The Royal Audit Authority (RAA) had asked the health ministry to justify how the construction of a 40-bed hospital in Tsirang became a 20-bed hospital.

The initial project was to construct a 40-bed hospital in Damphu, Tsirang. However, the RAA has found that the ministry had constructed 20-bed hospital.

According to sources, the initial plan was to build a 20-bed hospital but the proposal was made for 40-beds. However, when the tender for the works was floated, it was for a 20-bed hospital. 

The RAA’s report, which was issued on May 25, 2018 has asked the ministry to produce an approval of the competent authority for the change in design from the initial 40-bed hospital as proposed and accepted under Project Tied Assistance (PTA) by the Government of India (GoI) to a 20-bed hospital in actual construction in Tsirang. The ministry has three months to respond.

Health secretary Dr Ugen Dophu said that in all official communications, it was communicated as a 20-bed hospital.  

The RAA made a comparison of architectural drawings of the recently audited 40-bed hospital in Samtse with the 20-bed Tsirang hospital. 

It found that the 40-bed Samtse hospital was estimated at Nu 199.69M (million) and tendered for Nu 226.446M. While the 20-bed Tsirang hospital was estimated for Nu 228.768M and tendered at Nu 225.611M.

The RAA observed that this shows that the construction of the 20-bed Tsirang hospital was costing at par with the cost of 40-bed Samtse hospital, which has double the number of floors and room sizes.

Dr Ugen Dophu said that most of the dzongkhag hospitals built earlier were 20-bed with X-Ray facilities. “Now, we are installing ultrasound, dental chair and traditional medicine unit. Moreover, the overall construction cost has also increased over the years.”

The standard of the earlier built 20 bed hospitals and that of now is different because of new facilities like this, he said.

The RAA found a difference of 3,965.42sqm in the floor areas and 547.4sqm in the room sizes of the two hospitals.

In response to the audit memo that was issued, the ministry responded that the total built-up area of Tsirang hospital is less than Samtse hospital. Space constraint and building norms, the ministry said, restricted the designers to expand the building dimensions horizontally and vertically. Because of this, the ministry stated that it had no options than to approve the design considering the limitations. 

Despite the difference in the size, the ministry stated that the hospital could accommodate 40 beds. 

Other facilities, which were not incorporated in the main building such as a medical store, mortuary, water treatment plant and general store for waste segregation, are under construction to suffice the standard requirement of a 40-bed hospital.

It was learnt that in response to an inquiry by the Gross National Happiness Commission (GNHC) in 2015, the ministry justified that Tsirang hospital is a 40 bed hospital as stated in the initial plan document and not 20-bed as mentioned in the tender which can be proved from the hospital drawing.

The ministry stated that there wouldn’t be any contractual obligations, as the contractor is required to execute the work based on the drawings and bills of quantity, which is provided to the contractor as part of the tender document irrespective of the fact that the project is titled as 20-bed.

However, the RAA found that the 20-bed hospital has not only deviated from the initial approved design of 40-bed hospital under the GoI, PTA but was in contradiction to the justification submitted to the GNHC. 

Of the total Nu 254.430M approved budget for the construction of the 40-bed Tsirang hospital, the ministry had received and spent Nu 194.565M to date. 

It was also found that an amount of Nu 5,320,234 was diverted to Samtse hospital on account of clearing contractual obligation of the construction firm that executed the construction works of Samtse hospital. The project management and the ministry’s Administration and Finance Department have not recovered the fund to date.

According to sources, the ministry was also asked to justify for diverting the committed project fund to other capital works without the approval of the finance ministry.

The health ministry stated that there was a requirement for the ministry to clear the pending claims of Samtse hospital, as there was no fund balance for the hospital. To avoid contractual obligations and also to minimise underutilisation of the allocated fund for Tsirang hospital, the ministry had to pay the amount as an interim measure to other projects. 

The ministry stated that it had already taken up the matter with the GNHC for recouping the funds to Tsirang hospital project and the decision would be conveyed to RAA in due course.

RAA has asked the project management to immediately recoup the fund to Tsirang hospital construction and produce relevant documents for review and verification. 

When Kuensel reported on the hospital’s groundbreaking ceremony attended by the information and communications minister, DN Dhungyel in May 2015, it was reported as a 40-bed hospital.

Lyonpo DN Dungyel had then said that a sum of Nu 254M has been earmarked by the GoI for the construction of a 40-bedded hospital, which is scheduled for completion within the Plan.

The hospital’s construction, which was scheduled to complete by May this year is extended to the end of this month.

Dechen Tshomo