Performance Audit on Public Health Infrastructure and Management of Health Services, Punjab

An audit of Punjab's public health infrastructure and health services for 2016-21, updated where possible to 2021-22. It found half the sanctioned posts in the health system vacant, staff distributed without reference to population or patient load, health spending far below the National Health Policy 2017 targets, public money held outside the government account, and a state clinical establishments law that exempts private clinics of up to 50 beds from registering at all.

State: Punjab
Audit period: 1 Apr 2016 — 31 Mar 2021
Presented: 25 Mar 2025

Findings

34,949 of 68,949 sanctioned posts — 50.69 per cent — were vacant. Vacancies reached 59.19 per cent under the Director of Medical Education and Research.
“34,949, i.e., 50.69 per cent of the 68,949 sanctioned posts were vacant. In terms of percentage of vacant posts, Director Medical Education and Research, which includes sanctioned strength of four medical colleges at Amritsar, Faridkot, Patiala and SAS Nagar, has maximum shortage of manpower i.e. 59.19 per cent.”Executive Summary
Doctor shortages ranged from 12.40 per cent in Pathankot to 58.58 per cent in Faridkot; sanctioned posts do not track population, with one doctor sanctioned per 2,377 people in Rupnagar and per 7,376 in Moga.
“shortage of doctors against the sanctioned strength varied from 12.40 per cent in Pathankot district to 58.58 per cent in Faridkot district... population to doctor ratio ranged from one doctor sanctioned for 2,377 people in Rupnagar district to one doctor sanctioned for 7,376 people in Moga district.”Executive Summary
Punjab spent 3.11 per cent of total expenditure and 0.68 per cent of GSDP on health in 2021-22, against National Health Policy 2017 targets of over eight per cent of budget and 2.50 per cent of GSDP.
“The State Government could spend only 3.11 per cent of its total expenditure and 0.68 per cent of GSDP on health services during 2021-22, which was way below eight per cent of the budget and 2.50 per cent of GSDP targeted under NHP 2017.”Executive Summary
Punjab's Clinical Establishments Act, adopted only in October 2020 and still without rules, does not require private clinics of up to 50 beds to register — unlike the central Act of 2010.
“Provisions of Punjab Clinical Establishments (Registration and Regulation) Act, 2020 do not bind the private clinics or establishments having capacity upto 50 beds to get themselves registered unlike the Clinical Establishments (Registration and Regulation) Act, 2010 passed by the Central Government”Executive Summary

Findings

34,949 of 68,949 sanctioned posts — 50.69 per cent — were vacant. Vacancies reached 59.19 per cent under the Director of Medical Education and Research.

“34,949, i.e., 50.69 per cent of the 68,949 sanctioned posts were vacant. In terms of percentage of vacant posts, Director Medical Education and Research, which includes sanctioned strength of four medical colleges at Amritsar, Faridkot, Patiala and SAS Nagar, has maximum shortage of manpower i.e. 59.19 per cent.”Executive Summary

Doctor shortages ranged from 12.40 per cent in Pathankot to 58.58 per cent in Faridkot; sanctioned posts do not track population, with one doctor sanctioned per 2,377 people in Rupnagar and per 7,376 in Moga.

“shortage of doctors against the sanctioned strength varied from 12.40 per cent in Pathankot district to 58.58 per cent in Faridkot district... population to doctor ratio ranged from one doctor sanctioned for 2,377 people in Rupnagar district to one doctor sanctioned for 7,376 people in Moga district.”Executive Summary

Punjab spent 3.11 per cent of total expenditure and 0.68 per cent of GSDP on health in 2021-22, against National Health Policy 2017 targets of over eight per cent of budget and 2.50 per cent of GSDP.

“The State Government could spend only 3.11 per cent of its total expenditure and 0.68 per cent of GSDP on health services during 2021-22, which was way below eight per cent of the budget and 2.50 per cent of GSDP targeted under NHP 2017.”Executive Summary

Punjab's Clinical Establishments Act, adopted only in October 2020 and still without rules, does not require private clinics of up to 50 beds to register — unlike the central Act of 2010.

“Provisions of Punjab Clinical Establishments (Registration and Regulation) Act, 2020 do not bind the private clinics or establishments having capacity upto 50 beds to get themselves registered unlike the Clinical Establishments (Registration and Regulation) Act, 2010 passed by the Central Government”Executive Summary