New Delhi: A report by the Comptroller and Auditor General of India (CAG), likely to be presented in the ongoing Delhi assembly session Friday, has revealed that over two-thirds of patients visiting Mohalla Clinics could consult the on-duty doctor for less than a minute, ThePrint has learnt, raising concerns about the quality of care provided by the flagship initiative of the erstwhile AAP government.
Sources familiar with the report said the CAG also flagged the AAP government’s failure to meet the target of establishing 1,000 Mohalla Clinics—conceptualised as primary healthcare centres—by 2017. Only 523 clinics were operational by March 2023, with the auditor rejecting the AAP government’s explanation that the unavailability of land and the COVID-19 pandemic acted as obstacles.
The number of Mohalla Clinics, the CAG report is said to have shown, remained stagnant, with only 38 new units established between March 2020 and March 2023, but the patient footfall sharply increased. According to the sources, Mohalla Clinics grew by only 8 percent between 2019 and 2023 despite a more than 100 percent rise in outpatient department visits.
A functionary of the erstwhile AAP government argued that the average consultation time, as noted by the auditor, should be viewed in the context of doctors in existing clinics struggling to manage the growing demand, as highlighted in the CAG report.
ThePrint reached the AAP communications team to get the party’s response on what the yet-to-be-tabled report has flagged about Mohalla Clinics. The report will be updated as and when the party responds.
ThePrint also reached BJP MLA and spokesperson Harish Khurana for comment. The report will be updated as and when a response is received.
The AAP government set up the first Mohalla Clinic in the national capital in October 2015 at Peera Garhi, West Delhi. The idea behind these community health centres was to reduce the burden on government-run hospitals by providing services such as free consultations, medicines, and diagnostic tests.
The project received praise from two former United Nations secretary generals—Ban Ki-Moon and the late Kofi Annan. Moon and former prime minister of Norway Gro Harlem Brundtland visited the Peera Garhi clinic in September 2018. They praised then chief minister Arvind Kejriwal’s “vision” in expanding primary healthcare services in Delhi, with Moon saying: “This is exactly what we expect Prime Minister Modi will continue to do…”
However, as disputes festered between the AAP-led elected government and the successive lieutenant governors nominated by the Centre, the project also ran into rough weather. As the expansion of its network came to a virtual halt, the existing clinics, it is learnt, started reeling under a shortage of medical staff, drugs, and diagnostic tools.
More details in the CAG report
Looking into the consultation time for patients visiting Mohalla Clinics, the CAG has found that 70 percent of patients between October 2022 and March 2023 received consultations lasting less than a minute, ThePrint has learnt. Nearly 31 percent of the patients received consultations for only four to 30 seconds, and 39 percent received 31-second to one-minute consultations. Only 18 percent patients received medical attention for one to two minutes, and 12 percent had consultations exceeding two minutes.
Despite directives from the state nodal officer mandating 100 percent availability of 165 essential drugs in the Mohalla Clinics, there remained a significant gap in procurement and supply, according to those familiar with the yet-to-be-tabled CAG report. Either the Central Procurement Agency (CPA) did not procure essential medicines, or vendors did not supply them despite getting orders, according to the CAG.
In the North-East district, the district drug store ordered 151 essential medicines in Q3 of 2022-23 and 128 of them in Q4, but the CPA placed orders for only 120 (79 percent of what was required) and 95 (74 percent) medicines, respectively, it is learnt. Further, vendors failed to supply 35 medicines (29 percent of the order) in Q3 and 11 (12 percent) in Q4, with delays ranging from three to six months. That led to 26 essential medicines going out of stock, the CAG report is said to have revealed.
The drugs went out of stock in various districts in a few months, ranging from one to 16, between January 2022 and April 2023, with patients then left in the lurch.
During an inspection of 74 Mohalla Clinics in April-May 2023 across the South-West, West, North-East, and South districts, the CAG found that 39 clinics (53 percent) had less than 75 percent of essential medicines available, ThePrint has learnt.
According to some claims, the missing medicines had been procured through the Government e-Marketplace portal from the central Public Sector Undertakings. However, the CAG, it is learnt, has flagged that the shortages persisted, highlighting serious procurement and distribution flaws.
Medicine shortages remained a big concern. Nearly 53 percent of clinics reported the availability of less than 75 percent of essential medicines, according to those familiar with the yet-to-be-published CAG report. Facilities lacked several key diagnostic tools, as well. Several clinics did not have equipment such as pulse oximeters, glucometers, X-ray viewers, thermometers, and blood pressure monitors.
The audit, sources familiar with the report say, has uncovered several deficiencies during the joint physical inspection of 74 out of 81 selected Mohalla Clinics across Delhi’s four administrative districts. Basic infrastructure was lacking in many clinics, with no display board at 35 facilities, no drinking water at 10, and no toilet facilities at 21.
Storage conditions for medicines were also inadequate in 24 clinics, it is learnt. The 24 clinics had no AC facility for temperature-sensitive drugs and medicines often exposed to heat and moisture.
Fifteen clinics did not have power backup, and six had been functioning without an examination table, it is learnt. Only 10 clinics had a token vending machine for crowd management, leaving 71 having no system to regulate patient flow. Roughly 29 clinics also did not have fire extinguishers, and 24 lacked grievance redressal boards with authority details.
Varnika Dhawan is an intern with ThePrint.
(Edited by Madhurita Goswami)
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