Two years of AAP govt: Are mohalla clinics a game changer in Delhi?
Over five months, 110 mohalla clinics have treated 8 lakh patients, as per the government data. The AAP government showcased this as a path breaking achievement and received international acclaim. However, insiders believe that the project is still in its nascent stage and is far from being a game changer for health sector.
World leaders like former UN secretary general Kofi Annan and former WHO director general Dr Gro Harlem Brundtland praised the project for aiming to provide free public health care and indicated the need to scale up the project as well as improve its management. “The project could be a model for all Indian states embarking on the UHC (Universal Health Care) journeys,” read the letter to Delhi chief minister Arvind Kejriwal by Annan in his capacity as chair of The Elders, an organisation of independent global leaders founded by Nelson Mandela.
The government had planned to set up 1,000 mohalla clinics for consultation, medicines and tests free of cost by the end of 2016. This deadline has been extended to March 2017 but it is unlikely that the government will be able to meet it. With, only around 110 mohalla clinics functional, the AAP government has sought to take refuge in its infamous tussle with the lieutenant governor and Centre.
“The government had said that the project will reduce over-crowding in tertiary care centres like ours. However, the impact cannot be felt just with the 100 clinics. Once the project is complete we will be able to see the results,” said Punita Mahajan, medical director of Baba Saheb Ambedkar hospital.
Doctors working with the project also point to some inconsistencies.
“Looking at just the model clinic is not enough. Apart from routine out-patient clinic, we provide immunisation to children, DOTS centre for TB treatment and counselling for male sterilisation but these services are not available in the other clinics,” said Dr Alka Choudhary, who is posted in Peera Garhi Mohalla Clinic. Also, all clinics are not able to provide the promised 212 tests; her clinic provides only 25 tests, she said.
Space constraint and slow technology also add to the woes of doctors. “Since the time the clinic has started, the number of people has kept on increasing, so much so, that there is no place for the patients to wait. Add to that the slow tabs and the numerous fields we have to fill in, the wait period just keeps on increasing,” said Dr Preeti Saxena from Pandav Nagar mohalla clinic.
The BJP has also flagged the lack of monitoring in the project that has allegedly resulted in doctors giving inflated numbers to get bigger pay checks as they get paid on per patient basis. “I know of clinics where people with chronic conditions like COPD, asthma, diabetes are called every other day to get their medicines. This is done to drive up the OPD numbers as they get paid ₹30 per patient,” said Dr Choudhary, who is a contractual doctor under NRHM and has been posted in the clinic.
“Initially, doctors inflating the numbers for more money was a concern for us too but we later realised that these clinics receive so many patients that the doctor can either treat them or sit and fill in records,” a Delhi government official said.