NEW DELHI: The previous AAP government fell significantly short of its target for Mohalla Clinics, despite having allocated funds. One of the most touted flagship schemes, only 53 per cent of the targeted Mohalla Clinics were established in a decade of AAP rule with the second term seeing only 38 of these flagship primary healthcare centres.
Launched in 2015, the AAP government had committed to set up 1,000 such clinics to expand healthcare access for the common man, especially in underserved areas.
A report by the Comptroller and Auditor General (CAG), accessed by TNIE, has highlighted a significant shortfall in the completion of the project. Despite allocating a budget of Rs 35.16 crore for the construction of Mohalla Clinics between 2016 and 2023, only 28 per cent of the capital fund was utilised.
This resulted in a severe underachievement, with the Directorate General of Health Services (DGHS) failing to meet its target, setting up just 523 clinics by March 2023 - a far cry from the 1,000-target set in 2017.
The audit reveals that DGHS could not fully utilise the allocated funds, with a staggering 72 per cent of the funds left unspent. The total budget for the period amounted to Rs 13,114.10 crore, with the lion’s share, 99.73 per cent, allocated under the revenue head. Yet, under the capital head, which was meant for infrastructure development, the utilisation was alarmingly low, leaving crores of rupees unaccounted for.
According to the report, the non-construction of new Mohalla Clinics led to the overall underutilisation of development funds, with the shortfall ranging from 31 per cent in 2022-23 to 86 per cent in 2018-19.
“The non-construction of the Mohalla Clinics led to the overall on-utilisation of development funds ranging from 31.44 per cent (2022-23) to 86.36 per cent (2018-19) which indicates that there was a shortfall in planning and implementation of the project,” the CAG report commented.
When questioned by the audit body, the State Nodal Officer for the Mohalla Clinics project claimed that the funds were allocated to meet the operational costs of existing clinics. However, the CAG dismissed this explanation, stating that the budget should be based on the actual requirements for that year and not diverted for ongoing expenses.
“The reply is not acceptable as the budget estimate is to be based on estimated requirements for that year and establishes that the budget estimation exercise was faulty,” the CAG audit commented.
The CAG audit also revealed alarming deficiencies in Delhi's Mohalla Clinics, a cornerstone of the AAP government's healthcare promise. The Comptroller and Auditor General (CAG) report highlighted that 18 of the audited Mohalla Clinics remained closed for extended periods - ranging from 15 days to 23 months - due to issues such as de-empanelment, resignations, and doctors taking leave.
This shortage of medical professionals severely impacted patient care, with 70 per cent of visitors receiving consultations lasting less than one minute.
In addition to the shortage of doctors, the audit found that many clinics lacked essential medical equipment, including pulse oximeters, glucometers, X-ray viewers, thermometers, and blood pressure apparatus. The availability of prescribed medicines was also a concern, as 100 per cent availability of the 165 drugs listed in the Essential Drug List (EDL) was not ensured at 74 inspected clinics.
The audit also highlighted logistical issues with the supply of medicines. A significant number of required drugs were either not procured or not delivered by vendors despite orders being placed.
For instance, the District Drug Store in North-East Delhi requested the supply of 151 medicines in the third quarter of 2022-23, but only 79 per cent of the requested items were delivered. In the fourth quarter, the supply rate was even lower, at 74 per cent. Delayed deliveries, ranging from three to six months, further disrupted the clinics' ability to provide timely care.
The audit also noted that inspections of the clinics were grossly insufficient, with only 2 per cent of clinics in the selected districts being inspected from March 2018 to March 2023. Despite clear directives from the State Nodal Officer in May 2022 to ensure the timely supply and availability of medicines at the clinics, the system continues to fall short in addressing basic healthcare needs.