NEW DELHI: It was 10 on a sultry monsoon morning. The single room on the ground floor of an apartment building at Hari Nagar, Ashram was teeming with heads. The ones occupying every inch of space in the tiny room were patients waiting their turn. A hoarding in Hindi, barely big enough to draw notice, screamed, ‘Mohalla Clinic’.
Stacked neatly about in the room, too humble to crave attention or even qualify as a clinic, where boxes containing medicines. While some visitors patiently parked themselves wherever they could, others jostled for space in a bid to beat the rest to the doctor.
“Why would I spend money going to a private clinic when I can get my son treated for free here? My son got drenched in the rain a few days ago and came down with fever. So I brought him here. I’m also planning on getting a routine check-up done for myself,” said Raja Chabey, of Sunlight Colony in Ashram, as he sat waiting with his three-and-a-half-year-old son.
Since the first mohalla clinic opened in the city in 2015, as part of a flagship project of Chief Minister Arvind Kejriwal aimed at taking quality healthcare to the last man, they have found favour with residents. With more such clinics popping up in the years since they now stand testimony to being one of the key welfare initiatives of the Aam Aadmi Party government.
Buoyed by the success of this initiative, the government recently announced that it was in the process of identifying 40 such clinics, with a daily footfall of over 150, where services would be extended up to 12 hours.
Talking about what the policy lacks or needs to be done, Anant Bhan, Researcher- Global Health and Policy stated that the clinics need to move beyond free medicines and logistics and look into offering linkage with higher levels of healthcare.
"I feel the mohalla clinics need to go beyond dispensing medicines and treatment for free and consider linking up with top healthcare units. In terms of infrastructure and manpower, I think these clinics should be equipped in a way so that they can follow up cases even after patients have been prescribed necessary medication. They should also have the scope to refer cases which don't come within the ambit of these clinics to hospital offering specialised treatment,".
Why go to mohalla clinics?
“What I like most about these clinics is the welcoming ambience and the amicable nature of doctors and medical staff. From their conduct alone, one can sense that they care about their patients and are keen to make sure that every single visitor to these clinics is attended to. They also don’t compromise on the quality of treatment. While there are multi-speciality hospitals for major ailments, one can consider visiting these clinics for minor health issues. It’ll be good if more such clinics come up,” Raju, a frequent visitor to mohalla clinics, said.
“This is easily one of the best welfare-oriented initiatives that this government has come up with. I would be glad if one such clinic opens in my locality,” Raju said.
Rupesh Sharma, an auto-rickshaw driver, said the clinics have gone some way towards bridging the gap between the well-off and the middle and lower-income groups when it comes to availing quality healthcare. “Facilities being offered at these clinics are among the best that one can avail at a government-run healthcare unit and, that too, for free. Considering the money that one has to shell out these days to avail quality healthcare at prominent hospitals, these clinics are nothing short of a boon. For us, it really helps if we can save some money for other household expenses,” said Sharma, who lives in a slum near Vasant Kunj. He was visiting a mohalla clinic at Andheria Mod.
Expectations
Jasprit Singh, who deals in second-hand cars and runs a shop in Jangpura area, said that with a lone doctor at each clinic, patients often have to cut down on their visiting time in the face of swelling crowds at the clinics. “If more such clinics were to come up, patients will have more options when it comes to availing quality healthcare services and the doctors will have a lot more time on their hands to attend to their patients. At times, there’s such a mad rush of patients that doctors simply don’t have enough time to check on them. Although many tests could done for free here, some more, including expensive ones like X-rays and CT scan, could also be offered free of cost or at subsidised rates,” Singh said.
No smooth sailing for docs, staff
A mohalla clinic comprises a doctor, a pharmacist and a clinic assistant, or more precisely, a multitasker, catering to a population of 10,000 to 15,000 within a radius of 5km. Retired government doctors are mostly deployed at these clinics, while the other staff are empanelled or enlisted. The wages are incentive-based — each doctor is guaranteed `40 per patient.
While doctors said they’re happy with the working hours, the wage structure, based on the patient count, is a problem. “The job gives us an opportunity to stay in touch with this profession. However, at times, we are thrust into unseemly situations. We feel the need for security, especially when people barge in on us, threaten us or create a scene. They jostle to be the first to visit us and often, it gets very difficult to ensure order at the clinic,” said a doctor who asked not to be named.
Another doctor said at times, patients demand tests that they aren’t prescribed to undergo, as they know they are for free. “Many of them just take medicines or force us to get random tests done. We’re all for offering free medical services but there should be a systematic way of going about it,” the doctor said.
Paramedical staff claimed that around 200 of them were withdrawn by the Delhi government last year without any prior notice. A fraction of them, who have been retained, have to meet their everyday expenses from their own pockets.
“We even moved court on this. Our monthly income was barely around `6,000-`7,000 and many lost their jobs. However, since no new staff was appointed, the doctors held us back to help them run the clinics,” a non-medical staff said. The authorities concerned shied away from making a clear comment on this issue. However, health expert Chandrakant Lahariya said mohalla clinics are a ‘win-win’, as they have taken primary healthcare to underserved areas, slums and the marginalized migrant population. “They have enhanced accessibility, affordability and availability of health services,” he said.
1,000 promised, 196 delivered
Till date, the government has managed to deliver only 196 of the 1,000 mohalla clinics promised. Government officials claimed land allotment is an obstacle to setting up more mohalla clinics. While the DDA claimed there is no provision for the scheme in its Delhi Master Plan 2021, AAP leaders said it had been rejecting the government’s land allotment proposals citing technical reasons.
“Their (Delhi government’s) proposals are not consistent with what’s in the Master Plan. They’re randomly demanding 20 acres or 40 acres and even want existing buildings allotted as mohalla clinics. The Master Plan has a quota for setting up healthcare units but it is not consistent with the idea of a mohalla clinic. We said as much in court,” said a DDA official requesting anonymity.
“Delhi is a Union Territory where the Centre, state and MCDs have individual stakes. If the state is serious about making mohalla clinics a success, they need to sit with the other two stakeholders and chalk out a plan,” a civic official said.
A top official of the state health department said, “Only authorities concerned can comment on DDA’s claims. As far as MCDs are concerned, we’ve done (land) surveys and the matter is in the (Delhi) high court. We are taking plots on rent and the tender will be opened on August 6. The recruitment of doctors and non-medical staff for upcoming mohalla clinics is currently in process.”
Despite repeated calls and messages, Health Minister Satyender Jain couldn’t be reached for comment till the time of filing this report.
