have been organized under SCP &TSP in which 52,262 patients were provided with free consultation, check-up and medicines. (v) (vi) (vii) patients were treated in OPD patients treated in IPD. The financial performance is as given below: Table No. 8 (` in crore) BE RE Expenditure (upto ) Plan Regarding the projected requirement of funds, under plan for NIA for and the actual allocation made for and the financial performance for , the Ministry in a written reply has informed that for the year , the allocation made for NIA, Jaipur under BE was ` crore, which was

23 14 reduced to ` crore at RE stage because of reduced allocation of the Ministry at RE stage. The RE allocation had been fully utilized. However, further augmentation of ` 1.78 crore had been made at Final Estimate stage as per requirement. 4.3 In reply to a question regarding the updated status of the sanctioned strength and vacancy position in NIA, the Ministry has furnished the following information:- Table No. 9 Status of Vacancies (As on ) Name of Sanctioned Filled Filled on Action taken to fill up Post Strength Regular Contractual Vacant Basis Director 1 1 The post of Director, NIA is lying vacant since To fill up the post of Director, NIA advertised in the Employment News on 8-14 February, 2014 and readvertised in the Employment News February, 2015, total 31 applications have been received against both the advertisements. The scrutiny committee has been constituted on , for scrutiny of applications. The post of Director, NIA is likely to be filled within next 3-4 months. Professor During the year 2013, 5 Posts of Professors Associate and 5 Posts of Associate Professors were Prof. filled by Retired Teachers on contractual Assistant basis. During the year 2014, 4 Posts of Prof & Professors and 3 Posts of Associate Lecturer Professors were filled by Retired Teachers on contractual basis. During the year 2015, 4 Posts of Professors and 2 Posts of Associate Professors were filled by Retired Teachers on contractual basis. During the current year 2016, 6 posts of Professors and 4 Posts of Associate Professors stand filled by Retired Teachers on contractual basis against the vacancies. TOTAL The Committee has been reviewing the vacancy position at NIA, Jaipur and urging the Ministry to fill them up within a short span of time. The Committee is, therefore, deeply concerned to note that out of 95 Group A posts, as many as 23 are vacant. The Committee observes that such a large number of vacancies in Group A posts will certainly lead to compromise in its mandated activities and affect the quality of teaching and research at NIA. The Committee would, therefore,

24 15 reiterate its recommendation made in its 84th Report that the Ministry may explore the possibility of appropriately revising the methods and conditions of recruitment of senior faculty without compromising the requisite standards. 5. National Institute of Homoeopathy (NIH), Kolkata 5.1 National Institute of Homoeopathy (NIH) was established on 10th December, 1975 in Kolkata as an autonomous institution under the Ministry of AYUSH and imparts education in Homoeopathy serving as a model institution for other schools across the country. The brief information pertaining to achievements of NIH during as furnished by the Ministry as under:---- Academic Activities 5.2 On the issue of finalization of amendment to the Recruitment Rules concerning senior faculty, the Ministry in a written reply has submitted that the draft Recruitment Rules had been received from NIH and comments of Teachers Welfare Association on the draft Recruitment Rules (RRs) had also been received on , which are being processed for seeking approval of competent authority. 5.3 Regarding the vacant posts in National Institute of Homoeopathy, the Committee was informed that these will be filled up in the next 3-4 months. However, the vacant posts had been filled up on contractual/ outsourcing basis. 5.4 Taking into account that a number of vacancies in teaching cadre had been persisting since long, the Committee in its 84th Report on Demand for Grants ( ) of the Ministry had recommended to amend the Rules relating to recruitment, service conditions and quantum of emoluments of Group A posts at NIH so that it would attract talent towards this profession and facilitate filling of posts. Almost a year has elapsed since then, but the Recruitment Rules (RRs) are still under finalization. The Committee observes that NIH not only imparts education in Homoeopathy, but also serves as a model for other institutes/colleges across the country and therefore filling of vacant faculty posts at the earliest is of vital importance. The Committee, therefore, recommends that the finalization of amendments to RRs may be completed in a time bound manner. The Committee also desires to be apprised of the updated vacancy position of the faculty at NIH. 5.5 About the updated status of expansion of NIH, the Ministry in its reply has mentioned that the work of Hospital extension building had already been completed and taken over. Construction of Academic-cum- Library is complete and taken over. Eight departments had been shifted to new building. 5.6 In reply to a question regarding the updated status of implementation/development of Hospital at NIH and the time-line for completion thereof, the Ministry informed that for 2nd and 3rd phase of the project, major works had been completed and the project was expected to be completed by May The expansion of the Hospital at NIH from 100 to 250 bed has been engaging the attention of the Committee and has been commented upon in its various reports on Demands for Grants of the Ministry. The Committee observes that the expansion of the Hospital at NIH was targeted to be completed during During the examination of Demands for Grants ( ), the Ministry had informed the Committee that the original cost of ` crore had been revised upward to ` crore and that the project of the expansion of the Hospital Building was likely to

25 16 be completed by May, The Committee is, therefore, astonished to note the submission of the Ministry that major works had been completed and the project was expected to be completed by May, The Committee would, therefore, like the Ministry to explain as to why the project could not be completed by May, 2015 and whether the further delay of one year has entailed any cost escalation of the Project. 5.8 Regarding the research activities being undertaken at NIH, the Ministry has informed that the research and academic activities on Osteoarthritis, Thyroid disorders and Cancer are being undertaken. On being asked about the outcome of clinical research conducted on Thyroid Diseases, Psoriasis and Spondylitis as conducted by Research Wing of NIH, it was informed that at present research was being carried out on two aspects i.e. Thyroid Dysfunction and Spondylitis which were ongoing single blind clinical studies with emphasis on livelihood ratio of the participants. Till 31st March 2015, total 1292 participants had been screened in thyroid dysfunction out of which 148 participants showed marked improvement, 222 participants showed moderate improvement and 408 participants showed mild improvement. In Psoriasis, out of 250 participants, 30 participants showed marked improvement, 40 participants showed moderate improvement and 75 participants showed mild improvement. All the participants were being followed up in protocol. 5.9 The Committee notes that the research activities on Osteoarthritis, Thyroid disorders and Cancer are being undertaken at NIH. The Committee observes that research projects often witness appreciable time-lag in translating research leads and outcomes into tangible health products. The Committee, therefore, recommends that the Ministry should ensure that the above research projects are taken to their logical conclusion within the shortest possible span of time and the products generated out of the research projects reach our healthcare system and are used by the people. 6. All India Institute of Homoeopathy (AIIH) 6.1 A provision of ` crore had been made for All India Institute of Homoeopathy for BE which was raised to ` crore at RE stage. On being asked about the reasons for this sharp increase in the allocation at RE stage, details of progress made towards implementation of the project including its original cost, the Ministry has informed that the sharp increase in allocation at RE stage in was for the purchase of land for AIIH. The Committee s scrutiny of Demand No. 5 of the Ministry for the year reveals that no allocation has been made for AIIH for The Ministry has also informed that the possession of land was yet to be taken from DDA and the preliminary cost estimates for the AIIH was between ` crore excluding the cost of the land. The Expenditure Finance Committee (EFC) Memo was under process. The next step after EFC approval was selection of Project Management Consultant and preparation of Detailed Project Report (DPR). Thereafter, matter will be placed before the Cabinet by August The Committee notes that the preliminary cost estimates for the AIIH was between ` crore excluding the cost of the land and observes that it has been seen that the infrastructure projects often experience time and cost overruns. The Committee would, therefore, like the Ministry to ensure that the implementation of AIIH may be monitored closely at a sufficiently higher level in the Ministry and ensure that there is no tardiness in implementation of the Project and the resultant cost escalation. The Committee also recommends that all pre-project formalities may be completed within a set time-frame before making budgetary provisions for the AIIH.

26 17 7. Morarji Desai National Institute of Yoga (MDNIY), New Delhi 7.1 Morarji Desai National Institute of Yoga (MDNIY) is an autonomous Organisation under the Ministry of AYUSH and a focal Institute for Planning, Training, Promotion and coordination of Yoga Education, Training, Therapy and Research in all its aspects. 7.2 The Ministry of AYUSH during a power-point presentation before the Committee has listed out the following achievements in respect of the Institute: - 1st International Day of Yoga celebrated on 21st June, 2015, with two Guinness World Records involving 35,985 participants and Maximum number of Nationalities (84) in a single yoga event; An International Conference on Yoga for Holistic Health organised at Vigyan Bhawan; A new Central Sector Scheme titled as Yoga Training for Police Personnel has been launched; and Quality Council of India at the behest of Ministry of AYUSH has developed a Scheme for Voluntary Certification of Yoga Professionals. 7.3 The Ministry through a written submission has furnished the following information to the Committee regarding the financial performance of MDNIY for : - Table No. 10 (` in crore) BE RE Expenditure (upto ) Plan Non-Plan On being asked about the reasons for less utilisation of allocated funds, the Ministry has made the following written submission: 7.5 The provision for BE was made for ` crore on account of recruitment of faculties for B.Sc. degree Course in Yoga Science, diploma in Yoga Science and other educational courses and for creation of infrastructure for B.Sc. Degree course, certain major works like covering of Amphitheatre area, setting up Laboratories and for Release of Grant-in-aid to Swami Vivekananda District Yoga Wellness Centre (SVDYWC). 7.6 However, under Phase II only 32 centres under SVDYWC are being continued. Posts of Faculties have been recently created with the approval of Department of Expenditure. Recruitment of faculties for B.Sc (Yoga Science) could not be materialized. This has resulted the reduction at RE stage to ` 3.50 crore. 7.7 Out of RE 3.50 Crore an amount of ` 1.18 crore has been utilized and further utilization of ` 2.32 crore along with other committed expenditure are under process and will be utilized during the current financial year.

27 The Committee notes that the allocation of ` crore made for MDNIY on the plan side at the stage of BE was reduced to ` 1.18 crore at the RE stage. The sum of ` crore was earmarked for carrying out very important activities like setting up of laboratories, covering of amphitheatre, recruitment of faculties for B.Sc. degree courses in Yoga Science etc. which have significant bearing on improving the teaching of Yoga. It is, therefore, a matter of anguish for the Committee that substantial variations have occurred between the sanctioned provisions and the actual expenditure and a substantial amount of funds remained locked up due to the inefficiencies in the planning process. The Committee, therefore, recommends that the Ministry should take credible action to overcome the deficiencies in the planning process and ensure that the blockage of funds and their subsequent surrender do not recur. 7.9 The Committee has been informed that the allocation of fund for MDNIY under Plan and non-plan for is ` 4.00 crore and ` 4.50 crore respectively and these funds would be utilised for the following purposes:---- (A) Yoga Education programmes: 1. B. Sc(Yoga Science) with intake capacity of 60 students per year 2. Diploma in Yogic Science (D.Y.Sc.) for Graduates of One Year duration. 3. Certificate course in Yoga Science for target Group (para Militry personnel) (B) Yoga Training Programmes: 1. Certificate course in Yogasana and Certificate course in Pranayama and meditation for Health Promotion. 2. Foundation course in Yoga Science for wellness of moths duration. 3. Yoga and Health promotion programmes of One Hour each programme for general public 4. Yoga Workshops etc. (C) (D) (E) (F) (G) (H) Preventive Health care Units of Yoga in CGHS dispensaries. Yoga Therapy Centers in AYUSH/Allopathic Hospitals. National Yoga Week Participation in Aarogya Melas. International Day of Yoga etc. SVDYWC scheme 7.10 The Committee observes that among the quantifiable deliverables for are opening of Yoga Therapy Centres in AYUSH/ Allopathic Hospitals and preventive Healthcare units of Yoga in CGHS dispensaries. The Committee desires to be kept apprised of the achievements made vis-à-vis targets sets under these programmes. 8. Regulation of Naturopathy and Yoga 8.1 During the course of examination of Demands for Grants ( ), in reply to a query, the Committee