Inadequate registration counters at Singtam, Geyzing hospitals: CAG

Friday, Apr 02, 2021 08:00 [IST]

Last Update: Friday, Apr 02, 2021 02:23 [IST]

Inadequate registration counters at Singtam, Geyzing hospitals: CAG


GANGTOK, : The Comptroller & Auditor General (CAG) of India has made a couple of recommendations regarding registration of patients and services at the OPD clinics of its hospitals. The recommendations were made in the CAG report of a performance audit of select district hospitals in Sikkim for the year ended March 2019.
The audit body covered the period from 2014-15 to 2018-19.
As per the Indian Public Health Standards (IPHS), OPD (Out Patient Department) facility in a district hospital should be planned keeping in mind maximum peak hour patient load and should have scope for further expansion.
To avail of services in a hospital, patients first register at the registration counter of the hospital. The OPD doctors then examine them, and further diagnostic tests are prescribed where necessary, for evidence-based diagnosis and/or drugs are prescribed or admission in the hospital is advised.
In its report, the audit observed that the OPD counter for registration of patients in Singtam district hospital was located outside the hospital building “in a tin roofed open structure with no proper sitting/waiting area for the patients and their attendants/relatives.” There was also no scope for future expansion.
On the other hand, the OPD counter in Geyzing district hospital was located within the hospital building and had adequate arrangements for sitting/waiting comfort of the patients and their attendants coming to the hospital for treatment.
“Most of the OPD clinics in the New STNM Hospital did not have adequate seating arrangement for patients, thought it was a new hospital. Further, there was no provision of ceiling fans in the registration counters, waiting areas for patients and public in general,” said the CAG.
In conclusion, the audit body observed that the Singtam hospital and Geyzing hospital had inadequate registration counters as against the requirements. Further, except for the New STNM Hospital, the registration of patients was not computerized in the two district hospitals. Both the district hospitals did not have a system to record details of OPD patients referred to higher health centres from the OPD clinics, the audit body observed.
“The State government may ensure availability of basic facilities/services in the OPD of each hospital as prescribed in the Assessor’s Guidebook for Quality Assurance of Services in District Hospitals, 2013 (Vol-1). They may ensure documentation/computerisation of referral cases and clinical history of patients,” recommended the CAG.
Referred out Patients
During the period 2016-19, a total of 2,652 in-patients from Singtam district hospital and 1,411 from Geyzing district hospital were referred to STNM hospital in Gangtok due to non-availability of essential services in the district hospitals (specialists, equipment, trauma services and diagnostic facilities).
During the year 2019, 1,973 patients were referred from the STNM hospital to higher health facilities (CRH, Tadong and outside State) for medical treatment due to non-availability of required facilities (manpower, equipment, infrastructure, etc.) in the hospital.
As the STNM hospital was planned for specialised services and had idle equipment lying, the department may enquire into these referrals from STNM hospital to other hospitals for optimal use of resources and in interest of patient convenience and treatment.
- CAG report for the year ended March 2019

Sikkim at a Glance

  • Area: 7096 Sq Kms
  • Capital: Gangtok
  • Altitude: 5,840 ft
  • Population: 6.10 Lakhs
  • Topography: Hilly terrain elevation from 600 to over 28,509 ft above sea level
  • Climate:
  • Summer: Min- 13°C - Max 21°C
  • Winter: Min- 0.48°C - Max 13°C
  • Rainfall: 325 cms per annum
  • Language Spoken: Nepali, Bhutia, Lepcha, Tibetan, English, Hindi