Even as the Delhi government announced an extension of its flagship mohalla clinics scheme for another year, the opposition Congress has accused the Arvind Kejriwal-led AAP government of indulging in rampant corruption through the scheme. Alleging that AAP has sought to enrich its own cadre through this project, the country’s oldest party, which has also lodged a complaint with the Central Vigilance Commission, charged that the mishandling of the project has weakened the public health delivery system in the national capital.
The Congress’s attack assumes significance as the mohalla clinics are a core component of the AAP’s political plank in other states like Punjab, Gujarat and Goa, where it is emerging as a strong “secular” alternative to the Congress in the fight against the BJP and its allies.
On Thursday, the Congress released its survey report on the issue, titled ‘Mohalla Clinic Exposed: Party Propaganda not Public Health’. The report highlighted “lapses and ad-hocism” in the Kejriwal government’s ambitious health project.
In the report, the Congress, which had ruled Delhi for 15 years before the Aam Aadmi Party formed its first government in December 2013, said the AAP government had inherited 95 hospitals, 1,389 dispensaries, 973 polyclinics, 16 medical colleges and a total of 48,096 hospital beds, at an average of 2.71 beds per thousand people.
The Congress said the Kejriwal government had come into power when a vast network of health infrastructure was already in place. The party then “should have made efforts to strengthen its existing infrastructure, especially its dispensaries since they are better equipped, offer a greater range of services, and the public is already aware of their presence and location. However, to the contrary, the Delhi Government transferred out the staff from the existing dispensaries to its mohalla clinics.”
The Congress also said that there are a large number of dispensaries operating under municipal corporations and under the National Rural Health Mission. The Delhi government should have ideally attempted to set in place arrangements for their cross-use in the interest of public health, the report said.
Stating that the AAP government had announced a Mohalla Clinic Pilot Project Policy, under which 100 mohalla clinics were to be set up in rented or rent-free accommodation with private doctors engaged to manage the clinics as self-contained institutions, the Congress said as part of the policy daily OPD at the clinics were to run in four-hour shifts and doctors were to be reimbursed at the rate of Rs 30 per patient and the helpers at Rs 10 per patient. But, the Congress alleged, the mohalla clinic policy lacks a public health perspective. It said they “do not provide any kind of first-line defense against outbreaks, are not equipped to provide anything but OPD support of a very rudimentary nature”.
The party also said mohalla clinics open for only four hours a day in the morning, leaving a large number of patients out of the scheme’s coverage.
Since the clinics are operated with the support of private doctors, it said “their hours of operation cannot be expanded during times of emergencies or epidemics”.
Suspicious of the way these clinics are being run, the Congress said, “empanelling private doctors on a part-time, per patient basis is rife with conflict of interest issues such as referral to private practice, and rushing patients for registering increased numbers”.
It said there were many clinics where nearly 100 patients showed up each day and the doctors were being paid over Rs 75,000 per month in reimbursement, which was enough to hire a full-time doctor. It also charged that at places, doctors were devoting just two minutes per patient.
Another area of concern, it said, was that “there are no referral linkages to dispensaries or hospital under Delhi Government’s management” for patients not attended to.
Alleged special benefits to AAP workers
The Congress also alleged that there was violation of norms in the government extending pecuniary benefits to AAP workers in the mohalla clinic project. Citing examples of clinics being run from the premises of AAP workers, it said the rent for these clinics was inflated as compared to the market value and this was resulting in a loss to the exchequer.
The party also alleged that there were quality and regulation lapses as the names, qualification and photographs of the empanelled doctors were not displayed in any of the mohalla clinics. It even claimed that at some places, persons other than the empanelled doctor were found attending to the patients.
The Congress said often the prescriptions were found being written on simple pieces of paper and medicines were found to be kept in the open with untrained people tasked with distributing them in many mohalla clinics.
The party also charged that it found the doctors virtually practising “untouchability” at some clinics, like in a Dalit colony. It also charged that many of the clinics were operating from dirty premises, even parking lots.
With no system in place to record the arrival of patients or the issuance of prescriptions, the Congress said it was not clear on what basis the doctors were being reimbursed, leaving the door open for massive corruption.
In light of these findings, the Congress has demanded that these clinics be made to operate at least 12 hours a day and have 24-hour emergency care. It has also called for their linkage with dispensaries and other hospitals.
The party has also demanded the appointment of doctors and staff on a permanent basis for the clinics and the setting up of fair price shops where generic medicines are made available.
Earlier on September 21, Delhi Congress president Ajay Maken had spoken about how the report was prepared on the basis of a two-day survey conducted by party volunteers who covered the 105 mohalla clinics that had been opened by the AAP government in Delhi.
“The Mohalla clinics have been opened without any detailed analysis or study. These clinics lack basic facilities and there is no public participation which is evident as Delhi is reeling under a spurt of dengue and chikungunya,” he had stated.
Apart from not serving a proper purpose, he had alleged that these clinics had become instruments for the AAP to enrich its volunteers by using their properties. “There are several clinics which have been opened on properties of AAP members and office-bearers on rents many times more than the market rate which is nothing but corruption and waste of hard-earned money of the people of Delhi,” Maken said.
In a letter to the Central Vigilance Commission, the Congress had also demanded that these mohalla clinics had been opened at the premises of AAP members, workers and legislators in violation of the norms and without following due process.
“The Delhi Government not only by-passed the tender process but also shunned the obligation to ascertain the market rate while renting the multiple premises in Delhi, as the intention was to convey illegal monetary gain to the office bearers/ members of the ruling party, through the said project,” Maken said in the complaint.
The Congress leader had also promised that there would be a large expose on Thursday, which came in the form of the release of the report.
The only response from AAP on the issue came from its spokesperson, Nagender Sharma, who too had nothing substantive to say on the subject.
Those running private schools & private hospitals rackets in Delhi talking about Mohalla clinics – what a joke ! Shameless characters
— Nagendar Sharma (@sharmanagendar) September 22, 2016