Delhi mohalla clinics: Delayed doctor salaries speak of bureaucratic apathy

Doctors of Delhi’s mohalla clinics, the AAP government’s flagship initiative, have been working without salaries for several months. Their plight triggered the faceoff between Arvind Kejriwal’s AAP government and the city’s bureaucracy at a recent meeting of Delhi Legislative Assembly’s petition committee, when officials from health and finance departments were asked to explain the reasons behind the non-disbursal of salaries to the doctors.

In December 2020, mohalla clinics’ doctors had threatened to go on strike if their due salaries were not paid. At a recent press conference, AAP MLA Saurabh Bhardwaj said: “The delay in payment allegedly happened due to the bureaucratic indifference as the files kept moving from one department to the other. The finance department, on receiving the files, had asked for additional documents for sanctioning the funds.”

At the receiving end: Doctors

Doctors of mohalla clinics are empanelled on a contractual basis, which is up for renewal every year. Once empanelled, doctors are paid per consultation. “I have been working for the last three years. The finances have really dried up recently. My salary is pending for the past three months. There are talks of our salary being sanctioned, but till the time we don’t receive the amount, nothing can be said of the disbursal process,” said a doctor at the CR Park Mohalla clinic, requesting anonymity.

On probing further, she said, “I have been managing my expenses from my savings. Since I have a house in CR Park, my condition is slightly better compared to other doctors, some of whom are putting up in rented accommodation. It is getting extremely difficult with inflation affecting our purchasing power every month. We have collectively raised these issues multiple times, but the government machinery is such that the action is really slow.”

The doctor also revealed that in some clinics her colleagues are also bearing miscellaneous costs — for paying for the internet, the upkeep of the premises and transportation costs involved during medicine procurement.

Also read: Delhi govt to open 100 more mohalla clinics across city

She also conceded that the workload is immense in areas with a greater footfall. In our area (CR Park), there aren’t too many people visiting these clinics, but in areas where the population is from the lower middle class or below, the number of people visiting these primary facilities is overwhelming.

Alleged bureaucratic apathy

Last month, Deputy Chief Minister Manish Sisodia had alleged “indifference” on the part of civil servants in their interactions with the leaders of the AAP government.

In an affidavit to the Supreme Court, Sisodia had alleged that civil servants frequently skipped meetings without any prior notice or efforts to reschedule, refused to take phone calls from ministers, and disobeyed orders of ministers.

More importantly, Sisodia emphasised that these problems had become “more acute” since V.K Saxena was appointed as the lieutenant governor of the national capital in May this year.

The constitutional scheme of things

According to the Constitution, the lieutenant governor is the administrator for the National Capital Territory of Delhi, and the power to take disciplinary action against its bureaucrats ultimately lies with the Central government via the L-G.

The law gives Delhi’s elected representatives few powers over the state’s civil servants and the Union government holds a veto power over any decisions that can have an impact on the state’s bureaucrats.

The Delhi bureaucracy is not beholden to the state government for transfers and appraisals either, unlike in other states, where such officers report to the state government, which can transfer them at will and also has the final word on their appraisals. This unique state of affairs has led to an odd relationship between the bureaucracy and Delhi’s elected representatives.

The collateral damage

“My thyroid tests have been halted for the past one month. I am repeatedly turned away as testing facilities have come to a halt. I heard that the payments of dues to companies that conduct tests are pending for several months. Therefore, the companies have stopped conducting free tests,” said a patient named Renu Devi, as soon as she stepped out from a clinic at Kalkaji area near 429 bus stand, DDA flats.

Also read: Kejriwal blasted for promoting Mohalla clinics in a state voted best in healthcare

“As we belong to the lower strata of society, these facilities are of great help to us. But now everything is uncertain as the staff is not able to give a timeline for its resumption. They say it may resume on January 1, 2023. We can only hope it resumes as early as possible. Otherwise, Kejriwal’s very idea of a ‘good quality primary healthcare system’ will stand defeated,” said the 41-year-old woman.

Victim of AAP vs BJP politics?

The Bharatiya Janata Party (BJP) has constantly attacked the AAP government over issues of shortage of medicines, empty announcements and overworked staff. Delhi BJP working president Virendra Sachdeva has said: “Kejriwal acts like Ghoshna (announcement) minister rather than chief minister.”

Along with the much celebrated ‘Delhi Education Model’, AAP’s mohalla clinics have often been the centre of attraction during the visits of foreign dignitaries as well as government officials from other states when they come to Delhi. More importantly, mohalla clinics have become an example of the manifold benefits of a successful, functional primary healthcare system.

The way forward

Despite the grim situation, few doctors are hopeful. A doctor at Sangam Vihar’s mohalla clinic said, “These issues will be solved as soon as the finance department disburses the required funds. There is no paucity of funds, but due to bureaucratic processes, there is a delay. I hope the departments can iron out the issues at the earliest. Overall, the ‘mohalla clinic project’ has done very well. There will be glitches at times, but we will be united as a ‘healthcare fraternity’ and ensure that it remains among the AAP’s biggest projects in the city.”