Table of Contents

2000 April 24 : 91st Parliamentary Committee HRD (ISM AYURVEDA).................................................................1 2001 February : 98th Parliamentary Committee HRD (NIMHANS)..........................................................................2 OBSERVATIONS/RECOMMENDATIONS AT A GLANCE...................................................................................13 MINUTES OF THE COMMITTEE XV FIFTEENTH MEETING............................................................................14 2002 April : 116th parliamentary report HRD Grant requests 2002-03.....................................................................17 2003 April 10 : 125th Report HRD .............................................................................................................................19 CENTRAL INSTITUTE OF PSYCHIATRY, RANCHI.............................................................................................20 NATIONAL MENTAL HEALTH PROGRAMME.....................................................................................................21 2003 April : 135th REPORT ON DEMANDS FOR GRANTS 2003-2004 ..................................................................23 X IMPLEMENTATION OF HEALTH PROGRAMMES IN NORTH EAST SECTOR....................................24 2004 February 4 : 148th REPORT ON DEMANDS FOR GRANTS 2003-2004 .......................................................25 (X) IMPLEMENTATION OF HEALTH PROGRAMMES IN NORTH EAST SECTOR.....................................26 2004 August : Health 1st Meeting..............................................................................................................................27 2005 March 11 : Health 4th Meeting..........................................................................................................................28 2005 April 28 : Health 7th Meeting.............................................................................................................................29 2005 December 12 : Health 15th Meeting.................................................................................................................31 2005 April 28 : 9th parliamentary report Grant requests 2005-06 - AYUSH..............................................................33 2005 December 21 : 14th parliamentary report Grant requests 2005-06 AYUSH.....................................................33 Advanced Ayurvedic Centre for Mental Health in NIMHANS................................................................................33 2005 December 21 : 15th parliamentary report Grant requests 2005-06..................................................................34 2006 May 22 : 16 th Parliamentary committee report grant request 2006-07...........................................................35 2007 February 26 : 108th Parliamentary committee report review of Papers Laid on Table.....................................36 NATIONAL INSTITUTE OF MENTAL HEALTH AND NEURO SCIENCES (NIMHANS), BANGALORE.............36 2007 March 8 : 20th Parliamentary committee report grant request 2006-07...........................................................39 2007 May 3 : 22nd Parliamentary committee report on grant requests 2007-08......................................................40 2010 April 28 : 39th REPORT HEALTH......................................................................................................................42

2000 April 24 : 91st Parliamentary Committee HRD (ISM AYURVEDA)

http://164.100.24.167/book2/reports/HRD/91streport.htm 3.7 The Committee observes that there was a nominal provision of Rs. 1 lakh as Grant-in-aid for Advanced Ayurveda Centre for Mental Health in NIMHANS in BE 1997-98. However, allocation was increased to Rs. 25 lakhs at the RE stage which was fully utilised. In 1998-99 also, allocation of Rs. 20 lakhs was fully utilised. However, the Committee is surprised to note that provision of Rs. 20 lakhs in 1999-2000 had to be reduced to Rs. 1 lakh as the issue of sharing of project cost between the Department of Health and the Department of ISMH is pending, hence, no further grants were required to be released. The Committee is not convinced by the explanation given by the Department and expresses its serious concern over such an element of uncertainty in starting a new Scheme. The Committee, therefore, is of the view that decision in the matter should be taken at the earliest. ~

2001 February : 98th Parliamentary Committee HRD (NIMHANS)

http://164.100.24.167/book2/reports/HRD/98threport.htm
PARLIAMENT OF INDIA RAJYA SABHA 98

DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEE ON HUMAN RESOURCE DEVELOPMENT NINETY-EIGHTH REPORT ON ACTIONTAKEN BY GOVERNMENT ON THE RECOMMENDATIONS/OBSERVATIONS CONTAINED IN THE 54TH REPORT ON NATIONAL INSTITUTE OF MENTAL HEALTH AND NEURO SCIENCES (NIMHANS), BANGALORE (PRESENTED TO THE RAJYA SABHA ON 27TH FEBRUARY, 2001) LAID ON THE TABLE OF LOK SABHA ON 27TH FEBRUARY, 2001) CONTENTS 1. COMPOSITION OF THE COMMITTEE 2. PREFACE 3. REPORT CHAPTER I Recommendations/Observations that have been Accepted by the Government CHAPTER II Recommendations/Observations which the Committee Does not desire to pursue in view of the Governments replies CHAPTER III Recommendations/Observations in respect of which Replies of the Government have not been accepted By the Committee CHAPTER IV Recommendations/Observations in respect of which Government has not given any reply 4. OBSERVATIONS/RECOMMENDATIONS AT A GLANCE 5. MINUTES COMPOSITION OF THE COMMITTEE 1. Shri S.B. Chavan MEMBERS RAJYA SABHA 2. Shri Mourice Kujur 3. Shri Akhilesh Das 4. Shri Eduardo Faleiro 5. Shri Rajnath Singh Surya 6. Shri Dina Nath Mishra 7. Prof. R.B.S. Varma 8. Shri Bratin Sengupta 9. Dr. Ramendra Kumar Yadav Ravi 10. Shri Raj Mohinder Singh 11. Chaudhary Harmohan Singh Yadav Chairman

12. 13. 14. 15.

Shri Mrinal Sen Dr. C. Narayana Reddy Shri M.P. Abdussamad Samadani Dr. Alladi P. Rajkumar

LOK SABHA 16. Shrimati Jaskaur Meena 17. Shri Shankar Prasad Jaiswal 18. Shri Ramakant Angle 19. Shri Kirti Jha Azad 20. Shri Baliram Kashyap 21. Shri Ramanand Singh 22. Shri Dileep Sanghani 23. Shri Kishan Singh Sangwan 24. Shri G. S. Baswaraj 25. Shri V. M. Sudheeran 26. Shrimati Shyama Singh 27. Shri Sunil Dutt 28. Shri Ramesh Chennithala 29. Shri Kantilal Bhuriya 30. Dr. Ram Chandra Dome 31. Shri Samik Lahiri 32. Dr. D.V.G. Shankar Rao 33. Shri Davendra Singh Yadav 34. Shrimati Renu Kumari 35. Shri Shivaji Mane 36. Shri Anandrao Vithoba Adsul 37. Dr. Baliram 38. Dr. A.D.K. Jayaseelan 39. Dr. V. Saroja 40. Shri Trilochan Kanungo 41. Shri Mohammed Anwarul Haque 42. Shri Vanlal Zawma 43. Smt. Kumudini Patnaik SECRETARIAT Shri Satish Kumar, Additional Secretary Smt. Vandana Garg, Director Shri C.B. Rai, Under Secretariat Shri Gurnam Singh, Committee Officer

PREFACE I, the Chairman of the Department-related Parliamentary Standing Committee on Human Resource Development, having been authorised by the Committee to present the Report on its behalf, do hereby present this Ninety eighth Report of the Committee on Action Taken by the Government on the recommendations contained in the 54 th Report on National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore. 2. The Seventy-third Report of the Department-related Parliamentary Standing Committee on Human Resource Development was presented to Rajya Sabha and laid on the Table of Lok Sabha on 27th February, 2001. Replies of the Government on the recommendations contained in the Report, received from the Department of Health, Ministry of Health and Family Welfare were considered by the Committee. Clarifications were also

sought by the Committee from the representatives of the Department. . 3. The Committee considered the Draft Report and adopted the same at its meeting held nd January, 2001. on 22 NEW DELHI; January 22, 2001 Magha 2, 1922 (Saka) S.B. CHAVAN Chairman Department-related Parliamentary Standing Committee on Human Resource Development REPORT The Report of the Committee deals with the action taken by the Government on the recommendations contained in its Fifty-fourth Report on the Functioning of National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore which was presented to Rajya Sabha and laid on the Table of Lok Sabha on 25 th February, 1997. 2. Action Taken Notes have been received from the Government in respect of the recommendations contained in the Report. They have been categorized as follows:(i) Recommendations/Observations which have been accepted by the Government: 3, 5, 5.1, 5.2, 11 (Chapter I) (ii) Recommendations/Observations which the Committee does not desire to pursue in view of the Governments replies: 8, 9, 9.1, 10, 10.2, 10.3, 12, 13.1 (Chapter II) (iii) Recommendations/Observations in respect of which replies of the Government have not been accepted by the Committee: 4, 6, 7, 10.1, 13, 13.2, 13.3 (Chapter-III) (iv) Recommendations/Observations in respect of which replies of the Government have not been received Nil (Chapter IV) CHAPTER-I RECOMMENDATIONS/OBSERVATIONS ACCEPTED BY THE GOVERNEMNT III Recommendation 3. When the Committee sought to know as to whether the Institute is equipped with latest technology and sufficient equipments in all the departments, the Director stated that efforts have always been made to equip all the departments with the advanced technology and equipments. However, due to lack of funds they are not able to keep pace with latest improvements in technology, he added. The Committee was also informed that if a special grant is made available to the Institute then it would be possible to acquire the necessary

equipments. The Committee feels that the Institute is in need of sophisticated equipments for diagnosis, treatment & research and the Department of Health may consider making available sufficient funds for the purpose. Action Taken Government of India has released the entire funds and the equipment has been purchased by the Institute. V Recommendation 5. One of the three important objectives of the Institute is manpower development in the field of mental health and Neuro Sciences. The Committee notes that the Institute offers Post Graduate Courses including M.Phil, Post-certificate courses in nursing i.e. (Diploma in Psychiatric Nursing DPN and Diploma in Neurological Nursing DNN) are also offered in the Institute. Facilities to pursue PH.D Programmes are also available, it was added. Action Taken The Institute has introduced new courses: a) b) Post Doctoral Certificate course in Neuroanaesthesia M.Phil course in Speech Language Pathology.

Recommendation 5.1 The Committee was informed by the Director that the courses conducted by the Institute are always in great demand due to the limited intake capacity of the Institute. When asked to explain the steps taken to meet the demand, the Director replied that recently it has been proposed to increase the number of seats in the following courses: MD-Psychiatry DM-Neurology M.CH Neurosurgery M.Phil Clin. Psychology M.Phil in PSW 8 to 14 seats 4 to 6 seats 4 to 6 seats 12 to 15 seats 12 to 15 seats

5.2 The Committee desires that this proposal may be finalized as early as possible. For increasing the seats, the staff strength is also required to be increased. Necessary steps may therefore, be taken to sanction additional posts. Action Taken Medical Council of India has agreed to increase the number of seats as proposed by the Director, NIMHANS, Bangalore and the Institute has also increased the M.Phil Clinical Psychology and M.Phil in PSW as proposed. 11. Recommendation To overcome the problems occurring due to accidents and epilepsy, prevention is required for which public awareness is essential. To a question as to whether the Institute is publishing any literature for the awareness of the common public on the mental health related problems, the Director of the Institute responded that they are planning in this direction. One of the faculty members of the Institute has published nearly forty books in Kannada. The Institute is also planning to publish them in the regional languages, he added. The Director

also stated that the Health Education Bureau in the Institute is working on it. He also stated that the Institute is in a position to supply posters on mental health in case any State is in need of it. The Committee is of the opinion that there is need to publish the materials about mental health and related problems in all the regional languages so that people of all the regions/states can be benefited. Necessary steps may be taken in this direction. The Department should take the responsibility of publishing the material in various regional languages in a time-bound manner. Action Taken State Health Secretaries have been informed about the IEC materials developed by NIMHANS and have been requested to make use of these materials after getting it translated into local languages for generating public awareness. The Central Health Education Bureau has also been asked for the same. CHAPTER-II OBSERVATIONS/RECOMMENDATINS WHICH THE COMMITTEE DOES NOT DESIRE TO PURSUE IN VIEW OF THE GOVERNMENTS REPLY Recommendation 8. The Committee has learnt that a sixty bedded drug dependence unit is functioning in the Institute and funds are not being given for this by the Ministry of Health and Family Welfare while similar centres established in PGI Chandigarh, AIIMS, Delhi etc. are funded by the Govt. of India under the National Drug De-Addiction programme. The unique feature of the Centre in this Institute is, it has been started with community based activity. The Committee was also informed that the Ministry has been approached for providing additional funds for De-Addiction programme. The Committee, however, feels that the Institute should not over-burden itself with the Drug De-addiction programme, particularly when sufficient funds are not being received. Action Taken Ministry of Health has approved the inclusion of existing Drug De-addiction Centre of NIMHANS under National Drug De-addiction programme and sanctioned Rs. 517 lakhs in the 9th Five year plan and to make it a Regional Centre. Recommendation 9. The Committee has noted that a survey conducted on more that one lakh population on neurological disorders showed that approximately 31 people out of 1000 suffer from neurological disorders, the commonest being headache and epilepsy. Considering the gravity of the situation, the Committee feels that there is need for evolving a national strategy on epilepsy and other neurological disorders. Action Taken Under National Mental Health Programme, epilepsy is also included as one of the disorders and NIMHANS has taken up training of PHC doctors in the management of Mental disorders including epilepsy. Recommendation 9.1 The Committee also learnt that basic research studies on Yoga have helped in the

application of Kriya Yoga in the successful treatment of patients with depression. Since yoga treatment does not require any medicines and is free from side effects, it needs to be extensively used. The Committee, therefore, recommends that steps should be taken by the Institute to involve more yoga experts in treating the patients who suffer from depression. The yoga unit may be further developed. Action Taken The proposal for establishment of advanced centre in Ayurveda at NIMHANS has been agreed to by Deptt.of ISM&H and has released amount for providing infrastructure. Recommendation 10. The Institute caters to the needs of Patients suffering from Psychiatric and neurological disorders. The Institute has a bed capacity of 805. Besides this, the Institute also offers a combined neuro psychiatric out-patient service to impart better co-ordinated patient care. When the Committee sought to know as to whether the bed capacity is proposed to be increased, it was stated that they propose to increase the beds in casualty unit by 50 beds. They also propose to increase bed capacity in head injury unit and stroke unit, it was added. The Committee desires that necessary steps may be taken to increase the beds at the earliest. Action Taken Providing emergency care in the city is a State responsibility and NIMHANS being an apex referral Hospital should normally not be handling emergency cases which can detract from their primary focus which is aimed at evolving the best standards for teaching clinical research and patient care. However, subject to receiving State Govt.s financial support the proposal for establishing a 50 bedded casualty will be taken forward in the IX Plan. Recommendation 10.2 To save a number of lives from head injuries the Director apprised the Committee that by making wearing of helmets compulsory for two wheeler drivers all over the country, this problem can be solved to a large extent. The Committee feels that the suggestion is good and it should be looked into. Action Taken Ministry of Surface Transport has reiterated instruction to all States/UTs Transport Commissioners for imposing compulsory wearing of helmets by Two Wheeler drivers/pillion riders as prescribed under Section 129 of the Motor Vehicles Act, 1988. Recommendation 10.3 The Committee has noted that the Institute does not get sufficient kits for HIV testing. The Director informed that National Aids Control Organisation (NACO) has been requested to increase the number of HIV kits supplied. The Committee feels that the Institute is in need of HIV Kits and NACO may increase the supply of HIV Kits. The Committee is, however, of the view that the Institute should not over-burden itself with treating HIV cases. Action Taken NACO has provided sufficient HIV Kits to NIMHANS through State Government. Further, patients of HIV/AIDS having neurological and Psychiatric disorders are treated in NIMHANS. Other AIDS patients are not treated in NIMHANS.

Recommendation 12. There is a small unit under the control of Central Council of Ayurveda functioning in the Institute which is not a part of NIMHANS. The Committee was informed by the Director that there is a proposal to establish an advanced centre of Ayurveda in the Institute. The Committee, is, however,` of the opinion that the opening of advanced centre of Ayurveda is an additional burden for the Institute. Such a centre could be located elsewhere in an Ayurvedic Institute and the patients requiring treatment in Ayurveda could be referred there. Action Taken The proposal for setting up of advanced centre in Ayurveda at NIMHANS has been sanctioned by the Department of ISM&H. It is felt that patients should get the benefit of both the Ayurvedic System of medicine and the Modern Allopathic system of Medicine. Recommendation 13.1 The Committee was also informed that aid for development plans is received from many foreign countries such as Germany, Japan, U.S.A. etc. The Director pleaded that such aid should be made available to NIMHANS also. The Committee recommends that the Department of Health may look into the matter. Action Taken As and when such assistance is available all efforts would be made to make NIMHANS also a recipient of such assistance. CHAPTER-III RECOMMENDATIONS/OBSERVATIONS IN RESPECT OF WHICH REPLIES OF THE GOVERNMENT HAVE NOT BEEN ACCEPTED BY THE COMMITTEE 4. Recommendation The Committee has noted that the Institute proposes to have collaboration with foreign universities and when asked as to how far they are able to finalise the proposal, the Director informed the Committee that it has already developed collaboration with a renowned University and for making further efforts in this direction the active support of the Ministry of Human Resource Development is required. The Committee feels that it is a premier Institute of its kind in the country and collaboration with eminent and renowned foreign universities would further strengthen the Institute. The Committee, therefore, recommends that the Department of Health should take up the matter with the Ministry of HRD in this regard. Action Taken The matter regarding collaboration with foreign universities has been taken up with Ministry of Human Resource Development. Comments of the Committee The Committee feels that collaboration with foreign universities is very important because it provides additional funds for being spent on plan-programmes. The Committee is not satisfied with the effort of Department of Health in this regard and strongly recommends that it should vigorously pursue the matter of foreign collaboration with the Ministry of Human Resource Development.

6.

Recommendation The Committee has noted that the Staff Position in the Institute is as under:Sanctioned Working 122 737 Vacant 21 93

Teaching Non-teaching

143 830

As regards the vacancies on teaching side it was stated that for five faculty posts, interviews were already held. It was also stated that 14 posts are reserved for SCs/STs and recruitment is under process under special recruitment drive. Action is being taken to fill up the remaining posts, it was added. The Committee recommends that immediate steps may be taken to fill up the posts reserved for SCs/STs. The Committee also desires that the vacancies on the non-teaching side also may be filled up at the earliest. The Director also informed the Committee that some posts have to be kept vacant due to paucity of funds. The Committee views this with concern and strongly recommends that in future no post should be kept vacant just because of paucity of funds. Action Taken All reserved posts on the non-teaching side have been filled up. As regards the faculty posts, the Institute is facing difficulties in filling up the reserved posts even after resorting to a special recruitment drive. The Institute has re-advertised the posts and is in the process of conducting interviews. Further Comments The Committee specifically wanted to know whether the teaching posts in the reserved category were vacant due to paucity of funds or non-availability of qualified candidates. The Additional Secretary clarified that paucity of funds was not the reason for vacancies in the teaching category. It was the non availability of qualified candidates due to which these posts were vacant. It was informed that out of 21 vacant posts on the teaching side, 14 posts were reserved for SCs/STs and candidates with adequate qualifications were not available in spite of repeated advertisements. The Secretary subsequently informed the Committee that as per the reservation policy they had to keep attempting, by way of advertisements, to fill up the reserved posts. Comments of the Committee The Committee is anguished to note that in a prestigious institute like NIMHANS, which is a deemed university and only one of its kind in the country, teaching has been allowed to be affected adversely for long because of non-availability of suitable candidates from reserved category. The Committee observes that such a situation cannot be allowed to continue indefinitely, specially in a teaching institution. The Committee, therefore, recommends that if suitable candidates from reserved category are not available, the vacant posts should be filled up immediately on ad-hoc basis, as per the guidelines laid down by Government of India. The Committee may also be kept informed in the matter. 7. Recommendation Research activity encompasses a large spectrum from cellular mechanisms to social systems associated with various neurological and behavioural disorders. However, the Committee learnt that it has not been possible to spend adequate time for research in the

Neuro-surgery Department. When the Committee sought to know the reasons for this, it was stated that the Departments faculty are fully occupied with the operations and follow-up of the neuro-surgical patients leaving them with very little time for research. The gap can be bridged by increasing the staff strength, it was added. Neuro-surgery Department is a very important Department and research needs to be developed. The Department of Health may take necessary action to ensure that research activities are not hampered in the Neuro-surgery Department. Action Taken NIMHANS is initiating action to create posts by putting up proposals before the competent authorities. Further Comments The Director General of Health Services was of the opinion that the operational type of research, namely, which treatment is suited to what patient should be done by the surgeons themselves but basic research should be done by the Physiologists and Pathologists. Comments of the Committee The Committee was earlier informed that neuro-surgeons, being very busy with the operations and the follow up of the neuro-surgical patients, generally did not find much time for research. Therefore, some research issues were incorporated in the training programme of the Institution. The Committee, however, is of the view that a surgeon due to his or her direct exposure in handling neuro-surgical operations, has got lot of first hand practical experience which ought to be put to optimum use while carrying out basic research. The Committee expresses its reservations for creation of posts for such purpose. Recommendation 10.1 The Committee also learnt that people with even small accidents come from long distances for treatment in the hospital. This would only increase the burden of the Institute. For this, some kind of screening should be done at the local level General Hospitals from where a case should be referred to NIMHANS only if it requires specialized treatment. For this, the Committee feels that the matter should be taken up with the State Government requesting them to issue necessary circular to the general hospitals stating that whenever head injury cases come, they have to examine and admit unless it needs a special neurosurgical intervention. The Director assured the Committee that needful would be done in the matter. The Committee desires that it should be pursued by the Institute at regular intervals. Action Taken The matter regarding reducing the patient load on NIMHANS by screening the patients in the General Hospitals of the State Government has been taken up with the Secretary, Department of Health and Family Welfare, Govt. of Karnataka, Bangalore. They are in the process of establishing super-specialty hospital at Raichur. Comments of the Committee The Committee feels that NIMHANS should function as a referral Institute. The matter should be taken up with all the State Govts. that only such cases should be referred to the Institute which require special-neuro surgical intervention. 13. Recommendation The Committee noted that NIMHANS has been provided with Rs. 21.08 crores for

1996-97. On being asked as to whether this amount is sufficient to meet the requirements of the Institute, it was stated that a minimum of Rs. 30 crores was required. The Director also informed the Committee that the main problem faced by the Institute is the lack of funds for development. The Institute needs special grants for this purpose, he stated. Presently, the Institute is not getting any grants from UGC and the Director requested that since it is a Deemed University it may also be given development funds on the pattern of other Universities. The Committee recommends that this may be considered. He further explained that in the routine grants, every year 10% growth is there and due to escalation of costs, they are not able to meet the demand. While the number of patients are increasing every year, the non-plan expenditure is kept at the same level of 10% increase as per the Government norms. Due to this, the Committee was told, the Institute has to keep some posts vacant to have some non-plan money to spend for patient care. The Committee is also constrained to note that in view of this, it would be difficult to fill up all the posts and if all the posts are filled, there is no money for food for patients, drugs and other hospital management. The Committee feels that this would only hamper the activities of the Institute from doing good work. The Committee, therefore, recommends that the full requirements of the Institute may be taken care of by the Department of Health. The Committee feels that NIMHANS, being the only National Institute of its kind, should not starve for want of funds. The Ministry should plead the case properly with the Finance Ministry and Planning Commission for providing adequate funds. Action Taken The Budgetary requirements of NIMHANS, Bangalore are met on a sharing basis by the Central Government and the Government of Karnataka. While the sharing of Plan funds by the Centre and State Government is 75% and 25%, for non-Plan funds it is 45% and 55% respectively. Therefore, any increase in Central funds will have to be matched by increase in State funds to the Institute. The budgetary allocation for NIMHANS, Bangalore during the last five years from Govt. of India has been as under: (Rs. in crores) Year 1993-94 1994-95 1995-96 1996-97 1997-98 1998-99 Plan 4.42 4.40 6.50 5.50 7.00 8.55 Non-Plan 4.38 4.95 5.20 6.10 6.50 13.00 Total 8.80 9.35 11.70 11.60 13.50 21.55

The Institute has been advised to take up the matter with the University Grant Commission for development grants or project specific grants. Further Comments

Clarifying the matter of contribution by the Karnataka Government to meet the Budgetary requirements of NIMHANS, the Secretary replied that earlier NIMHANS was a mental hospital under the Government of Karnataka which was later taken over by the Government of India and upgraded as a National Institute. It was further clarified by the Secretary that as per the agreement at the time of taking over the Karnataka Government was to put in one third of the money and the Government of India was to put in two third. The Secretary also stated that NIMHANS being an autonomous body did not require matching funds from the state government. Furthermore, the Central Government has been contributing larger percentage towards plan as well as non-plan budget over the years. Comments of the Committee The Committee notes that the Central Government is meeting its part of financial obligation, so far as NIMHANS is concerned. The Committee is of the view that since NIMHANS has been taken over by the Central Government and upgraded as a National Institute, it has, therefore, the sole responsibility to ensure its smooth and proper functioning. Efforts should by made to make required funds available for the Institute. Recommendations The Committee was surprised to find that different methods were being followed in the case of committed expenditure of the previous plan. According to the understanding of the Committee, committed expenditure will not get reflected in any shape or form in the subsequent plan. What is termed as a non-plan expenditure of the subsequent plan becomes relevant only to the expenditure of new non-plan expenditure of the subsequent plan period. This applies in the case of both autonomous as well as deemed university institutions. In order to get further clarification in the matter the Secretary and the Financial Advisor of the Ministry of Health and Family Welfare were specially called to clarify as to whether this view of the Committee is correct or not. The Secretary could not come because of illness. The Financial Advisor appeared before the Chairman and he confirmed that the non-plan committed expenditure of the previous plan should not get reflected into the non-plan expenditure of the subsequent plan. He also confirmed that they are not making any distinction between the Government institution and other autonomous and deemed university institutions which naturally means that the confusion which is prevailing in some of institutions in treating committed expenditure as part of the new non-plan expenditure should be clarified by the department concerned to all the institutions in the country so that there should be uniformity in matters of procedure of not including the committed non-plan expenditure in the subsequent plans non-plan expenditure. Action Taken Specific guidelines of Planning Commission in this regard have been brought to the notice of all institutions under the Ministry of Health and Family Welfare. Recommendations 13.3 The Committee also noticed that in some of the Institutions where vacancies were available, they were utilizing the funds meant for vacancies, for the purpose of non-plan expenditure, which according to the Committee is not a desireable feature. Plan money can not be diverted for non-plan side or even the non-plan expenditure should not have any element of the scheme provided under the plan. All the vacancies prevailing in different institutions will have to be filled in against the non-plan expenditure of the subsequent plan as the burden of the expenditure will not be there.

Action Taken The observations of the Committee have been noted for guidance. Further Comments The Financial Advisor informed the Committee that in respect of transfer of committed liability, the Department had taken up the matter with the Ministry of Finance and got the following response:The proposal of the Department of Health has been considered and it has been decided with the approval of Secretary (Expenditure), that a provision of additional Rs. 110 crores to the Department of Health under non-plan in lieu of transfer of a committed liability of various Eighth plan schemes will be considered at RE stage by making an equal cut in the Plan Outlay. It was further clarified that in case of the Department of Health, the total committed liability of Rs. 110 crores had been shifted from plan to non-plan side. Out of this, the committed liability of NIMHANS was Rs. 5.13 crores which had been shifted to Non-Plan side. Comments of the Committee The Committee expresses deep anguish at the entire approach, which is not only totally against the recommendations of the Finance Commission but also against the mandate of the Constitution. The Committee has been repeatedly and strongly observing regarding committed liability but this issue has not been sorted out as yet. It once again reiterates its earlier observation and hopes that the issue will be sorted out at the earliest in consultation with the concerned Ministries/Departments. CHAPTER-IV RECOMMENDATIONS/OBSERVATIONS IN RESPECT OF WHICH REPLIES OF THE GOVERNMENT HAVE NOT BEEN RECEIVED NIL

OBSERVATIONS/RECOMMENDATIONS AT A GLANCE
Comments of the Committee The Committee feels that collaboration with foreign universities is very important because it provides additional funds for being spent on plan-programmes. The Committee is not satisfied with the effort of Department of Health in this regard and strongly recommends that it should vigorously pursue the matter of foreign collaboration with the Ministry of Human Resource Development.(Para 4) Comments of the Committee The Committee is anguished to note that in a prestigious institute like NIMHANS, which is a deemed university and only one of its kind in the country, teaching has been allowed to be affected adversely for long because of non-availability of suitable candidates from reserved category. The Committee observes that such a situation cannot be allowed to continue indefinitely, specially in a teaching institution. The Committee, therefore,

recommends that if suitable candidates from reserved category are not available, the vacant posts should be filled up immediately on ad-hoc basis, as per the guidelines laid down by Government of India. The Committee may also be kept informed in the matter. (Para 6) Comments of the Committee The Committee was earlier informed that neuro-surgeons, being very busy with the operations and the follow up of the neuro-surgical patients, generally did not find much time for research. Therefore, some research issues were incorporated in the training programme of the Institution. The Committee, however, is of the view that a surgeon due to his or her direct exposure in handling neuro-surgical operations, has got lot of first hand practical experience which ought to be put to optimum use while carrying out basic research. The Committee expresses its reservations for creation of posts for such purpose. (Para 7) Comments of the Committee The Committee feels that NIMHANS should function as a referral Institute. The matter should be taken up with all the State Govts. that only such cases should be referred to the Institute which require special-neuro surgical intervention. (Para 10.1) Comments of the Committee The Committee notes that the Central Government is meeting its part of financial obligation, so far as NIMHANS is concerned. The Committee is of the view that since NIMHANS has been taken over by the Central Government and upgraded as a National Institute, it has, therefore, the sole responsibility to ensure its smooth and proper functioning. Efforts should by made to make required funds available for the Institute. (Para 13) Comments of the Committee The Committee expresses deep anguish at the entire approach, which is not only totally against the recommendations of the Finance Commission but also against the mandate of the Constitution. The Committee has been repeatedly and strongly observing regarding committed liability but this issue has not been sorted out as yet. It once again reiterates its earlier observation and hopes that the issue will be sorted out at the earliest in consultation with the concerned Ministries/Departments. (Para 13.3)

MINUTES OF THE COMMITTEE XV

FIFTEENTH MEETING

The Committee met at 10.00 A.M on Friday the 22nd September, 2000 in Committee Room `A`, Ground Floor, Parliament House Annexe, New Delhi. MEMBERS PRESENT 1. Shri S.B. Chavan RAJYA SABHA Chairman

2. Shri Mourice Kujur 3. Shri Rajnath Singh Surya 4. Shri Dina Nath Mishra 5. Prof. R. B. S. Varma 6. Shri Bratin Sengupta 7. Dr. Ramendra Kumar Yadav Ravi 8. Dr. C. Narayana Reddy LOK SABHA 9. Shri Shankar Prasad Jaiswal

10. Shri Satyabrata Mookherjee 11. Shri Baliram Kashyap 12. Shri Kishan Singh Sangwan 13. Shri G.S. Baswaraj 14. Shrimati Shyama Singh 15. Dr. D.V.G. Shankar Rao 16. Shri Davendra Singh Yadav 17. Shri Mohammed Anwarul Haque SECRETARIAT Shri Satish Kumar, Additional Secretary Shrimati. Vandana Garg, Director Shri C. B. Rai, Under Secretary Shri Gurnam Singh, Committee Officer WITNESSES Representatives of the Department of Health 1. 2. 3. Shri J.A. Chowdhury, Secretary Dr. S.P. Agarwal, DGHS Shri JUR Prasada Rao, Addl. Secretary

2. At the outset, the Chairman welcomed the Members of the Committee and officials of the Department of Health. The Committee then took up for discussion the Action Taken by the Government on the 54th Report of the Committee on the Functioning of National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore. Members raised certain queries on the number of teaching posts lying vacant, particularly in the reserved categories and shortage of funds. 3. Thereafter, the Committee discussed the Action Taken by the Government on the 73rd Report of the

Committee on Dreaded Diseases. The Secretary and other officials of the Department answered the queries put by the Members. 4. The Chairman informed that the Committee could taken up Higher Education and UGC in its subsequent meetings, besides other business. A verbatim record of the proceedings of the meeting was kept. 5. The Committee then adjourned at 12.30 P.M. FIRST MEETING The Committee met at 10.30 A. M. on Monday, the 22 nd January, 2001 in Committee Room `D`, Ground Floor, Parliament House Annexe, New Delhi. The following were present: MEMBERS PRESENT 1. Shri S.B. Chavan RAJYA SABHA 2. Shri Eduardo Faleiro 3. Prof. R.B.S. Varma 4. Shri Bratin Sengupta 5. Chaudhary Harmohan Singh Yadav 6. Dr. C. Narayana Reddy LOK SABHA 7. Shri Shankar Prasad Jaiswal 8. Shri Ramakant Angle 9. Shri Baliram Kashyap 10.Shri Dileep Sanghani 11. Shri Kishan Singh Sangwan 12.Shri G. S. Baswaraj 13.Shri V. M. Sudheeran 14.Shrimati Shyama Singh 15.Shri Sunil Dutt 16.Dr. Ram Chandra Dome 17.Shri Samik Lahiri 18.Shri Davendra Singh Yadav 19.Shrimati Renu Kumari 20.Shri Shivaji Mane 21.Dr. A.D.K. Jayaseelan 22.Shri Vanlal Zawma SECRETARIAT Chairman

Shri .Satish Kumar Additional Secretary Shrimati. Vandana Garg, Director Shri C. B. Rai, Under Secretary Shri Gurnam Singh, Committee Officer

2. The Committee considered the Draft Action Taken Reports on 54th Report on National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore and 73rd Report on Dreaded Diseases. The Committee, after some discussion, suggested some modifications in the Draft Reports and authorised the Chairman of the Committee to effect them. 2. The Committee then decided that both the Reports may be presented/laid in both the Houses on 27th February, 2001. The Committee, in this connection, authorised Shri Eduardo Faleiro and Prof. R.B.S.Verma to present the Reports in the Rajya Sabha and Shri Ramakant Angle and Smt. Shyama Singh to lay the Reports in the Lok Sabha. 3. The Committee also directed the Secretariat to get copies of Draft National Health Policy from the Deparment of Health for circulation to the Members of the Committee. 4. The Committee, thereafter, adjourned at 12.45 P.M. ~

2002 April : 116th parliamentary report HRD Grant requests 2002-03

http://164.100.24.167/book2/reports/HRD/116threport.htm

VI. CENTRAL INSTITUTE OF PSYCHIATRY, RANCHI 6.1 The Plan allocation for the Central Institute of Psychiatry, Ranchi in BE 2001-2002 was Rs.7.00 crores which was drastically reduced to Rs.2.50 crores at the RE stage. Plan allocation for 2002-03 is Rs. 3.50 crores against the projected demand of Rs. 8.30 crores made by the Institute. On being asked to specify the reasons for drastic cut made in the allocation, the Department has clarified that the Plan budget of the Department of Health was reduced by Rs.104 crores at RE stage which had to be apportioned amongst the Institutes and Programmes. The amount of Rs.4.80 crores for purchase of equipments for the Institute was sanctioned only in December, 2001, by which time the RE had been decided and allocation of the Institute was cut due to low expenditure upto that date. 6.2 The exercise of purchasing the required equipments for the Institute has been continuing for a considerable period of time. The Committee has been informed that the amount of Rs. 4.80 crores for purchasing equipments was sanctioned in December, 2001. The Committee is, however, constrained to observe that the formal letter conveying the approval of the Competent Authority in this regard could be issued only on 19thFebruary, 2002. It is understood that at that time the Institute was having an unspent balance of Rs. 3,01,76,510 against which some of the equipments out of the sanctioned equipments could have been purchased during 2001-02 itself. The Committee apprehends that this amount could not have been utilized for want of completion of procedural formalities. This becomes clear from the request of the Institute for increased allocation of Rs. 8.30 crores for meeting the expenditure

towards purchase of equipments amounting to Rs. 4.80 crores. It seems that the Institute will have to wait upto the RE stage as the allocation of only Rs. 3.50 crores has been made for 2002-03. The Committee is deeply anguished at this state of affairs. The Committee, strongly recommends that the Department should suitably enhance the allocation of CIP, Ranchi so that these equipments which are essential to meet the needs of the patients can be procured at the earliest. 6.2 The Department has further informed that a proposal for creation/recreation of 41 posts at the Central Institute of Psychiatry based on the reports of the two Study Groups (one under the Chairmanship of Smt. Sunila Basant, then Joint Secretary in the Ministry and another Expert Group from NIMHANS, Bangalore) has been under the consideration of DGHS. Out of these 41 posts, Directorate General recommended for creation of only 24 posts, which are primarily required for augmenting the Institute. It was also indicated by the Ministry that 13 posts could be abolished to find some savings towards creation of the 24 posts, the expenditure for which after abolition of 13 posts was computed at Rs.38.00 lakhs per annum. The proposal was forwarded to the Department of Expenditure on 17.7.2001, which sought some additional information in a statement showing cases handled in the last 10 years, posts sanctioned in various grades and in existence, number of posts now to be created discipline-wise. The said information has been sent to the Department of Expenditure through the Internal Finance in January, 2002 for their approval and the approval is awaited. 6.4 The issue of creation of required posts for CIP, Ranchi started with an IWSU study conducted as early as in 1997. Thereafter, another study was conducted by NIMHANS IN 2000. Final outcome has been that out of the proposal for creation/recreation of 41 posts, only 24 posts have been recommended for creation by DGHS. 6.5 On a specific query about the scaling down of number of proposed posts, the Department has clarified that austerity measures and the ban on creation/revival /filling up of posts led to revision of the proposal. The Committee expresses its serious reservations on this development. What is more shocking is that as a bargain for creating these 24 posts, the Ministry has wished for abolishing 13 existing posts. 6.6 The Committee strongly feels that the position is very bad in CIP, Ranchi. Creation of required posts apart, even sanctioned posts are not filled up. Out of 19 teaching posts of Associate/Assistant/Professor, only 6 are filled up. Similarly, out of 24 non-teaching posts, only 9 are in position. The Committee is of the view that drastic steps need to be taken by all the concerned authorities so that the Central Institute of Psychiatry, Ranchi can provide the services in the area of mental health care which is very much required in the present scenario.

IX NATIONAL MENTAL HEALTH PROGRAMME 19.1 The Programme, started in 1982, envisages a community based approach to the problem. Funds are provided by the Govt. to the State Govts. and the nodal institutes to meet the expenditure on staff, equipments, training, IEC activities etc. At present, District Mental Health Programme is under implementation in 25 districts in 20 States. 19.2 Against a Plan allocation of Rs. 4.00 crores in RE 2001-02, allocation in BE 2002-2003

has been astronomically increased to Rs. 27.00 crores. The Department has informed that an increased allocation has been made for 2002-2003 based on the Tenth Five Year Plan proposal which envisages apart from sustaining the existing District Mental Health Programme, adding more districts to provide assistance for upgrading the infrastructure and modernization of the existing mental health facilities in mental hospitals and psychiatric departments of medical colleges; to undertake research in the field of mental health and to develop, disseminate and use IEC programmes at national level. 19.3 The Committee notes that shortage of trained psychiatric manpower and lack of awareness regarding treatment are the two main barriers to the provision of mental health services in the country. The Committee has been given to understand that about 4000 clinical psychologists, psychiatric social workers and psychiatric nurses are working in the country which is inadequate to meet the total needs of persons with mental disorders in the country. The shortage of psychiatric manpower is felt in all the States, specially in rural areas. The Committee strongly feels that there is a need for having systematic evaluation regarding Statewise requirement of manpower. The Committee also observes that mental health programmes are being implemented in a varying degree by different States. The Committee has been informed that the District Mental Health Programme is to be enlarged and made more effective covering the entire country during the Tenth Plan. The Committee feels that there is an urgent need for expanding the mental health services. While appreciating the substantive allocation of funds for this programme for 2002-03, the first year of Tenth Plan, the Committee would like to emphasise that there should be regular and extensive monitoring at all levels to ensure optimum and judicious utilization of funds. ~

2003 April 10 : 125th Report HRD

http://164.100.24.167/book2/reports/HRD/Report125th.htm DEPARTMENT-RELATED PARLIAMENTARY STANDING COMMITTEE ON HUMAN RESOURCE DEVELOPMENT HUNDRED TWENTY FIFTH REPORT ON ACTION TAKEN BY GOVERNMENT ON THE RECOMMENDATIONS/OBSERVATIONS CONTAINED IN THE HUNDRED SIXTEENTH REPORT ON DEMANDS FOR GRANTS 2002-2003 (DEMAND NO. 42) OF THE DEPARTMENT OF HEALTH (MINISTRY OF HEALTH AND FAMILY WELFARE)

CENTRAL INSTITUTE OF PSYCHIATRY, RANCHI Recommendation/Observation 6.6 The Committee strongly feels that the position is very bad in CIP, Ranchi. Creation of required posts apart, even sanctioned posts are not filled up. Out of 19 teaching posts of Associate/Assistant/Professor, only 6 are filled up. Similarly, out of 24 non-teaching posts, only 9 are in position. The Committee is of the view that drastic steps need to be taken by all the concerned authorities so that the Central Institute of Psychiatry, Ranchi can provide the services in the area of mental health care which is very much required in the present scenario.

Action Taken 6.6 The Directorate General of Health Services and the Central Institute of Psychiatry, Ranchi have been advised to take immediate urgent necessary action for filling up all vacant posts, including the 21 newly revived scientific posts. Action has been initiated to fill up these posts.

CHAPTER-II RECOMMENDATIONS/OBSERVATIONS WHICH THE COMMITTEE DOES NOT DESIRE TO PURSUE IN VIEW OF GOVERNMENT'S REPLY

CENTRAL INSTITUTE OF PSYCHIATRY, RANCHI

Recommendation/Observation 6.2 The exercise of purchasing the required equipments for the Institute has been continuing for a considerable period of time. The Committee has been informed that the amount of Rs.4.80 crores for purchasing equipments was sanctioned in December, 2001. The Committee is, however, constrained to observe that the formal letter conveying the approval of the Competent Authority in this regard could be issued only on 19th February, 2002. It is understood that at that time the Institute was having an unspent balance of Rs.3,01,76,510 against which some of the equipments out of the sanctioned equipments could have been purchased during 2001-02 itself. The Committee apprehends that this amount could not have been utilised for want of completion of procedural formalities. This becomes clear from the request of the Institute for increased allocation of Rs.8.30 crores for meeting the expenditure towards purchase of equipments amounting to Rs.4.80 crores. It seems that the Institute will have to wait up to the RE stage as the allocation of only Rs.3.50 crores has been made for 2002-03. The Committee is deeply anguished at this state of affairs. The Committee, strongly recommends that the Department should suitably enhance the allocation of CIP, Ranchi so that these equipments, which are essential to meet the needs of the patients, can be procured at the earliest. Action Taken The delay in issue of the formal approval of the competent authority was due to incorrect information submitted by the Institute regarding the availability of funds at the disposal of the Institute. The Institute was having only Rs.3.34 crores (Rs.3.29 crores under Plan and Rs. 0.05 crores under Non-Plan) in the Budget Estimates 2001-02 under the sub-head Machinery & Equipments. During 2002-03 an amount of Rs.1.07 crores (Rs.1.02 crores under Plan and Rs.0.05 crores under Non-Plan) has been provided to the Central Institute of Psychiatry under sub-head Machinery & Equipments in the Budget Estimates 2002-03. Additional requirement of funds under sub-head Machinery & Equipments will be taken up with Budget Division of the Ministry at the RE Stage. Recommendation/Observation The Department has further informed that a proposal for creation/recreation of 41 posts at the Central Institute of Psychiatry based on the reports of the two Study Groups (one under the Chairmanship of Smt.Sunila Basant, then Joint Secretary in the Ministry and another Expert Group from NIMHANS, Bangalore) has been under the consideration of DGHS. Out of these 41 posts, Directorate General recommended for creation of only 24 posts, which are primarily

required for augmenting the Institute. It was also indicated by the Ministry that 13 posts could be abolished to find some savings towards creation of the 24 posts, the expenditure for which after abolition of 13 posts was computed at Rs.38.00 lakhs per annum. The proposal was forwarded to the Department of Expenditure on 17.7.2001, which sought some additional information in a statement showing cases handled in the last 10 years, posts sanctioned in various grades and in existence, number of posts now to be created discipline-wise. The said information has been sent to the Department of Expenditure through the Internal Finance in January, 2002 for their approval and the approval is awaited. Recommendation/Observation 6.4 The issue of creation of required posts for CIP, Ranchi started with an IWSU study conducted as early as in 1997. Thereafter, another study was conducted by NIMHANS IN 2000. Final outcome has been that out of the proposal for creation/recreation of 41 posts, only 24 posts have been recommended for creation by DGHS. Recommendation/Observation 6.5 On a specific query about the scaling down of number of proposed posts, the Department has clarified that austerity measures and the ban on creation/revival/filling up of posts led to revision of the proposal. The Committee expresses its serious reservations on this development. What is more shocking is that as a bargain for creating these 24 posts, the Ministry has wished for abolishing 13 existing posts. Action Taken 6.3 to 6.5 The 41 posts were proposed for creation/re-creation/re-designation, includes Scientific and non-scientific posts by abolition of 13 posts. Out of these 41 posts, Directorate General of Health Services recommended for creation of 24 scientific posts, in the first instance, which are primarily required for functioning of the Institute. The proposal was taken up as recommended by the Directorate General of Health Services and orders for creation of these 21 scientific posts have been issued vide letter No. Z/15018/20/2000-RD Cell/PH dated 15th May, 2002. The Central Institute of Psychiatry, Ranchi and the Directorate General of Health Services will be requested to submit the proposal for creation/re-creation/redesignation of non-scientific posts with justification for further taking up the matter with the Department of Expenditure.

NATIONAL MENTAL HEALTH PROGRAMME

Recommendation/Observation 19.2 The Committee notes that shortage of trained psychiatric manpower and lack of awareness regarding treatment are the two main barriers to the provision of mental health services in the country. The Committee has been given to understand that about 4000 clinical psychologists, psychiatric social workers and psychiatric nurses are working in the country which is inadequate to meet the total needs of persons with mental disorders in the country. The shortage of psychiatric manpower is felt in all the States, specially in rural areas. The Committee strongly feels that there is a need for having systematic evaluation regarding Statewise requirement of manpower. The Committee also observes that mental health programmes are being implemented in a varying degree by different States. The Committee has been informed that the District Mental Health Programme is to be enlarged and made

more effective covering the entire country during the Tenth Plan. The Committee feels that there is an urgent need for expanding the mental health services. While appreciating the substantive allocation of funds for this programme for 2002-03, the first year of Tenth Plan, the Committee would like to emphasise that there should be regular and extensive monitoring at all levels to ensure optimum and judicious utilization of funds. Action Taken 19.3 About 1-2% of the population suffer from major mental disorders and about 5% of the population i.e., 50 million people suffer from minor depressive disorders. It is also estimated that 25% of people who attend primary health care clinics suffer from various types of psychological problems. However, most of these patients do not require hospitalization. There are presently 37 specialized mental hospitals in the country in the Government sector with a total bed strength of over 18,000 beds. In addition, the various medical colleges and general hospitals in the country have about 200 psychiatry units of varying sizes with bed strength varying 2-200, at an average of 20 beds. There are about 3,500 such beds available in such units. There are about 40 training centers for postgraduate study in psychiatry. In addition, there are about 40-50 private psychiatric facilities in the country. Availability of psychotropic drugs is satisfactory and the cost of such drugs is reasonable/affordable. Two mental hospitals namely NIMHANS, Bangalore and CIP, Ranchi are under the administrative control of the Central Government. A comprehensive study had been conducted in this regard by this Ministry in two workshops held in February 1999 for the Medical Superintendents of mental hospitals and in June, 1999 for State Health Secretaries regarding the minimum standard of care in mental hospitals. Further, the National Institute of Mental Health and Neuro-sciences, Bangalore an autonomous body under this Ministry, also undertook a review of the functioning of all the State-run mental hospitals and psychiatric units in a project commissioned by NHRC in 1999. Another detailed study of mental health care in the country was also undertaken by this Ministry in November-December, 2001 and in June-July, 2002 by all the State Governments on the direction of the Honble Supreme Court. The overall condition of mental health care delivery system in the country as assessed by Union Health Secretary on the basis of affidavits submitted by all the State Chief Secretaries, was placed before the Honble Supreme Court. In the affidavit it was pointed out that the Courts direction to the Central Government to set up at least one psychiatric hospital in each State for the purpose of making available increased manpower and facilities in the field of mental health, may not be proper and be reviewed, since as per the new scientific thinking, community based treatment is preferable and beneficial to the hospital based ones. The improved psychotic drugs can now be given in the community itself and the family bond between the patient and family members is maintained which results in quicker cure and rehabilitation. The mental health programme will, therefore, popularize community-based treatment required for a large number of cases of mental illness. It is in this context that the District Mental Health Programme will provide community care with treatment shifting from custodial to therapeutic. It removes stigmatization and isolation of mentally ill persons in society. The mental health programme will popularize community based treatment required for large number of cases of mental illness. Under the District Mental Health Programme, the mental hospitals and medical colleges which have professional expertise in the field are designated as nodal agencies to build a District Health Team to provide service to needy mentally ill patients at their families in

the district and adjoining areas. In service candidates and personnel appointed as clinical psychologist, trained social worker, psychiatrist, psychiatric nurse on contract basis are expected to perform the task of early detection of illness and quick treatment at the community level itself. There are presently few people choosing the field of psychiatry as a career, but still with the limited availability of personnel, through District Mental Health Programme, the activities have been expanded to cater to larger population. As a sequel to this approach, there is shift in emphasis from mental hospitals to upgrading psychiatric units in medical hospitals/colleges closer to the community. Secondly, as to the States demand for overcoming shortage of trained manpower in the categories of psychiatrists, clinical Psychologists, Psychiatric Social Worker and Psychiatric Nurses in mental hospitals, it was suggested to the State Governments that one of the ways to tide over the problem is that in-service personnel (Medical Officers, Social Workers and Nurses) may be detailed by the States/UT authorities concerned, for short-term skill-based training in the disciplines at reputed institutions such as NIMHANS, Bangalore and CIP, Ranchi. With the upgradation of infrastructure of mental hospitals, psychiatric units in medical colleges, expansion of District Mental Health Programme from 27 districts to 100 districts along-with IEC activities and research in the 10th Plan period, the need for proper mental health services with sufficient infrastructure and manpower is expected to be fulfilled. ~ http://164.100.24.167/book2/reports/HRD/Report135th.htm

2003 April : 135th REPORT ON DEMANDS FOR GRANTS 20032004

IX NATIONAL MENTAL HEALTH PROGRAMME 9.1 Plan allocation for National Mental Health Programme in BE 2003-2004 is Rs. 28.00 crores. The Committee notes that during 2002-2003, allocation for the Programme in BE was Rs. 27.00 crores which has been substantially reduced to Rs. 3.50 crores at the RE stage. Explaining the reasons the Department has given the information that an amount of Rs 27 crores was proposed at BE stage to implement a comprehensive National Mental Health Programme during the year 2002-03. However, the EFC meeting to consider the said programme for the 10th Five Year Plan was held only on 26.12.2002 and the minutes received in February, 2003. Further, the approval of the CCEA for the scheme is being taken. Therefore, the activities proposed for the year 2002-2003 viz; expansion of District Mental Health Programme, Strengthening of Psychiatric hospitals and psychiatric departments of Medical colleges, IEC and Research activities, could not be undertaken during 2002-2003, which led to drastic cut in the Revised Estimate stage for the year 2002-2003. However, during the year 2002-2003, as per the decision taken by EFC, it is now proposed only to sustain the District Mental Health Programme in districts which are already under implementation under IX Plan and which have not received the full five year assistance subject to submission of utilization certificate in respect of assistance provided during the previous years. Apart from sustaining the District Mental Health Programme, it is proposed to undertake further expansion of the programme strengthening or psychiatric hospitals and psychiatric departments of Medical Colleges IEC and Research activities during 2003-2004, on receipt of approval of CCEA; hence budget allocation has been increased.

9.2 The Committee is aware that due to ever increasing materialization, and consequent changes in life style, the cases of mental and psychological aberration are on the increase. The Committee notes with concern the delay in implementation of the comprehensive Mental Health Programme caused solely due to delay in holding the EFC meeting. The EFC meeting should have been held as per the requirements of the situation and not vice-versa. The Committee deprecates such delays and recommends that all out efforts should be made to ensure that such a situation does not recur and the comprehensive Mental Health Programme be fully implemented in the current year.

X IMPLEMENTATION OF HEALTH PROGRAMMES IN NORTH EAST SECTOR

Plan allocation for Implementation Of Health Programmes In North East Sector in BE 20032004 is Rs. 155 crores. The Committee notes that during BE 2002-2003, plan allocation was Rs. 155 crores which was reduced to Rs. 137.50 crores at the RE stage. 10.2 The scheme wise expenditure under Lumpsum Provision for projects /schemes of NEA and Sikkim is as follows : (Rs. in crore) S.No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Name of the Programme/scheme Funds earmarked Amount reappropriated for exp. 29.05 2.50 26.96 0.90 0.28 0.50 4.44 3.00 40.00 3.00 110.63

National Vector Borne Disease Control Programme 38.00 National Leprosy Eradication Programme 2.50 National TB Control Programme 5.00 National AIDS Control Programme 27.00 Integrated Disease Surveillance Programme National Blindness Control Programme 3.50 National Cancer Control Programme 5.00 National Mental Health Programme 1.00 Drug De-addiction Programme 0.50 New Initiatives in the Tenth Plan National Iodine Deficiency Disorder Programme 1.00 Assistance to States for Capacity Building 4.50 C.G.H.S. 3.00 NEIGRIHMS 40.00 Indian Council of Medical Research. 6.50 Total 137.50

10.3 The Committee notes that in respect of programmes such as National TB Control, National Blindness Control, National Cancer Control, National Mental Health, Drug Deaddiction, National Iodine Deficiency Disorder and Indian Council of Medical Research the amount re-appropriated for expenditure is much below the funds earmarked for them. The Committee deprecates the trend in view of the fact that the NE states, because of their inhospitable geography do not attract much of health care services. The Committee

observes that these border states need to be assured that they are a part of national mainstream and need to be provided what is due to them. At the same time efforts need to made to ensure optimum utilisation of funds to bring them at par with the rest of the Country. The Committee observes that the Country is way behind in providing state-of-the-art facilities and an efficient and responsive Health Care system in the Country. There is need for tremendous improvement all round and people must have the feeling that being a welfare state, it cares for the people. ~

2004 February 4 : 148th REPORT ON DEMANDS FOR GRANTS 2003-2004

http://164.100.24.167/book2/reports/HRD/148threport.htm ACTION TAKEN BY GOVERNMENT ON THE RECOMMENDATIONS/OBSERVATIONS CONTAINED IN THE HUNDRED THIRTY FIFTH REPORT ON DEMANDS FOR GRANTS 2003-2004 (DEMAND NO. 46) OF THE DEPARTMENT OF HEALTH III NATIONAL MENTAL HEALTH PROGRAMME:

Recommendations/Observation 9.1 Plan allocation for National Mental Health Programme in BE 2003-2004 is Rs. 28.00 crores. The Committee notes that during 2002-2003, allocation for the Programme in BE was Rs. 27.00 crores which has been substantially reduced to Rs. 3.50 crores at the RE stage. Explaining the reasons the Department has given the information that an amount of Rs 27 crores was proposed at BE stage to implement a comprehensive National Mental Health Programme during the year 2002-03. However, the EFC meeting to consider the said programme for the 10th Five Year Plan was held only on 26.12.2002 and the minutes received in February, 2003. Further, the approval of the CCEA for the scheme is being taken. Therefore, the activities proposed for the year 2002-2003 viz; expansion of District Mental Health Programme, Strengthening of Psychiatric hospitals and psychiatric departments of Medical colleges, IEC and Research activities, could not be undertaken during 2002-2003, which led to drastic cut in the Revised Estimate stage for the year 2002-2003. However, during the year 2002-2003, as per the decision taken by EFC, it is now proposed only to sustain the District Mental Health Programme in districts which are already under implementation under IX Plan and which have not received the full five year assistance subject to submission of utilization certificate in respect of assistance provided during the previous years. Apart from sustaining the District Mental Health Programme, it is proposed to undertake further expansion of the programme strengthening or psychiatric hospitals and psychiatric departments of Medical Colleges IEC and Research activities during 2003-2004, on receipt of approval of CCEA; hence budget allocation has been increased.

Recommendations/Observation 9.2 The Committee is aware that due to ever increasing materialization, and consequent changes in life style, the cases of mental and psychological aberration are on the increase. The Committee notes with concern the delay in implementation of the comprehensive Mental Health Programme caused solely due to delay in holding the EFC meeting. The EFC meeting should have been held as per the requirements of the situation and not vice-versa. The Committee deprecates such delays and recommends that all out efforts should be made to ensure that such a situation does not recur and the comprehensive Mental Health Programme be fully implemented in the current year. Action Taken 9.2 The recommendation of the Committee has been noted for compliance.

(X) IMPLEMENTATION OF HEALTH PROGRAMMES IN NORTH EAST SECTOR

Recommendations/Observation 10.2 The scheme wise expenditure under Lump sum Provision for projects /schemes of NEA and Sikkim is as follows : S.No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. (Rs. in crore) Name of the Programme/scheme Funds earmarked Amount reappropriated for exp. 29.05 2.50 26.96 0.90 0.28 0.50 4.44 3.00 40.00 3.00 110.63

National Vector Borne Disease Control 38.00 Programme National Leprosy Eradication Programme 2.50 National TB Control Programme 5.00 National AIDS Control Programme 27.00 Integrated Disease Surveillance Programme National Blindness Control Programme 3.50 National Cancer Control Programme 5.00 National Mental Health Programme 1.00 Drug De-addiction Programme 0.50 New Initiatives in the Tenth Plan National Iodine Deficiency Disorder Programme 1.00 Assistance to States for Capacity Building 4.50 C.G.H.S. 3.00 NEIGRIHMS 40.00 Indian Council of Medical Research. 6.50 Total 137.50

Recommendations/Observation 10.3 The Committee notes that in respect of programmes such as National TB Control, National Blindness Control, National Cancer Control, National Iodine Deficiency Disorder and Indian Council of Medical Research, the amounts re-appropriated for expenditure are much below the funds earmarked for them. The Committee observes that these border states need to be assured that they are a part of national mainstream and need to be provided what is due to them. At the same time efforts be made to ensure optimum utilization of funds to bring them at par with the rest of the country. The Committee observes that the country is way behind in providing state-of-the-art facilities and an efficient and responsive Health Care system in the country. There is need for tremendous improvement all round and people must have the feeling that being a welfare state, it cares for the people. Action Taken 10.3 National Mental Health Programme: The amount re-appropriated for expenditure has been indicated as nil. The fact is that a sum of Rs.4.04 lakhs have been re-appropriated vide letter No.G.23011/1/2002-Budget dated 31 st March, 2003 and was utilized. ~

2004 August : Health 1st Meeting

http://164.100.24.167/book2/reports/health/1streport.htm

XIV. NATIONAL MENTAL HEALTH PROGRAMME 14.1 The District Mental Health Programme was launched in 1996-97 in four districts, one each in Andhra Pradesh, Assam, Rajasthan and Tamil Nadu. The programme envisages a community base approach to the problem which includes training of the mental health team at the identified nodal institutes and also increasing awareness about mental health problems. The programme was extended to seven districts in 1997-98, five districts in 1998-99, districts in 1999-2000 and three districts in 2000-01. With the addition of two more districts in 2001-02, this programme is being implemented in 27 districts in 22 states. Funds are provided by the Central Government to State Governments for nodal institutes to meet the expenditure on staff, equipment, medicine, training, IEC and contingencies for an initial period of five years on the undertaking of the State Govts. to continue the programme on their own after the committed period of central assistance is over. 14.2: The Committee observes that it has taken the entire Ninth Plan (1997-2002) to cover 27districts in 22 states. Mental Health Programme has the following objectives in the Tenth Plan: Adequate funding/infrastructural support under District Mental Health Programmes to ensure delivery of mental health care through Primary Health Centres

Strengthening of departments of psychiatry in medical colleges Upgradation of Mental Hospitals Promotion of R&D Activities Promotion of IEC Activities

14.3: The Committee notes that an ambitious national Mental Health Programme with an approved outlay of Rs. 190 crores is proposed to be launched in the Tenth Plan. The Committee is of the view that the Department will have to take specific steps for expansion of this programme in the maximum number of districts in the country to achieve the targets set out in the Tenth Plan. The Committee is not aware whether any survey has been conducted so far with regard to prevalence of mental health problems in different states of the country. The Committee is of the view that in order to have effective implementation and maximum coverage; programme should first be extended to those districts where such cases have been noticed more as compared to other areas.
~

2005 March 11 : Health 4th Meeting

http://164.100.24.167/book2/reports/health/4threport.htm XIV.NATIONAL MENTAL HEALTH PROGRAMME Recommendations/Observations 14.2 The Committee observes that it has taken the entire Ninth Plan (1997-2002) to cover 27 districts in 22 States. Mental Health Programme has the following objectives in the Tenth Plan: Adequate funding/infrastructural support under District Mental Health Programmes to ensure delivery of mental health care through Primary Health Centres Strengthening of departments of psychiatry in medical colleges Upgradation of Mental Hospitals Promotion of R&D Activities Promotion of IEC Activities

Action Taken The Ministry has formulated a comprehensive National Mental Health Programme with an approved outlay of Rs. 190 crores to be implemented during the Tenth Plan. The underlying objective has been to diagnose mentally ill persons at an early stage and treat them in the community itself and therefore, improve the mental health care delivery system throughout the country. The mental health care is proposed to be improved at three levels: (a) at the district level by increasing coverage of District Mental Health Programme from 27 districts to 100 districts. Each such district will cover the adjacent 4 to 5 districts with a goal to cover all

districts in the country, (b) to strengthen psychiatric units of 75 medical colleges/general hospitals so that patients need not visit mental hospitals for minor and other major disorders, etc. (c) to improve the facilities at the 37 Government mental hospitals in order to cater to the needs of growing number of mentally ill patients who require treatment for major disorders. Action Taken On the direction of Supreme Court of India in the Erwadi case, Chief Secretaries of all the States have got conducted a need based survey about the mentally ill patients and the facilities available. It is on this basis that the State/UTs were requested, during the launch workshop on National Mental Health Programme held in October, 2003 by Central Government, to identify specific districts, psychiatric units and mental hospitals which require to be included in the programme for funding. On the basis of this criteria, the State Governments have submitted proposals which are under examination. It is felt that at the end of Tenth Plan, the National Mental Health Programme will have a maximum coverage of districts in the country and thus improve the mental health care. Recommendations/Observations 14.3 The Committee notes that an ambitious National Mental Health Programme with an approved outlay of Rs. 190 crores is proposed to be launched in the Tenth Plan. The Committee is of the view that the Department will have to take specific steps for expansion of this programme in the maximum number of districts in the country to achieve the targets set out in the Tenth Plan. The Committee is not aware whether any survey has been conducted so far with regard to prevalence of mental health problems in different states of the country. The Committee is of the view that in order to have effective implementation and maximum coverage; programme should first be extended to those districts where such cases have been noticed more as compared to other areas. COMMENTS OF THE COMMITTEE The Committee is of the view that in order to utilise the approved outlay of Rs. 190/- crores to implement the National Mental Health Programme during the Tenth Plan, necessary steps may be taken urgently on priority basis to identify the districts so as to increase the coverage to 100 districts as planned. The Committee is of the opinion that unless the districts are identified urgently the utilization of funds may not be achieved during the Tenth Plan (Para 14.3)
~

2005 April 28 : Health 7th Meeting

http://164.100.24.167/book2/reports/health/7threport.htm XIV NATIONAL MENTAL HEALTH PROGRAMME 14.1 It is estimated that about 5% of the population in the country suffers from various psychological disorders. About 1% of the population suffers from serious mental disorders and 0.5% of the population may be in the need of active treatment. The Central Govt. Supplements the efforts of the State Govts. in promoting mental health care. An amount of Rs. 139 crores has been allocated for this programme during the Tenth Plan, which was meant for expanding District Mental Health Programme to cover 100 districts, strengthening

37 Govt. mental health institutes and psychiatric wings of 75 medical colleges, undertaking IEC activities and research and training. 14.2 The Committee notes that during the Ninth Plan, there was an allocation of Rs. 28 crores under this Programme. However, utilization figures are only Rs. 18.19 crores. The Committee is constrained to observe that a massive enhancement of Plan allocation for this Programme during the Tenth Plan,i.e.Rs. 139 crores has failed to make any noticeable impact for the simple reason that allocated funds have remained unutilized so far. Against an allocation of Rs. 30.00 crore in 2002-03, the first year of Tenth Plan, utilization figures are only Rs. 9 lakhs. Actual expenditure figures for 2003-04 are not available. However, reduction of BE allocation of Rs. 30.00 to Rs. 5.00 crore at the RE stage clearly indicates the dismal achievement level. Full estimated expenditure of allocated funds of Rs. 33 crores in 2004-05 has been projected. In the event of success in achievement level in 2004-05, the fact remains that in the last year of the Tenth Plan, Rs. 100.91 crore out of total allocation of Rs. 139 crore are available under this programme. 14.3 The Committee finds that due to approval of the Scheme in December, 2002, no activity was there during the first year of Tenth Plan. Situation does not seem to have improved much as out of 48 districts envisaged to be covered during 2003-04, only 17 could be covered. With regard to target of modernization of 37 mental hospitals and up gradation of 75 medical colleges, progress charts shows zero performance rate of similar targets in the 2004-05 is not yet known. 14.4 The Committee has been informed that on the direction of Supreme Court in the Erwadi case, Chief Secretaries of all the States have got conducted a need-based survey about the mentally ill patients and the facilities available in the state. Subsequently, in a launch workshop held in October, 2003, all Health Secretaries were requested to identity specific districts, psychiatric units and mental hospitals which required to be funded under the Programme. The Committee is constrained to note that the appraisal exercise of proposals submitted by State Govts is still going on. The Committee would like to emphasize that the Deptt. should make concerted efforts to expedite the process of approval so that implementation could be started. The Committee would also like to point out that the eleven States/UTs which have failed to forward their proposals should be actively pursued for doing the same. 14.5 The Committee notes that the Central Mental Health Authority is supposed to oversee the implementation of the Mental Health Act, 1987. The Act also provides for creation of State Mental Health Authority. The Committee would like to be apprised about the number of States where such Authorities have been created. ~

2005 December 12 : Health 15th Meeting

http://164.100.24.167/book2/reports/health/15threport.htm CHAPTER- II RECOMMENDATIONS/OBSERVATIONS WHICH THE COMMITTEE DOES NOT DESIRE TO PURSUE IN VIEW OF THE GOVERNMENTS REPLIES XIV. NATIONAL MENTAL HEALTH PROGRAMME 14.2& 14.3 Recommendations/Observations The Committee notes that during the Ninth Plan, there was an allocation of Rs.28 crores

under this Programme. However, utilization figures are only Rs.18.19 crores. The Committee is constrained to observe that a massive enhancement of Plan allocation for this Programme during the Tenth Plan, i.e. Rs.139 crores has failed to make any noticeable impact for the simple reason that allocated funds have remained underutilized so far. Against an allocation of Rs.30.00 crore in 2002-03, the first year of Tenth Plan, utilization figures are only Rs.9 lakhs. Actual expenditure figures for 2003-04 are not available. However, reduction of BE allocation of Rs.30.00 to Rs.5.00 crore at the RE stage clearly indicates the dismal achievement level. Full estimated expenditure of allocated funds of Rs.33 crores in 2004-05 has been projected. In the event of success in achievement level in 2004-05, the fact remains that in the last year of the Tenth Plan, Rs.100.91 crore out of total allocation of Rs.139 crore are available under this programme. The Committee finds that due to approval of the Scheme in December, 2002, no activity was there during the first year of Tenth Plan. Situation does not seem to have improved much as out of 48 districts envisaged to be covered during 2003-04, only 17 could be covered. With regard to target of modernization of 37 mental hospitals and upgradation of 75 medical colleges, progress charts shows nil progress. Performance rate of similar targets in 2004-05 is not yet known. Action Taken During the 9th Plan, the National Mental Health Programme had only the component of District Mental Health Programme. Funds could not be released for the programme for want of Utilisation Certificates from the implementing agencies. However, during the 10th Plan, NMHP has apart from DMHP, other components like upgradation OF 37 Government mental hospitals, psychiatric wards of medical colleges/district hospitals, IEC, Research, etc. Accordingly increased outlay was provided. In the first two years of 10th Plan the funds could be released only to the districts under the on-going pilot project, as the revised National Mental Health Programme was launched only in October, 2003. Since, utilization certificates were not forthcoming from the old districts, the allocated funds could not be utilized during the first two years. The new NMHP has several other components along with the district component of earlier pilot project viz. upgradation of Mental Health Institutes, strengthening of psychiatric wings of medical colleges and general hospitals, research and IEC activities. The proposals from the State Governments, which had been called for in October, 2003, had to be appraised before funding for the effective implementation. However, 17 new districts were sanctioned under the District Mental Health Programme and an amount of Rs.4.92 crores was utilized as against Rs.5.00 crore in the RE 2003-04. During 2004-05, 50 more new districts have been funded apart from 9 medical colleges and one mental health institute. Proposals for upgradation of other institutions are also being evaluated and funds would be released during the current year. Funds were also released for I.E.C. and Research activities. The total expenditure during 2004-05 was Rs.19.39 crore against BE of Rs.33 crore, as the allocation was reduced to Rs.21 crore in the RE. 14.5 Recommendations/Observations The Committee notes that the Central Mental Health Authority is supposed to oversee the implementation of the Mental Health Act, 1987. The Act also provides for creation of State mental Health Authority. The Committee would like to be appraised about the number of States where such Authorities have been created.

Action Taken The State Mental Health Authority had been constituted in 25 States and Union Territories. CHAPTER III RECOMMENDATIONS/OBSERVATIONS IN RESPECT OF WHICH REPLIES OF THE GOVERNMENT HAVE NOT BEEN ACCEPTED BY THE COMMITTEE XIV. NATIONAL MENTAL HEALTH PROGRAMME 14.4 Recommendations/Observations The Committee has been informed that on the direction of Supreme Court in the Erwadi case, Chief Secretaries of all the States have got conducted a need-based survey about the mentally ill patients and the facilities available in the states. Subsequently, in a launch workshop held in October, 2003, all Health Secretaries were requested to identify specific districts, psychiatric units and mental hospitals which required to be funded under the programme. The Committee is constrained to note that the appraisal exercise of proposals submitted by State Governments is still going on. The Committee would like to emphasize that the Deptt. should make concerted efforts to expedite the process of approval so that implementation could be started. The Committee would also like to point out that the eleven States/UTs which have failed to forward their proposals should be actively pursued for doing the same. Action Taken The reports of the Appraisal Teams received are being processed and it is expected to utilize the allocated funds in full during 2005-06. Comments of the Committee The Committee is constrained to observe that the reports of the State Appraisal Teams regarding identification of specific districts, psychiatric units and mental hospitals to be funded under the Mental Health Programme are still being processed. The Department has also failed to specify whether reports have been received from all the States. The Committee urges upon the Department to expedite the process so that there is optimum and judicious utilisation of the allocated funds. ~

2005 April 28 : 9th parliamentary report Grant requests 2005-06 AYUSH

http://164.100.24.167/book2/reports/health/9threport.htm

V. HOSPITALS AND DISPENSARIES

Advanced Ayurvedic Centre for Mental Health in NIMHANS 5.1 An Advanced Ayurvedic Centre for Mental Health was proposed to be set up in NIMHANS, Bangalore. Accordingly Rs. 1.45 crore were provided in Ninth Plan. The Committee observes that although Rs. 97 lakhs were spent during the Ninth Plan period, nothing seems to have materialized in the operationalisation of the centre. The Committee has to make such a comment only because of trend of expenditure in the three years of the Tenth Plan. Rs. 26 lakhs were provided in 2002-03 but the allocated funds remained unutilized. There was no provision during 2003-04. However, in 2004-05 Rs. 1 lakh has been provided for this Centre. The Committee strongly feels that any scheme/plan proposed to be implemented should only be taken up after due consideration of its feasibility and other allied aspects. Advanced Ayurvedic Centre for Mental Health in NIMHANS, Bangalore seems to have been forsaken by the Department. The Committee would like to be apprised about the actual status of this Centre.

2005 December 21 : 14th parliamentary report Grant requests 2005-06 AYUSH

http://164.100.24.167/book2/reports/health/14threport.htm V. HOSPITALS AND DISPENSARIES

Advanced Ayurvedic Centre for Mental Health in NIMHANS

Recommendations/Observations 5.1 An Advanced Ayurvedic Centrefor Mental Health was proposed to be set up in NIMHANS, Bangalore. Accordingly Rs. 1.45 crore were provided in Ninth Plan. The Committee observes that although Rs. 97 lakhs were spent during the Ninth Plan period, nothing seems to have materialized in the operationalisation of the centre. The Committee has to make such a comment only because of trend of expenditure in the three years of the Tenth Plan. Rs. 26 lakhs were provided in 2002-03 but the allocated funds remained unutilized. There was no provision during 2003-04. However, in 2004-05, Rs. 1 lakh has been provided for this Centre. The Committee strongly feels that any scheme/plan proposed to be implemented should only be taken up after due consideration of its feasibility and other allied aspects. Advanced Ayurvedic Centre for Mental Health in NIMHANS, Bangalore seems to have been forsaken by the Department. The Committee would like to be apprised about the actual status of this Centre. Action Taken During the 9th Plan, it was proposed to upgrade the Central Research Unit (CRU) of Ayurveda, a unit of the CCRAS situated within the Compound of the NIMHANS, Bangalore, to the level of the Advanced Ayurveda Centre (AAC) for Mental Health & Neuro Science with the setting up of a 30 bed IPD and strengthening of the existing research activities.

Since the CRU is a small unit having no expertise to implement Civil construction activities as such the responsibility was entrusted to the NIMHANS, which is having its own Civil Engineering wing. The new building with 30 beds IPD has been completed by the NIMHANS in May, 2003 and handed over to the CCRAS. The ACA has shifted to its new building under the administrative control of the CCRAS, as it was prior to its upgradation. The budget for ACA is being provided as a component of the budget of the CCRAS and the notional allocation of Rs.1.00 lakh, for NIMHANS, has been made erroneously. The ACA, is a specialized unit of the CCRAS and is being strengthened by providing additional budget and Personnel. ~

2005 December 21 : 15th parliamentary report Grant requests 2005-06

http://164.100.24.167/book2/reports/health/15threport.htm XVI NATIONAL MENTAL HEALTH PROGRAMME Recommendations/Observations 16.2 Tenth Plan outlay of Rs. 139 crore was approved for the National Mental Health Programme. However, the Committee notes that although funds were released every year during the Plan period, utilization figures reveal a very discouraging picture. During the first three years of the Plan period, against an allocation of Rs. 90.00 crore, expenditure reported is only Rs. 33.55 crore. The Committee apprehends that expenditure would not have shown any increasing trend in 2005-06 in spite of there being an enhanced allocation of Rs. 40.00 crore. The main factor responsible for this state of affairs was the delay in approval of the revised District Mental Health Programme. As a result, against a target of up gradation of 37 Govt. Mental Hospitals and 75 medical colleges during the Tenth Plan period, only 18 Govt. Mental Hospitals and 13 medical colleges could be funded, as per the latest reports. The Committee hopes that during the last year of the Tenth Plan, the programme would ultimately take off and implemented as envisaged. The Committee is also of the view that shortage of trained psychiatric manpower and lack of awareness regarding treatment, the two major constraints of the programme need to be addressed without any further delay. Action Taken During the Tenth Five Year Plan it is envisaged to expand District Mental Health Programme to cover 100 districts in the country, strengthen the 37 Government mental health institutes and also psychiatric wings of 75 medical colleges, undertake IEC activities and research and training. So far 94 districts have been covered under the District Mental Health Programme; funds have been released for up-gradation of psychiatric wings of 24 medical colleges and 19 Mental Hospitals. Further, funds have also been released for undertaking research and IEC activities. In fact, during the year 2005-06, under National Mental Health Programme Rs.46.00 crores has been released (Rs.40.00 crores from the NMHP Programme and Rs.6.00 crores under North East Funds). As regards shortage of trained psychiatric manpower, there are over 3000 qualified psychiatrists, 500 clinical psychiatrists, 300

psychiatric social workers and about 400 trained psychiatric nurses in the country. The effort of the Government is to diagnose the mentally ill patients at an early stage and treat them through the general health deli9very system. For this purpose under the National Mental Health Programme, the General Duty Medical Officers are given short-term training in the field of psy- chiatry for handling cases of mental illness. The Government is also providing primary treatment to the common man through the District Mental Health Programme (DMHP). Comments of the Committee The Committee is pleased to note that under the District Mental Health Programme, out of 100 districts to be covered during the 10 thFive Year Plan, 94 districts have been covered. However, in respect of the target of upgradation of 75 medical colleges and 37 Govt. mental hospitals, during the same period, the achievement figures so far are only 24 & 19 respectively. Therefore, the performance of the Department in this regard has fallen woefully short of its target. With only a few months left for the completion of the 10 thPlan, the Committee has serious doubts whether these targets will ever be achieved. The Committee feels that up-gradation of these medical hospitals and mental hospitals is required to be carried out on an urgent basis as it will help in curing the patients at the initial stage and save him or her from the agony of being sent to the mental asylum. ~

2006 May 22 : 16 th Parliamentary committee report grant request 2006-07

http://164.100.24.167/book2/reports/health/16threport.htm XVI NATIONAL MENTAL HEALTH PROGRAMME 16.1 The Programme envisages a community based approach to the problem which includes training of the mental health workers at the identified nodal institutes within the State, increasing awareness about mental health problems, providing services for early detection and treatment to community and providing valuable data and experience for future planning improvement in service and research. 16.2 Tenth Plan outlay of Rs. 139 crore was approved for the National Mental Health Programme. However, the Committee notes that although funds were released every year during the Plan period, utilization figures reveal a very discouraging picture. During the first three years of the Plan period, against an allocation of Rs. 90.00 crore, expenditure reported is only Rs. 33.55 crores. The Committee apprehends that expenditure would not have shown any increasing trend in 2005-06 in spite of there being an enhanced allocation of Rs. 40.00 crore. The main factor responsible for this state of affairs was the delay in approval of the revised District Mental Health Programme. As a result, against a target of up gradation of 37 Govt. Mental Hospitals and 75 medical colleges during the Tenth Plan period, only 18 Govt. Mental Hospitals and 13 medical colleges could be funded, as per the latest reports. The Committee hopes that during the last year of the Tenth Plan, the programme would ultimately take off and implemented as envisaged. The Committee is also of the view that shortage of

trained psychiatric manpower and lack of awareness regarding treatment, the two major constraints of the programme need to be addressed without any further delay. ~

2007 February 26 : 108th Parliamentary committee report review of Papers Laid on Table
http://164.100.24.167/book2/reports/plaid/108threport.htm PART-IV

NATIONAL INSTITUTE OF MENTAL HEALTH AND NEURO SCIENCES (NIMHANS), BANGALORE

The National Institute of Mental Health and Neuro Sciences is a multidisciplinary Institute for patient care and academic pursuit in the frontier area of Mental Health and Neuro Sciences. The Lunatic Asylum which came into being in the latter part of the 19 th Century was renamed as Mental Hospital in 1925 by the erstwhile Government of Mysore. This hospital and All India Institute of Mental Health established in 1954 by Government of India were amalgamated on 27 th December 1974, and thus was formed the autonomous National Institute of Mental Health and Neuro Sciences (NIMHANS). The priority gradiant adopted at the Institute is service, manpower development and research. Multidisciplinary integrated approach is the mainstay of this Institute, paving the way to translate the results from the bench to the bedside. On November 14, 1994 NIMHANS has been declared a Deemed University by the University Grants Commission, with academic autonomy. The Institute functions under the direction of the Ministry of Health and Family Welfare, Govt. of India and Ministry of Health and Family Welfare, Government of Karnataka. Several national and international funding organisations provide resources for research. The mission of the Institute are as follows: Evolve strategies to offer diagonostic and therapeutic facilities to all corners of India in the field of Mental Health and Neurosciences utilizing the advances in information technology and to be the nodal centre. Establish training facilities and impart knowledge in the field of Mental Health and Neurosciences to all the developing countries by institutional and distance learning.

 Establish state-of-the-art diagnostic and therapeutic facilities in neurological disorders with special reference to genetically transmitted disorders and vaccinology of tropical infectious diseases and be the nodal center for the country in research and development. Develop strategies for Disaster Management and Psychological Rehabilitation. Integrate physical and metaphysical aspects of Neuroscience Research. Participate in Neuroscience and Behavioural Research related to Space, Atomic Energy and Transplantation. Be part of world leadership in the field of Neuroscience and Behavioural Science. 2. The recommendation of the Committee on Papers Laid on the Table Rajya Sabha (1 st Report) requires that the Annual Report and Audited Accounts of the Government Company/Organization are to be laid on the Table of the Rajya Sabha within 9 months from the date of closure of its annual accounts. As the accounts of the NIMHANS close on the 31 st March every year, the Annual Reports and Audited Accounts of the Institute have to be laid by the 31stDecember. 3. The laying position of the Annual Reports and Audited Accounts of the NIMHANS from 19981999 onwards is as under: Year 1998-99 1999-00 2000-01 2001-02 2002-03 2003-04 2004-05 Due Date 31.12.1999 31.12.2000 31.12.2001 31.12.2002 31.12.2003 31.12.2004 31.12.2005 Laid on 22.12.2000 03.12.2001 12.08.2002 05.05.2003 26.08.2004 06.05.2005 23.12.2005 Y 00 00 00 00 00 00 Delay M 11 11 07 04 07 04 In Time

D 21 02 11 04 25 05

4. It is apparent that there has been persistent delay in laying the papers of the Institute for the years 1998-99 onwards. The delay ranges from 4 months to 11 months 21 days. As per the recommendations of the Committee, in case of anticipated delay, the Ministry should approach the Committee sufficiently in advance and seek extension of time for laying the papers by citing cogent reasons for doing so. In the instant case, the Ministry had failed to do so, it had not sought extension of time for past few years 5. The Committee in its meeting held on the 13 th September, 2006 considered the laying position of the Annual Reports and Audited Accounts of the NIMHNS and decided to seek clarifications thereon

from the Institute. The Committee met the representatives of both the Institute and the Ministry of Health & Family Welfare at the headquarters of the Institute on the 7th November, 2006. 6. While explaining the reasons for delay, the Director of the Institute informed the Committee that the delay had occurred either due to delay in compilation/preparation of Annual Accounts or in receipt of Audit certificate. 7. Following is the details of various stages for laying the Annual Reports and Audited Accounts of the Institute and the time taken in processing the each stage for the last 7 years:
Particular 1998-99 Date of handing over of draft 7.9.99 accounts to AG Date of Audit 4.10.99 6.3.00 Date of Receipt of Audit Report24.8.00 alongwith certified accounts Date of placement before Finance20.10.00 Committee Date of placement before Board22.12.00 of Management Date of sending to the Ministry18.09.00 for placing before Parliament Date of placing on the Table of22.12.00 the House 1999-00 6.10.00 YEAR 2000-01 31.8.01 2001-02 26.08.02 2002-03 24.07.03 2003-04 3.08.04 2004-05 28.7.05

to27.11.00 to15.10.01 to4.09.02 to4.8.03 to09.08.04 to16.08.05 to 7.2.01 15.12.01 27.11.02 29.08.03 15.10.04 22.10.05 13.6.01 27.02.02 30.01.03 17.10.03 14.12.04 23.11.05 16.6.01 3.7.01 11.09.01 03.12.01 27.03.02 30.03.02 21.06.02 12.08.02 05.02.03 15.03.03 18.03.03 05.05.03 21.10.03 10.11.03 1.12.03 26.08.04 20.12.04 25.01.05 25.02.05 06.05.05 24.11.05 24.11.05 28.11.05 23.12.05

8. It is seen from the above table that for all the years since 1998-99 the draft accounts had been handed over to AG at least after 5 months (maximum after 7 months) of closure of accounts on 31st March. The Committee observes that such delays can be avoided if the various stages in preparing the accounts are streamlined and monitored properly. 9. The Committee then raised the matter relating to laying of a comprehensive delay statement alongwith the Annual Reports and Audited Accounts. The representative of the Ministry regretted the failure to furnish detailed information in the delay statements for the years 2002-03 and 2003-04 in chronological order. The Committee observes that the Institute and the Ministry both are fully responsible for laying of the papers as per the recommendations of the Committee. The Committee, therefore, directs the Ministry and the Institute to streamline the affairs at their end and adhere to the recommendations of the Committee in this regard. 10. The Committee further impresses upon the Ministry to follow a proper procedure for seeking extension of time and approach the Committee sufficiently in advance for seeking

extension of time in case of delay in laying of the papers by citing cogent reasons and lay the papers on the Table of the House within the extended period granted by it. 11. The Committee directs the Ministry as well as the NIMHANS to take all possible steps to ensure that the accounts of the Institute are updated and its future reports are laid on the Table of the House in time. 12. The Committee expresses hope that the Ministry of Health and Family Welfare and NIMHANS would take necessary action to fulfil statutory requirement of ensuring timely laying of the Annual Reports and Audited Accounts of the Institute on the Table of the House. ~

2007 March 8 : 20th Parliamentary committee report grant request 2006-07

http://164.100.24.167/book2/reports/health/20threport.htm XVI NATIONAL MENTAL HEALTH PROGRAMME Recommendations/Observations 16.2 Tenth Plan outlay of Rs. 139 crore was approved for the National Mental Health Programme. However, the Committee notes that although funds were released every year during the Plan period, utilization figures reveal a very discouraging picture. During the first three years of the Plan period, against an allocation of Rs. 90.00 crore, expenditure reported is only Rs. 33.55 crore. The Committee apprehends that expenditure would not have shown any increasing trend in 2005-06 in spite of there being an enhanced allocation of Rs. 40.00 crore. The main factor responsible for this state of affairs was the delay in approval of the revised District Mental Health Programme. As a result, against a target of up gradation of 37 Govt. Mental Hospitals and 75 medical colleges during the Tenth Plan period, only 18 Govt. Mental Hospitals and 13 medical colleges could be funded, as per the latest reports. The Committee hopes that during the last year of the Tenth Plan, the programme would ultimately take off and implemented as envisaged. The Committee is also of the view that shortage of trained psychiatric manpower and lack of awareness regarding treatment, the two major constraints of the programme need to be addressed without any further delay. Action Taken During the Tenth Five Year Plan it is envisaged to expand District Mental Health Programme to cover 100 districts in the country, strengthen the 37 Government mental health institutes and also psychiatric wings of 75 medical colleges, undertake IEC activities and research and training. So far 94 districts have been covered under the District Mental Health Programme; funds have been released for up-gradation of psychiatric wings of 24 medical colleges and 19 Mental Hospitals. Further, funds have also been released for undertaking research and IEC activities. In fact, during the year 2005-06, under National Mental Health Programme

Rs.46.00 crores has been released (Rs.40.00 crores from the NMHP Programme and Rs.6.00 crores under North East Funds). As regards shortage of trained psychiatric manpower, there are over 3000 qualified psychiatrists, 500 clinical psychiatrists, 300 psychiatric social workers and about 400 trained psychiatric nurses in the country. The effort of the Government is to diagnose the mentally ill patients at an early stage and treat them through the general health deli9very system. For this purpose under the National Mental Health Programme, the General Duty Medical Officers are given short-term training in the field of psychiatry for handling cases of mental illness. The Government is also providing primary treatment to the common man through the District Mental Health Programme (DMHP). Comments of the Committee The Committee is pleased to note that under the District Mental Health Programme, out of 100 districts to be covered during the 10 thFive Year Plan, 94 districts have been covered. However, in respect of the target of upgradation of 75 medical colleges and 37 Govt. mental hospitals, during the same period, the achievement figures so far are only 24 & 19 respectively. Therefore, the performance of the Department in this regard has fallen woefully short of its target. With only a few months left for the completion of the 10 thPlan, the Committee has serious doubts whether these targets will ever be achieved. The Committee feels that up-gradation of these medical hospitals and mental hospitals is required to be carried out on an urgent basis as it will help in curing the patients at the initial stage and save him or her from the agony of being sent to the mental asylum. ~

2007 May 3 : 22nd Parliamentary committee report on grant requests 2007-08

http://164.100.24.167/book2/reports/health/22ndreport.htm XVIII NATIONAL MENTAL HEALTH PROGRAMME (NMHP) 18.1. Main strategies of National Mental Health Programme duringthe TenthPlan period are as follows: Expansion of DMHP to 100 districts all over the country. Strengthening and modernization of mental hospitals Upgradation of psychiatry wings in the general hospital/ medical colleges. Research & training in Mental Health for improving service delivery 18.2 NMHP now covers 94 districts in 29 States/UnionTerritories all over the country. The programme envisages a community based approach to the problem, which includes: Training of mental health team at the identified nodal institutions. Increase awareness about Mental Health problems. Provide services for early detection & treatment of mental illnesses in the community (OPD/Indoor & follow up)

Provide valuable data & experience at the level of community at the state & center for future planning & improvement in service & research. 18.3 Plan allocation of Rs. 50.00 crores for 2006-07 under these programme had to be reduced to Rs. 45.00 crores at the RE stage. Reason given by the Department is non-receipt of complete proposals from State Government/ Institutions.The Committee is constrained to note that against this reduced provision, expenditure reported upto 15 thFebruary, 2007 was only Rs. 24.01 crores. Committee had been given to understand that provisional expenditure as on 31stMarch, 2007 would be Rs. 35.93 crores. The Committee takes a serious view of this trend of utilization of funds during 2006-07. The Committee urges upon the Department to take all possible measures to ensure optimum utilization of Rs. 70.00 crores proposed for 2007-08. Feed-back made available to the Committee clearly indicates that inspite of special efforts being made on the part of the Department for expediting utilization certificates for grants released to various states, not much progress could be made. The Committee views with serious concern the achievements reported under upgradation of mental hospitals also. Out of the 10 targeted mental hospitals, funds could be released only for mental hospital atIndore. 18.4The Committee notes that in a meeting held on 12 thFebruary, 2007 representatives of State Governments were requested to furnish new proposals with all requisite information under the programme. The Committee feels that this is a step in the right direction and such interactions should continue to be held in future also. 18.5 As per the information given in the Annual Report the Department has identified the following issues and challenges in respect of NMHP as given below: Strengthening of DMHP & enhance its visibility at grass root level. Filling up manpower gap in the field of psychiatry in general & DMHP in particular. Harnessing NGOs help in the community based care of mentally ill. Focusing on preventive & promotive components of mental health in addition to treatment of serious mental ailments. Strengthening the EIC activities particularly in the School Health Programme. Training of general practitioners in Mental Health Programme. Need to develop the urban Mental Health Programme. Development of standardized training manuals for doctors and health care workers. 18.6 The Committee would like to be informed about the manner in which it proposes to meet these challenges during the Eleventh Plan. The Committee would also like to be informed about the specific steps taken to bridge the manpower gap in the field of psychiatry in general and DMHP in particular, to harness NGOs help in this field and to train general practitioners in Mental Health Programme. http://164.100.24.167/book2/reports/health/22ndreport.htm
~

2010 April 28 : 39th REPORT HEALTH

THIRTY-NINTH REPORT ON DEMANDS FOR GRANTS 2010-11 (DEMAND NO.46) OF THE DEPARTMENT OF HEALTH AND FAMILY WELFARE (MINISTRY OF HEALTH AND FAMILY WELFARE) CLICK HERE FOR DOCUMENT :

http://164.100.47.5/newcommittee/reports/EnglishCommittees/Committee %20on%20Health%20and%20Family%20Welfare/website%20report%20of %20H&FW.pdf