Once on frontline, now ‘disposable', Delhi mohalla clinics staff in lurch amid BJP's arogya mandir push

The Print

2 days ago

(Upon transition of mohalla clinics to arogya mandirs, we will give you first preference)
Protest was a last resort, to call attention to the insecurity looming over Delhi's mohalla clinics since March when Health Minister Pankaj Kumar Singh said in no uncertain terms that these urban primary healthcare units, which he termed 'just tin boxes', would neither be rebranded nor continued. CM Rekha Gupta later assured healthcare workers on 16 May, in media glare, ' Jab arogya mandir banenge, hum pehle aap logon ko occupy karenge .'
New Delhi: They came in the dozens. Some in white coats, others in plainclothes. The mohalla clinic staffers gathered outside Delhi Secretariat, staged a sit-in protest and in a memorandum to officials pleaded they not be sacked. Some had received phone calls asking them to resign, others said they hadn't been paid in two months.
Her words did little to quell panic and speculation among doctors, pharmacists, multi-task workers, nurses and attendants employed at the nearly 553 mohalla clinics across Delhi.
Jitendra Kumar, president of Aam Aadmi Mohalla Clinic Union (AAMCU) who was part of the delegation that met minister Singh's OSD Vaibhav Rikhari on 2 June, told ThePrint, 'There were no clear answers. We asked whether existing mohalla clinic staff would be retained in the new arogya mandirs, only vague assurances were given.'
'On salary delays, we were told new officials have been appointed and disbursement will happen soon,' read minutes of the meeting maintained by AAMCU.
In days leading up to the protest Monday, ThePrint visited mohalla clinics in East, South, West, North and Central Delhi, where multiple staffers said they had been handed a 'one-sided' MoU with an added clause common across all specialties. Their jobs or positions, it stated, would be valid from 1 April 2025 till 31 March 2026, or until they are replaced by the new staff for the Urban/Ayushman Arogya Mandirs (UAAMs/AAMs), whichever is earlier.
'Is that job security or countdown to my termination,' remarked a pharmacist at a mohalla clinic in Delhi's South West district who did not wish to be named for fear of reprisal.
Launched in 2015 during Arvind Kejriwal's second term, the mohalla clinic initiative emerged from 'sabhas' (neighbourhood meetings) organised by Aam Aadmi Party (AAP), as a way to decentralise primary healthcare. Touted by the previous AAP government as a 'healthcare revolution,' these neighbourhood clinics were set up to cater to a population of 10,000 to 15,000 residents, offering accessible and affordable care close to home.
On average, each clinic sees between 70 to 100 patients daily, providing a range of free services that include 212 diagnostic tests through empanelled laboratories and 109 essential medicines from the government's approved list. The initiative was also praised by former UN Secretary-General Kofi Annan who in a letter to Kejriwal in 2017 said it 'may prove to be a good model to scale up UHC [universal health coverage] in India'.
The idea caught on. A prime example was Karnataka's Namma Clinics, more than a hundred of which were inaugurated by the previous BJP administration led by Basavaraj Bommai in December 2022. The number of Namma Clinics has grown since the Siddaramaiah-led Congress government came to power in May 2023.
Back in Delhi, soon after it assumed charge the newly elected BJP government announced that mohalla clinics would be 'replaced' by arogya mandirs—a model intended to integrate existing primary health facilities under the Centre's flagship Ayushman Bharat scheme.
In an interview with ThePrint in March, Health Minister Pankaj Kumar Singh termed mohalla clinics 'fundamentally flawed'. It is not viable for government to continue to run some 240 mohalla clinics which are on 'rented properties' or suffered 'significant financial losses'.
The minister, however, did not clarify whether mohalla clinics would be phased out entirely, or if only units housed on government land would be considered for transition to arogya mandirs—a move that could affect nearly a third of operational centres.
Coupled with the absence of a concrete timeline for the transition, this is what led mohalla clinic staffers to stage a sit-in protest at the Delhi Secretariat on 2 June.
The government, they said, pledged in March to transform primary healthcare in the capital in its first hundred days. But a hundred days later, confusion outweighs clarity. With unclear MoUs, disrupted routines, and unanswered questions about job security, both patients and staff find themselves navigating a system in transition, with little say in the outcome.
AAMCU's Kumar told ThePrint Wednesday, 'We were recruited into mohalla clinics through an exam. Now, the new government wants to introduce new criteria for hiring. Does that mean the exam we cleared no longer holds value just because the government changed?
'I don't understand this. Why aren't we being absorbed in the new arogya mandirs? CM said we would be given priority. But in the newly inaugurated AAMs new staff is being hired while old mohalla clinic staff wasn't even considered. What are we to make of this?'
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'On frontline during COVID, now we're disposable?'
The Kusumpur Pahari mohalla clinic is located near the upscale neighbourhood of Vasant Vihar, set amidst stark socio-economic disparity. This is the facility where AAMCU president Jitendra Kumar, who is also a pharmacist, is employed.
'Some of us signed the MoU, but only after attaching a letter of disagreement' to express their discontent with the first clause which puts our livelihood at stake, he told ThePrint. 'Others were hesitant because the language was vague—some would even call it one-sided. It doesn't clarify whether our job security will be protected.'
Another staffer chimed in, 'In the name of politics, we might end up sitting at home for months. There's no proper communication, no clarity on our future. We've dedicated years to public healthcare, and been on the frontline during COVID.'
Jitendra clarified that the union trusts CM Rekha Gupta, but 'bureaucrats, junior officers are doing 'red tapism'; they should change that line in the MoU.'
At another mohalla clinic in North Delhi, a doctor who did not wish to be named remarked, 'The new MoU gives with one hand and takes with the other. It says we can stay, but only until someone is hired. Then what?'
A pregnant pharmacist at a mohalla clinic in West Delhi said on condition of anonymity that her request for maternity leave was ignored and she was instead transferred to another mohalla clinic last week. 'My colleagues and I have been transferred to another AAMC and replaced by staff hailing from government dispensaries. When that mohalla clinic is converted into an UAAM, where will we go? Where will the staff already working there go?'
'No one from the [health] department told us we were being shifted. One day, I was told to report to a different clinic, without explanation, why were we being made to sign no-dues forms?' asked a multi-task worker. 'I wasn't even issued a notice—how is that legal?'
He, like all mohalla clinic staffers, had cleared the exam at Indraprastha University. He was attached to a mohalla clinic in West Delhi in the third week of May when ThePrint visited.
The 'no-dues' form had three options: de-empanelment, resignation, and transfer. The staffers were told to sign the form in the week of the inauguration of 33 arogya mandirs on 31 May. The MoU handed to them earlier also mentioned the transfer option.
The Print also visited a mohalla clinic in Multani Dhanda, Paharganj, which has been converted. The board outside read: Urban Ayushman Arogya Mandir. Inside, little had changed. 'It's just the board,' a staff member said, pointing to the new signage. 'Everything else remains the same—for now. We're still waiting to see what happens next.'
While the Delhi government has embarked on its ambitious mission to strengthen the primary healthcare setup with plans to set up at least 33 arogya mandirs across the national capital in the first phase, doctors, nurses, pharmacists and other staffers attached with mohalla clinics said they felt blindsided. Even before they highlighted their concerns at the protest Monday, some had told ThePrint they hadn't been paid in over two months.
'We were the face of public health during COVID. Now, we're disposable?' said a pharmacist at a mohalla clinic in South Delhi who had been in the system since 2019.
A doctor at a mohalla clinic in Delhi's South West district did not express as much concern about his own prospects, and seemed more troubled about the future of his medical staff—nurses, pharmacists and multi-task workers. If nothing works out, doctors can set up practices of their own but that's not the case with medical staff, he explained.
Mohalla Clinics: Routine, referral & trust
Sangam Vihar resident Jagvir, 70, said he visited the mohalla clinic in his neighbourhood once every 10 days to get his blood pressure checked, and restock his insulin.
The way mohalla clinics are structured, empanelled doctors are paid Rs 40 per patient and pharmacists Rs 12, while multi-task workers are paid rupees 8 per patient.
With arogya mandirs now in the mix, emphasis may now be laid on referrals to state-run hospitals, as well as private hospitals empaneled under the Centre's Ayushman Bharat scheme, to ensure integration.
Doctors at mohalla clinics ThePrint spoke to said the referral system—especially with a role for centrally-run hospitals—could help streamline patient care and ease the burden on overworked clinics. Arogya mandirs are also reported to offer immunisation and antenatal services that were only planned for mohalla clinics but never fully implemented.
'In theory, this expansion could help. Depending on where the UAAMs are located, they may attract higher footfall and reduce the doctor-patient ratio,' said a doctor at a mohalla clinic in Central Delhi. 'But in practice, there are many complications.'
As for patients, for many the real loss is the bond they built with mohalla clinic staffers over time. 'We know our people—they come to us not just for medicine, but for trust. We become part of their family care,' said a doctor who had been with a mohalla clinic in South West Delhi for six years.
On the flip side, many regular patients said they were looking forward to the arogya mandirs. 'As long as I get good health care and free medicine, it doesn't matter whose face or name is on the clinic,' said Mohan, a resident of Lajpat Nagar.
Paharganj resident Usha Rani, who lives in front of the newly established arogya mandir, said she expected the BJP government in Delhi to give 'something extra, other than the change of board, like a gym'.
Kartikay Chaturvedi and Aleeza Ahmed are interns who graduated from ThePrint School of Journalism; Suryansh Tripathi is an intern with ThePrint
(Edited by Amrtansh Arora)
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