Delhi Assembly election results: Mohalla clinics win over Ayushman Bharat in Delhi

Healthcare was a key issue in the Delhi assembly elections, with Aam Aadmi Party (AAP) using its mohalla clinics and upcoming hospitals as poll pitch and the Bharatiya Janata Party (BJP) complaining about non-implementation of its flagship national health insurance scheme, Ayushman Bharat.

AAP chief ministerial candidate Arvind Kejriwal said on Tuesday evening, “The people of Delhi have given birth to a new kind of politics in the country; it is called the politics of work. They have said the votes would go to the person who gets schools made, who gets mohalla clinics made.”

After coming to power in 2015, the AAP government had promised to set up 1,000 mohalla clinics – one for each square kilometre of the inhabited area in Delhi – to provide free consultation, medicines, and 212 tests.

The AAP government inaugurated 450 mohalla clinics till January this year, with the tussle with the Lieutenant Governor and problems in acquiring land delayed the project.

“Healthcare has to follow a pyramid structure, with primary care at the bottom. The pyramid in India is inverted, with all the focus on tertiary care, less on secondary and almost no focus on primary care,” Delhi’s health minister Satyendar Jain had told HT before the polls.

The clinics have been hailed as a step in the right direction towards achieving the sustainable development goal of universal health coverage by health experts, including former United Nations Secretaries-General Ban Ki-Moon and Kofi Annan.

“The AAP government’s mohalla clinics have brought healthcare right inside the slums. It has strengthened primary healthcare. It is a low cost and extremely effective. It has also paid a huge political dividend for the party,” said former health secretary K Sujatha Rao.

Former director of AIIMS in New Delhi, Dr MC Mishra, said that there is a need to invest in primary healthcare, no matter which party does it.

“The mohalla clinics are a good concept, but it has to be implemented properly on ground. There have been several news reports of deficiencies. One of the key components of the Ayushman Bharat are the wellness centres as well. There is a need to focus on primary level preventive healthcare, it is the only way to save on future health problems,” he said.

For tertiary care service, the AAP government started the Delhi Arogya Kosh scheme that reimburses private healthcare for providing its patients over 1,200 medical and surgical procedures and expensive radiological tests that are either not offered in Delhi government hospital or the waiting period is over one month. The treatment of accident, fire and acid attack victims is covered under Farishtey scheme.

Work is also ongoing for building or revamping 26 hospitals to add 15,154 to the existing 11,353.

The BJP, however, has been targeting the government for not implementing the central Ayushman Bharat insurance scheme.

“What is the fault of the poor Delhiites that they are not getting the benefit of free treatment of up to R 5 lakh? If a Delhi resident who is a beneficiary of the scheme who goes to Gwalior, Bhopal, Surat, Nagpur, Hyderabad, or Chennai for some work and falls ill suddenly there. Then, will these mohalla clinics go there? But, under Ayushman Bharat scheme the person would have received free treatment in the hospitals there,” said Modi in a rally in Delhi.

The government countered saying that the scheme would not benefit a majority of Delhiites and does not cover OPD services, which the AAP government provides free to everyone under their healthcare schemes.

“If we implement Ayushman Bharat in Delhi, only about two per cent of the 2 crore people will get covered. What would we do with the rest of the 98 per cent? The scheme does not even cover OPD services. If a person is prescribed an MRI, CT scan or lab test in OPD, it will not get covered. This means you have to wait for admission. Why? If you have diabetes or hypertension, treat that. Why do you need to wait till you get a heart attack?” Jain had told HT.

“The scheme in Delhi is universal and also has no cap. I think it is working well. Why then would the government want to implement the central scheme and share credit with the other government? It is not possible to confine treatment only to public hospitals as the demand is huge and the private sector is necessary to ensure equitable access. The government also has to invest in its own hospitals so that they become quality markers,” said Rao.

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